Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Health Sciences Center, Kuwait University, Kuwait.
Department of Pathology, Faculty of Medicine, Health Sciences Center, Kuwait University, Kuwait.
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296231223195. doi: 10.1177/10760296231223195.
Thrombophilia in venous thromboembolism (VTE) is multifactorial. Von Willebrand factor (vWF) plays a major role in primary hemostasis. While elevated vWF levels are well documented in VTE, findings related to its cleaving protease (ADAMTS-13) are contradicting. The aim of this study was to determine vWF, ADAMTS-13, and the multifactorial Thrombospondin-1 (TSP-1) protein levels in patients after 3-6 months following an unprovoked VTE episode. We also explored a possible association with factor V Leiden (FVL) mutation. vWF, ADAMTS-13 and TSP-1 were analyzed using ELISA kits in 60 VTE patients and 60 controls. Patients had higher levels of vWF antigen ( = .021), vWF collagen-binding activity ( = .008), and TSP-1 protein ( < .001) compared to controls. ADAMTS-13 antigen was lower in patients ( = .046) compared to controls but ADAMTS-13 activity was comparable between the two groups ( = .172). TSP-1 showed positive correlation with vWF antigen (rho = 0.303, = .021) and negative correlation with ADAMTS-13 activity (rho = -0.244, = .033) and ADAMTS-13 activity/vWF antigen ratio (rho = -0.348, = .007). A significant association was found between the presence of FVL mutation and VTE (odds ratio (OR): 9.672 (95% confidence interval (CI) 2.074-45.091- = .004), but no association was found between the mutation and the studied proteins ( > .05). There appears to be an imbalance between vWF and ADAMTS-13 in VTE patients even after 3-6 months following the onset of VTE. We report that the odds of developing VTE in carriers of FVL mutation are 9.672 times those without the mutation, but the presence of this mutation is not associated with the studied proteins.
静脉血栓栓塞症(VTE)中的血栓形成倾向是多因素的。血管性血友病因子(vWF)在初级止血中起主要作用。尽管 VTE 中 vWF 水平升高已有充分的记录,但与其切割蛋白酶(ADAMTS-13)相关的研究结果却相互矛盾。本研究的目的是确定 VTE 发作后 3-6 个月的患者的 vWF、ADAMTS-13 和多因素血栓调节蛋白-1(TSP-1)蛋白水平。我们还探讨了与因子 V 莱顿突变(FVL)的可能关联。使用 ELISA 试剂盒在 60 例 VTE 患者和 60 例对照中分析 vWF、ADAMTS-13 和 TSP-1。与对照组相比,患者的 vWF 抗原( = .021)、vWF 胶原结合活性( = .008)和 TSP-1 蛋白水平更高( < .001)。与对照组相比,患者的 ADAMTS-13 抗原水平较低( = .046),但两组的 ADAMTS-13 活性相当( = .172)。TSP-1 与 vWF 抗原呈正相关(rho = 0.303, = .021),与 ADAMTS-13 活性(rho = -0.244, = .033)和 ADAMTS-13 活性/vWF 抗原比值(rho = -0.348, = .007)呈负相关。FVL 突变与 VTE 之间存在显著关联(比值比(OR):9.672(95%置信区间(CI)2.074-45.091- = .004),但突变与研究蛋白之间无关联( > .05)。即使在 VTE 发作后 3-6 个月,VTE 患者的 vWF 和 ADAMTS-13 之间似乎存在失衡。我们报告称,FVL 突变携带者发生 VTE 的几率是无突变者的 9.672 倍,但该突变的存在与所研究的蛋白无关。