Activation of the contact system and intrinsic pathway in peripheral and portal venous circulations in liver cirrhosis.

IF 5 2区医学 Q1 HEMATOLOGY

Thrombosis and haemostasis Pub Date : 2024-12-24 DOI:10.1055/a-2507-2449

Elena Campello, Alberto ZAnetto, Yuriy Prokopenko, Anton Ilich, Chatphatai Moonla, Cristiana Bulato, Serena Toffanin, Sarah Shalaby, Romilda Cardin, Giulio Barbiero, Sabrina Gavasso, Nigel S Key, Marco Senzolo, Paolo Simioni

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引用次数: 0

Abstract

Background: Portal vein system-specific risk factors contributing to portal vein thrombosis in cirrhosis are poorly investigated.

Aims: To quantify contact system and intrinsic pathway activation in peripheral compared to portal venous blood in patients with decompensated cirrhosis.

Methods: Adult patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt underwent simultaneous blood sampling from a peripheral vein and the portal vein. Complexes of serine proteases with their respective inhibitors were measured by ELISA to quantify contact system (PKa:C1INH [kallikrein:C1-esterase inhibitor] and FXIIa:C1INH) and intrinsic pathway activation (FXIa:C1INH, FXIa:α1at [alpha-1 antitrypsin], FXIa:AT [antithrombin], and FIXa:AT).

Results: Twenty patients with cirrhosis (mean age 55 ± 7 years, M=58%, Child-Pugh A/B/C 6/11/3) and 25 healthy controls (mean age 45 ± 12 years, M=60%) were enrolled. Aetiology of cirrhosis was primarily alcohol abuse, followed by chronic viral infection. Log-transformed peripheral levels of all the complexes were significantly higher in patients compared with controls. While levels of PKa:C1 INH, FXIIa:C1 INH, FXIa:C1 INH and FXIa:α1at were similar in peripheral and portal venous blood in cirrhotic patients, FXIa:AT and FIXa:AT levels were significantly higher in portal blood (p = 0.013 and 0.011, respectively). FXIa:C1 INH significantly correlated with both contact system complexes (FXIIa:C1 INH and PKa:C1 INH) and with FIX:AT.

Conclusions: Markers of contact system and intrinsic pathway activation in the systemic circulation were significantly higher in cirrhosis vs. controls. Complexes of FXIa and FIXa with AT were significantly higher in the portal than in peripheral plasma in cirrhosis, possibly indicating unique heparin-like effect in portal venous blood.

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来源期刊

Thrombosis and haemostasis 医学-外周血管病

CiteScore

11.90

自引率

9.00%

发文量

140

审稿时长

1 months

期刊介绍： Thrombosis and Haemostasis publishes reports on basic, translational and clinical research dedicated to novel results and highest quality in any area of thrombosis and haemostasis, vascular biology and medicine, inflammation and infection, platelet and leukocyte biology, from genetic, molecular & cellular studies, diagnostic, therapeutic & preventative studies to high-level translational and clinical research. The journal provides position and guideline papers, state-of-the-art papers, expert analysis and commentaries, and dedicated theme issues covering recent developments and key topics in the field.