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[Maturation of proteins C and S in childhood]
H González1, B Izquierdo, F J Guisasola
1Departamento de Pediatría, Obstetricia y Ginecología, Facultad de Medicina, Valladolid.
Insights
This study tracked protein C, protein S, and other clotting factors in children. Results show variable maturation, with most reaching adult levels within two years, influenced by Vitamin K.
Area of Science:
- Pediatric Hematology
- Hemostasis and Thrombosis
- Biochemistry
Background:
- Hemostasis is crucial for preventing excessive bleeding.
- Developmental changes in coagulation factors during childhood are not fully understood.
- Protein C, protein S, C4BP, and factor II are key components of the coagulation cascade.
Purpose of the Study:
- To investigate the developmental changes in antigenic concentrations of protein C, total protein S (TPS), free protein S (FPS), C4BP, and factor II throughout childhood.
- To determine the age at which these factors reach adult levels.
- To assess the impact of Vitamin K on these factors in newborns.
Main Methods:
- Longitudinal study measuring antigenic concentrations of specific coagulation factors.
- Sampling included cord blood, 48 hours, 15 days, 1-6 months, 6 months-2 years, 2-7 years, and 7-14 years.
- Analysis of thrombotic index for protein C and protein S at specific time points.
Main Results:
- Maturation of factors varied: protein C and TPS reached adult levels by 1-6 months; factor II by 15 days; C4BP by 6 months-2 years.
- Vitamin K administration at 48 hours increased protein C, factor II, and FPS levels.
- Thrombotic index for protein C was <0.6 at 15 days, while protein S was >1.0 at the same age.
Conclusions:
- Coagulation factor concentrations undergo significant developmental changes during childhood.
- Vitamin K plays a role in the early postnatal normalization of certain procoagulant factors.
- The thrombotic potential, as indicated by protein S levels, appears relatively higher in early infancy compared to protein C.
Abstract:
The antigenic concentrations of protein C, total protein S (TPS), free protein S (FPS) percentage of protein S that corresponds to the free form (PFPS), C4BP and factor II throughout childhood (values in cord blood, at 48 hours, at 15 days, 1-6 months, 6 months-2 years, 2-7 years and 7-14 years) have been studied. The maturation of these factors is variable, reaching average values similar to those of adults at between 1 to 6 months for protein C and TPS; at 15 days for factor II; and at between 6 months and 2 years for C4BP, whose development occurs latest. Vitamin K increases the values of protein C, factor II and FPS at 48 hours after birth, but does not modify the figures for TPS or C4BP. The thrombotic index is below 0.6 for protein C at 15 days, but at this age the figure for protein S is above 1.0.