Endotoxaemia induces resistance to activated protein C in healthy humans.

Abstract:

:Systemic inflammation activates the tissue factor/factor VIIa complex (TF/FVIIa), leading to a procoagulant state, which may be enhanced by impairment of physiological anticoagulant pathways, such as the protein C system. Besides impaired protein C activation, resistance to activated protein C (APC) may occur. We studied the effect of endotoxemia on APC resistance, analysed its determinants and evaluated the effect of TF/FVIIa inhibition on endotoxin-induced APC resistance. Sixteen healthy male volunteers participated in the study, eight receiving endotoxin alone and eight receiving the combination of endotoxin and recombinant Nematode Anticoagulant Protein c2 (rNAPc2), a potent inhibitor of TF/FVIIa. Parameters of coagulation were subsequently studied. The sensitivity to APC was determined by two tests: a test based on the endogenous thrombin potential and a test based on the activated partial thromboplastin time. In response to endotoxemia, both tests detected a transient APC resistance that was predominantly mediated by an increase in factor VIII and was not influenced by TF/FVIIa inhibition. In vitro tests confirmed that an increase in factor VIII induced APC resistance, as measured by both tests. This finding suggests that APC resistance might play a role in the procoagulant state occurring during human endotoxemia.

journal_name

Br J Haematol

authors

de Pont AC,Bakhtiari K,Hutten BA,de Jonge E,Vlasuk GP,Rote WE,Levi M,Büller HR,Meijers JC

doi

10.1111/j.1365-2141.2006.06127.x

subject

Has Abstract

pub_date

2006-07-01 00:00:00

pages

213-9

issue

2

eissn

0007-1048

issn

1365-2141

pii

BJH6127

journal_volume

134

pub_type

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