title: Plasma thrombin-activatable fibrinolysis inhibitor and plasminogen activator inhibitor-1 levels in inflammatory bowel disease.
abstract: BACKGROUND
  Patients with inflammatory bowel disease (IBD) have an increased risk of thromboembolic events. Imbalance of fibrinolysis has been suggested as one of the possible pathogenetic mechanisms. As plasminogen activator inhibitor-1 (PAI-1) and thrombin-activatable fibrinolysis inhibitor (TAFI) are inhibitors of fibrinolysis, we studied TAFI as well as PAI-1 plasma levels in IBD patients compared with healthy controls.
  
  
  METHODS
  A total of 132 IBD patients [68 ulcerative colitis (UC) and 64 Crohn's disease (CD)] and 50 healthy controls were enrolled. PAI-1 and TAFI plasma levels were assessed by commercially available enzyme-linked immunosorbent assay kits. Their relationship with clinical parameters of UC and CD was assessed.
  
  
  RESULTS
  Mean plasma PAI-1 levels were significantly higher in both UC patients (3.9+/-1.3 IU/ml) and CD patients (4.0+/-1.5 IU/ml) compared with healthy controls (3.1+/-1.1 IU/ml) (P=0.01). On the other hand, mean plasma TAFI levels were significantly lower in both UC patients (14.7+/-3.1 microg/ml) and CD patients (13.3+/-3.4 microg/ml) compared with healthy controls (17.4+/-3.0 microg/ml) (P<0.0001). Patients with active disease had significantly higher PAI-1 levels compared with patients with inactive disease for both diseases (P=0.03 and P=0.01, respectively). No significant association between plasma TAFI levels and disease activity was also found. Plasma TAFI levels were significantly lower in patients with ileal CD compared with patients with colonic CD.
  
  
  CONCLUSIONS
  PAI-1 plasma levels are increased whereas TAFI levels are decreased in IBD patients. These results suggest an imbalance of fibrinolysis in IBD.
authors.affiliation: Department of Gastroenterology, University Hospital Heraklion, Heraklion, Crete, Greece. ikoutroub@med.uoc.gr
authors.forename: Ioannis E
authors.initials: IE
authors.lastname: Koutroubakis
authors.forename: Aekaterini
authors.initials: A
authors.lastname: Sfiridaki
authors.forename: Georgia
authors.initials: G
authors.lastname: Tsiolakidou
authors.forename: Constantina
authors.initials: C
authors.lastname: Coucoutsi
authors.forename: Angeliki
authors.initials: A
authors.lastname: Theodoropoulou
authors.forename: Elias A
authors.initials: EA
authors.lastname: Kouroumalis
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D025901:Carboxypeptidase B2 / Q000097:blood*; D003093:Colitis, Ulcerative / Q000097:blood; D003424:Crohn Disease / Q000097:blood; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood*; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*
chemical_list: D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D025901:Carboxypeptidase B2