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Inflammatory markers in thrombosis associated with primary antiphospholipid syndrome

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Abstract

The role of inflammation in thrombotic complications of primary antiphospholipid syndrome (PAPS) is controversial. The aim of this study was to evaluate levels of inflammation and coagulation markers in patients with thrombotic PAPS (t-PAPS). Patients with t-PAPS and individuals with no history of thrombosis were enrolled. The association of t-PAPS with levels of tumor necrosis factor (TNF)-α, C-reactive protein (hs-CRP), interferon (IFN)-α, interleukins (IL)-6, -8, factor VIII (FVIII), von Willebrand factor (VWF) and tissue factor (TF) was evaluated by regression models. The levels of these markers were also compared between controls and subgroups of t-PAPS patients with triple positivity, recently diagnosed thrombosis, recurrent thrombosis and venous thrombosis. Patients with t-PAPS (n = 101) had a 8.6-fold increased levels of TNF-α, 90% increased levels of hs-CRP, 80% increased levels of IL-6, 30% increased levels of FVIIIAg, 50% increased levels of VWF and 66% increased levels of TF as compared to controls (n = 131), and the differences did not change after adjustments for sex, age and cardiovascular risk factors. Inflammatory markers were elevated in t-PAPS regardless of the aPL profile, number of previous thrombosis or time elapsed since diagnosis. TNF-α and IL-8 levels were higher in t-PAPS patients with venous thrombosis, in comparison with those with arterial thrombosis and controls. Patients with t-PAPS presented with increased levels of inflammatory and coagulation markers, which suggests that t-PAPS is associated not only with hypercoagulability but also with a persistent inflammatory state.

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Acknowledgments

This work was supported by the São Paulo Research Foundation, FAPESP [Grant Number 2016/14172-6] and by Brazilian Federal Agency for the Support and Evaluation of Graduate Education, CAPES [to Fernanda T. Arantes and Laís Q. Tobaldini].

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Authors and Affiliations

  1. School of Medical Sciences, University of Campinas, Campinas, Brazil

    Fernanda T. Arantes, Bruna M. Mazetto, Sabrina S. Saraiva, Laís Q. Tobaldini, Ana Paula R. dos Santos & Fernanda A. Orsi

  2. Department of Clinical Medicine, School of Medical Sciences, University of Campinas, Campinas, Brazil

    Joyce Annichino-Bizzacchi

  3. Department of Clinical Pathology, School of Medical Sciences, School of Medical Sciences, University of Campinas, Campinas R. Tessália Vieira de Camargo, 126. Cidade Universitária, Campinas, 13083-887, Brazil

    Fernanda A. Orsi

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Contributions

FTA performed the laboratory and statistical analyses and drafted the manuscript; BMM was responsible for the laboratory analyses and revised the manuscript; LQT and APRdS performed the laboratory analyses and revised the manuscript; SSS and JA-B revised the manuscript and FAO designed the study, the analyses and revised the manuscript.

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Correspondence to Fernanda A. Orsi.

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Arantes, F.T., Mazetto, B.M., Saraiva, S.S. et al. Inflammatory markers in thrombosis associated with primary antiphospholipid syndrome. J Thromb Thrombolysis 50, 772–781 (2020). https://doi.org/10.1007/s11239-020-02155-y

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