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Diagnostic Value of Protein C Depletion in Pathologies Associated with the Activation of the Blood Coagulation System
Daria S Korolova1, Tetyana M Platonova1, Olga V Gornytska1
1Protein Structure and Functions Department, Palladin Institute of Biochemistry of NAS of Ukraine, 01054 Kyiv, Ukraine.
Insights
Protein C (PC), a key anticoagulant, decreases in conditions like SLE and IHD, indicating clotting activation. Monitoring PC levels is crucial for managing complex diseases and preventing imbalances in blood coagulation.
Area of Science:
- Biochemistry
- Hematology
- Pathophysiology
Background:
- Protein C (PC) is a primary anticoagulant protein regulating the hemostasis system.
- PC inhibits the blood clotting cascade, preventing thrombus formation.
- PC concentration can decrease during heightened blood clotting activation.
Purpose of the Study:
- To investigate the association between Protein C levels and various pathologies.
- To highlight the clinical significance of PC levels in disease states.
- To emphasize the importance of anticoagulant status in managing complex coagulation disorders.
Main Methods:
- Observational analysis of Protein C levels in patients with Systemic Lupus Erythematosus (SLE), Ischemic Heart Disease (IHD), and Abdominal Aortic Aneurysm (AAA).
- Correlation analysis between PC levels, inflammation index, soluble fibrin monomeric complexes (SFMCs), and blood loss.
- Clinical assessment of PC concentration in relation to disease severity and clotting activation markers.
Main Results:
- PC levels were significantly decreased in SLE (median 75%) and severe IHD (medians 60-63%), correlating with inflammation and clotting activation.
- In AAA patients, pre-surgery PC levels below 78% were linked to substantial blood loss (>1.5 L).
- Decreased PC levels indicate an imbalance between coagulation and anticoagulation processes.
Conclusions:
- Reduced Protein C levels are indicative of significant clotting activation in various complex pathologies.
- Monitoring PC levels alongside traditional markers is essential for effective management of thrombotic disorders.
- Assessing the anticoagulant capacity is vital for predicting outcomes and guiding treatment in patients with activated coagulation systems.
Abstract:
Protein C (PC) is the main anticoagulant protein of the hemostasis system. It can inhibit the blood clotting cascade before the formation of a thrombus, while its concentration can decrease significantly during strong activation of blood clotting. The PC concentration was found to decrease during systemic lupus erythematosus (SLE) (with a median of 75%) and depended heavily on the inflammation index. It was also associated with the accumulation of soluble fibrin monomeric (SFMCs) (with a median of 7 µg/mL). A low PC level was detected during severe ischemic heart disease (IHD) (with medians of 60 and 63%, respectively). These pathologies also were associated with clotting activation. During abdominal aortic aneurysm (AAA), the PC level in blood plasma before surgery was found to range from 40% to 119%. A decrease in the PC level in the blood plasma of patients with AAA before surgery, lower than 78%, was associated with high blood loss (more than 1.5 L). A decrease in the PC level can lead to an imbalance between coagulation and anticoagulation. Thus, during the treatment of complex pathologies associated with the activation of coagulation, specific attention should be paid not only to classic markers of thrombus formation but also to the state of the anticoagulant link.
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