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Thromb Haemost 2007; 97(04): 573-580
DOI: 10.1160/TH06-12-0730
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

The risk for thromboembolic disease in lupus anticoagulant patients due to pathways involving P-selectin and CD154

Peter Bugert   *
1   Institute of Transfusion Medicine and Immunology, German Red Cross Blood Service of Baden-Württemberg – Hessen, University of Heidelberg, Faculty of Clinical Medicine, Mannheim, Germany
,
Ingrid Pabinger   *
2   Division of Haematology and Haemostaseology, Department of Internal Medicine
,
Kathrin Stamer
1   Institute of Transfusion Medicine and Immunology, German Red Cross Blood Service of Baden-Württemberg – Hessen, University of Heidelberg, Faculty of Clinical Medicine, Mannheim, Germany
,
Rainer Vormittag
2   Division of Haematology and Haemostaseology, Department of Internal Medicine
,
Robert C. Skeate
4   Division of Health Informatics, Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
,
Monika M. Wahi
5   Department of Epidemiology and Biostatistics, University of South Florida College of Public Health, and Johnnie B. Byrd, Sr. Alzheimer’s Center and Research Institute, Tampa, Florida, USA
,
Simon Panzer
3   Clinic for Blood Group Serology, Medical University Vienna, Austria
› InstitutsangabenFinancial support: Supported by the Grant No 2027 from the “Medizinisch-Wissenschaftlichen Fonds des Bürgermeisters der Bundeshauptstadt Wien”.
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Publikationsverlauf

Received 22. Dezember 2006

Accepted after revision 23. Januar 2007

Publikationsdatum:
24. November 2017 (online)

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Summary

Individuals with lupus anticoagulants (LA) are at risk for thromboembolism(TE). Chronic inflammation is an important characteristicin LA patients which may dispose for TE. Platelets play akey role in inflammation and TE. We therefore investigated genepolymorphisms as well as plasma levels of platelet receptors aspredictors of TE in 107 LA patients. We compared 74 patientswith a history of thromboembolic disease (TE+),56 with venousthrombosis (VT), 12 with arterial thrombosis (AT), and six patientswho had both, with 33 LA patients without previousthrombosis (TE-).The P-selectin Pro715 allele was slightly morefrequent inVT (OR=3.167,95 % CI 0.955–10.503;p=0.0594),butno patient with AT had this allele (OR=0.099, 95 % CI0.001–0.790; p=0.0238) which therefore may protect from AT. Plasma levels of P-selectin, collected a median of 35 months(range 2–329 months) after the last thrombotic event, werehigher in patients withVT (p=0.0096) than inTE-,but not withAT(p=0.4713).These high P-selectin levels were not explained bythe P-selectin polymorphism. The CA repeat polymorphism inthe 3’-noncoding region of CD154 was significantly associatedwith the development of AT (OR=4.035, 95 % CI 1.329–12.249;p=0.0138). Plasma levels of CD154 were not significantly differentamong the subgroups. Thus, theThr715Pro polymorphism ofP-selectin and CA repeats of CD154 are differentiating betweenthe risk for VT and AT. Further, soluble P-selectin is elevated inLA patients with previousVT, but its role to predictVT needs to be evaluated in prospective studies.

Keywords

Lupus anticoagulant - thromboembolism - P-selectin - CD154

* These authors contributed equally to this manuscript.


 

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