Endoscopic activity, tissue factor and Crohn's disease: findings in clinical remission patients

Author(s):Show less -

Andrade, Adriana Ribas ^{[1, 2]} ; Flores da Rocha, Tania Rubia ^{[1, 2]} ; Ortiz-Agostinho, Carmen Lucia ^{[1, 2]} ; Nishitokukado, Ieda ^{[1, 2]} ; Carlos, Alexandre Sousa ^{[1, 2]} ; Cardoso de Azevedo, Matheus Freitas ^{[1, 2]} ; Hashimoto, Claudio Lioshi ^{[1, 2]} ; Moura Cintra Damiao, Aderson Omar ^{[1, 2]} ; Carrilho, Flair Jose ^{[1, 2]} ; D'Amico, Elbio ^{[1, 2]} ; Sipahi, Aytan Miranda ^{[1, 2]} ; de Arruda Leite, Andre Zonetti ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Sch Med, Lab Gastroenterol Clin & Expt LIM 07, Gastroenterol, Av Dr Arnaldo 455, Sala 4384, BR-01246903 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Div Hematol, Coagulat Lab, Sch Med, Av Dr Eneas de Carvalho Aguiar, Sao Paulo - Brazil

• Document type: Journal article
• Source: THERAPEUTIC ADVANCES IN GASTROENTEROLOGY; v. 13, AUG 2020.
• Web of Science Citations: 0

Abstract

Background: As Crohn's disease (CD) is associated with a high risk of thromboembolic events (TE), including patients with subclinical inflammation, we aim to evaluate the correlation between the impact of endoscopic activity (EA) in the coagulation profiling of CD patients while in clinical remission. Methods: From 164 consecutive CD patients included in clinical remission {[}Crohn's disease activity index (CDAI) < 150], 75 were in the EA group {[}Simplified Endoscopic Score for CD (SES-CD) > 7], 89 were in the endoscopic remission (ER) group (SES-CD <= 2), and 50 were included as healthy controls in the study. Blood samples were analyzed for tissue factor (TF), factor VIII (FVIII), thrombomodulin (TM), ADAMTS-13, von Willebrand factor (VWF), and endogenous thrombin potential (ETP), as well as collecting data regarding risk factors for TE and CD profile. Results: Mean plasma TF activity showed significantly higher levels in the EA group when compared with the ER and control groups (127 pMversus103 pMversus84 pM;p = 0.001), although the VWF:Ag (160%versus168%versus110%;p = 0.001), VWF/ADAMTS-13 (191versus219versus138;p = 0.003), FVIII (150%versus144%versus90%;p = 0.001) and TM (5.13 ng/mlversus4.91 ng/mLversus3.81 ng/ml;p < 0.001) were only increased in CD regardless of EA status when compared with controls. Lastly, ETP with and without TM remained the same in all three groups. Conclusions: CD patients in clinical remission with EA present endothelial lesion inducing TF exposure and subsequent coagulation cascade activation. Recommended thromboprophylaxis for EA outpatient subgroups will require additional investigation in order to be validated. (AU)

• FAPESP's process: 15/06196-0 - Correlation between thrombin generation and endoscopic activity in Crohn's disease
• Grantee: André Zonetti de Arruda Leite
• Support Opportunities: Regular Research Grants