Endoscopic activity, tissue factor and Crohn’s disease: findings in clinical remission patients
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 remissio...
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doaj-4fb7f1d831b44287b2c266d1bbb1c2c42021-07-20T04:03:20ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482020-08-011310.1177/1756284820939412Endoscopic activity, tissue factor and Crohn’s disease: findings in clinical remission patientsAdriana Ribas AndradeTania Rubia Flores da RochaCarmen Lucia Ortiz-AgostinhoIêda NishitokukadoAlexandre Sousa CarlosMatheus Freitas Cardoso de AzevedoClaudio Lioshi HashimotoAderson Omar Moura Cintra DamiãoFlair José CarrilhoElbio D’AmicoAytan Miranda SipahiAndré Zonetti de Arruda LeiteBackground: 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 pM versus 103 pM versus 84 pM; p = 0.001), although the VWF:Ag (160% versus 168% versus 110%; p = 0.001), VWF/ADAMTS-13 (191 versus 219 versus 138; p = 0.003), FVIII (150% versus 144% versus 90%; p = 0.001) and TM (5.13 ng/ml versus 4.91 ng/mL versus 3.81 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.https://doi.org/10.1177/1756284820939412 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Adriana Ribas Andrade Tania Rubia Flores da Rocha Carmen Lucia Ortiz-Agostinho Iêda Nishitokukado Alexandre Sousa Carlos Matheus Freitas Cardoso de Azevedo Claudio Lioshi Hashimoto Aderson Omar Moura Cintra Damião Flair José Carrilho Elbio D’Amico Aytan Miranda Sipahi André Zonetti de Arruda Leite |
spellingShingle |
Adriana Ribas Andrade Tania Rubia Flores da Rocha Carmen Lucia Ortiz-Agostinho Iêda Nishitokukado Alexandre Sousa Carlos Matheus Freitas Cardoso de Azevedo Claudio Lioshi Hashimoto Aderson Omar Moura Cintra Damião Flair José Carrilho Elbio D’Amico Aytan Miranda Sipahi André Zonetti de Arruda Leite Endoscopic activity, tissue factor and Crohn’s disease: findings in clinical remission patients Therapeutic Advances in Gastroenterology |
author_facet |
Adriana Ribas Andrade Tania Rubia Flores da Rocha Carmen Lucia Ortiz-Agostinho Iêda Nishitokukado Alexandre Sousa Carlos Matheus Freitas Cardoso de Azevedo Claudio Lioshi Hashimoto Aderson Omar Moura Cintra Damião Flair José Carrilho Elbio D’Amico Aytan Miranda Sipahi André Zonetti de Arruda Leite |
author_sort |
Adriana Ribas Andrade |
title |
Endoscopic activity, tissue factor and Crohn’s disease: findings in clinical remission patients |
title_short |
Endoscopic activity, tissue factor and Crohn’s disease: findings in clinical remission patients |
title_full |
Endoscopic activity, tissue factor and Crohn’s disease: findings in clinical remission patients |
title_fullStr |
Endoscopic activity, tissue factor and Crohn’s disease: findings in clinical remission patients |
title_full_unstemmed |
Endoscopic activity, tissue factor and Crohn’s disease: findings in clinical remission patients |
title_sort |
endoscopic activity, tissue factor and crohn’s disease: findings in clinical remission patients |
publisher |
SAGE Publishing |
series |
Therapeutic Advances in Gastroenterology |
issn |
1756-2848 |
publishDate |
2020-08-01 |
description |
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 pM versus 103 pM versus 84 pM; p = 0.001), although the VWF:Ag (160% versus 168% versus 110%; p = 0.001), VWF/ADAMTS-13 (191 versus 219 versus 138; p = 0.003), FVIII (150% versus 144% versus 90%; p = 0.001) and TM (5.13 ng/ml versus 4.91 ng/mL versus 3.81 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. |
url |
https://doi.org/10.1177/1756284820939412 |
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