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Laboratory Testing for Activated Protein C Resistance (APCR): An Update
Emmanuel J Favaloro1,2, Soma Mohammed3, Ronny Vong3
1School of Medical Sciences, Faculty of Medicine and Health University of Sydney, Westmead Hospital, Westmead, NSW, Australia. emmanuel.favaloro@health.nsw.gov.au.
Methods in Molecular Biology (Clifton, N.J.)
|May 19, 2023
Summary
Activated protein C resistance (APCR) is a hemostatic imbalance increasing venous thromboembolism risk. Factor V Leiden mutation is a common cause, making blood clotting more likely.
Area of Science:
- Hematology
- Molecular Biology
- Genetics
Background:
- Activated protein C resistance (APCR) signifies impaired anticoagulant function.
- This condition elevates the risk of venous thromboembolism due to hemostatic imbalance.
- APCR results from resistance to activated protein C (APC)-mediated degradation of Factors V and VIII.
Purpose of the Study:
- To describe activated protein C resistance (APCR).
- To explain the role of Factor V Leiden (FVL) mutation in APCR.
- To detail a laboratory assay for detecting APCR.
Main Methods:
- Focuses on a laboratory assay for APCR detection.
- Utilizes a commercially available clotting assay.
- Employs snake venom and ACL TOP analyzers for analysis.
Main Results:
- Factor V Leiden (FVL) mutation, specifically G1691A, is the most common cause of hereditary APCR.
- FVL mutation results in resistance to APC-mediated inactivation of Factor Va.
- This resistance leads to increased thrombin production and a procoagulant state.
Conclusions:
- APCR is a significant risk factor for venous thromboembolism.
- The Factor V Leiden mutation is a primary genetic cause of APCR.
- Laboratory assays are crucial for diagnosing APCR and managing thrombotic risk.
