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Updated: Feb 10, 2026

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Hemostasis biomarkers in multiple sclerosis
N Ziliotto1,2, F Bernardi1, D Jakimovski2
1Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy.
Background And Purpose:
The aim was to investigate the plasma levels of hemostasis components in multiple sclerosis (MS) and their association with clinical and magnetic resonance imaging (MRI) outcomes.
Methods:
In all, 138 MS patients [85 with relapsing-remitting MS (RR-MS) and 53 with progressive MS (P-MS) with a mean age of 54 years; 72.5% female; median Expanded Disability Status Scale 3.5; mean disease duration 21 years] and 42 age- and sex-matched healthy individuals (HI) were studied. All subjects were examined with 3 T MRI and clinical examinations. Plasma levels of hemostasis factors [procoagulant, factor XII (FXII)] and inhibitors [tissue factor pathway inhibitor (TFPI), thrombomodulin, heparin cofactor II, a disintegrin-like and metalloprotease with thrombospondin type 1 motif 13 (ADAMTS13) and plasminogen activator inhibitor 1 (PAI-1)] were evaluated by magnetic Luminex assays and enzyme-linked immunosorbent assay. Associations between hemostasis plasma levels and clinical and MRI outcomes were assessed.
Results:
Lower ADAMTS13 levels were found in MS patients compared to HI (P = 0.008) and in MS patients presenting with cerebral microbleeds compared to those without (P = 0.034). Higher PAI-1 levels were found in MS patients compared to HI (P = 0.02). TFPI levels were higher in the P-MS subgroup compared to RR-MS patients (P = 0.011) and compared to HI (P = 0.002). No significant associations between hemostasis plasma levels and clinical or MRI outcomes were found.
Conclusions:
Decreased ADAMTS13, particularly in MS patients with cerebral microbleeds, which deserves further investigation, and increased PAI-1 and TFPI levels were observed in MS patients, which deserves further investigation. No relationship between hemostasis plasma levels and measures of disease severity was detected.
Insights
This study found altered levels of hemostasis factors in multiple sclerosis (MS) patients, with lower ADAMTS13 and higher PAI-1 and TFPI. No association was found with disease severity or MRI outcomes.
Area of Science:
- Neuroscience
- Hematology
- Immunology
Background:
- Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system.
- Hemostasis, the process of stopping bleeding, involves complex interactions of factors and inhibitors.
- Alterations in hemostasis may play a role in MS pathogenesis and progression.
Purpose of the Study:
- To investigate plasma levels of hemostasis components in MS patients.
- To explore associations between these levels and clinical/MRI outcomes in MS.
- To compare hemostasis profiles between MS subtypes and healthy individuals.
Main Methods:
- Studied 138 MS patients (RR-MS and P-MS) and 42 healthy individuals (HI).
- Assessed plasma levels of hemostasis factors (FXII) and inhibitors (TFPI, ADAMTS13, PAI-1, etc.) using Luminex assays and ELISA.
- Performed 3T MRI and clinical examinations for all participants.
Main Results:
- MS patients showed lower ADAMTS13 levels compared to HI (P=0.008).
- MS patients with cerebral microbleeds had lower ADAMTS13 levels (P=0.034).
- Higher PAI-1 (P=0.02) and TFPI (P=0.002) levels were observed in MS patients compared to HI, with TFPI elevated in progressive MS (P-MS) versus relapsing-remitting MS (RR-MS) (P=0.011).
Conclusions:
- MS patients exhibit distinct hemostasis profiles, including decreased ADAMTS13 and increased PAI-1 and TFPI.
- Lower ADAMTS13 in MS patients with cerebral microbleeds warrants further investigation.
- No significant associations were found between hemostasis plasma levels and measures of disease severity or MRI outcomes.
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