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Free protein S deficiency in patients with Crohn's disease
E Aadland1, O R Odegaard, A Røseth
1Dept. of Medicine, Aker University Hospital, Oslo, Norway.
Insights
Low free protein S levels are common in Crohn's disease (CD), suggesting a role in disease development. This protein deficiency may contribute to blood clots and intestinal damage in CD patients.
Area of Science:
- Gastroenterology
- Hematology
- Immunology
Background:
- Multifocal intestinal infarctions from small vessel thrombosis are a potential mechanism in Crohn's disease (CD).
- Deficiency in free protein S may predispose individuals to thrombotic occlusions, contributing to CD pathogenesis.
Purpose of the Study:
- To investigate the levels of free protein S in patients diagnosed with Crohn's disease.
- To determine if free protein S deficiency is associated with the development or complications of CD.
Main Methods:
- Plasma concentrations of free protein S were measured in 54 patients with CD.
- Levels were compared to those in healthy subjects.
- Concentrations of C4b-binding protein and protein C were also assessed.
Main Results:
- 57.4% of CD patients exhibited below-normal plasma concentrations of free protein S.
- The mean free protein S level in CD patients (72.2%) was significantly lower than in healthy subjects (97.5%; p < 0.01).
- Levels of C4b-binding protein and protein C did not differ between groups; free protein S levels showed no correlation with disease activity or complications.
Conclusions:
- Patients with CD frequently show impaired free protein S levels, indicating a potential link to coagulation.
- This impairment in the protein S/protein C/thrombomodulin system may be significant in the development of CD and its thromboembolic complications.
Abstract:
Multifocal intestinal infarctions, due to thrombosis in small vessels, might be a pathogenetic mechanism for Crohn's disease (CD). Deficiency of free protein S may contribute to the development of such thrombotic occlusions. In the present study free protein S was measured in 54 patients with CD. In 31 patients (57.4%) the plasma concentrations of free protein S were below the lower normal range. The mean value of free protein S in CD patients was 72.2%, as compared with 97.5% in healthy subjects (p < 0.01). The concentrations of C4b-binding protein and protein C were similar in the two groups. Free protein S levels were not correlated to disease activity, previous surgery or complications, extraintestinal manifestations, or current medical therapy. The impairment of the protein S/protein C/thrombomodulin system found in patients with CD favours coagulation and might be of importance for both the development of CD and its thromboembolic complications.