title: Increased thrombin generation in inflammatory bowel diseases.
abstract: BACKGROUND
  Inflammatory bowel diseases (IBD) are characterized by an increased thrombotic risk of uncertain etiology. Endogenous thrombin potential (ETP), a parameter of the thrombin generation curve, represents a new tool in the evaluation of thrombotic and bleeding disorders.
  
  
  OBJECTIVE
  To study ETP in IBD patients and to correlate the results with clinical and biochemical features.
  
  
  METHODS
  Seventy-four IBD patients (37 ulcerative colitis and 37 Crohn's disease) and 74 sex- and age-matched healthy individuals. ETP was measured upon activation of coagulation with small amounts of tissue factor and phospholipids in the presence or absence of thrombomodulin; results were expressed as nM thrombin.minutes.
  
  
  RESULTS
  Mean+/-SD ETP values were significantly higher in patients (1,499+/-454) than controls (1,261+/-385) (p<0.001) only when the test was performed in the presence of thrombomodulin. ETP evaluated as ratio (with/without thrombomodulin), taken as an index of hypercoagulability, was significantly higher in patients (0.69+/-0.14) than controls (0.62+/-0.18) (p<0.006). Patients with increased C-reactive protein (CRP) had significantly higher mean ETP (1,721+/-458) than those with normal CRP (1,357+/-394) or controls (1,261+/-385) (p<0.001). Patients who at the time of blood sampling were classified as having a clinically active disease had ETP higher than those who were quiescent (1,655+/-451 versus 1,388+/-427, p<0.001) or controls (1,261+/-385, p<0.001).
  
  
  CONCLUSIONS
  ETP measured in the presence of thrombomodulin or as ratio (with/without thrombomodulin) is increased in IBD patients, mainly in those with increased CRP or active disease. It may be considered as a candidate test for prospective studies aimed at assessing the risk of thrombosis in IBD patients.
authors.affiliation: Department of Internal Medicine and Hepatology, Azienda Ospedaliera Fatebenefratelli e Oftalmico, Milan, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Saibeni
authors.forename: Valeria
authors.initials: V
authors.lastname: Saladino
authors.forename: Veena
authors.initials: V
authors.lastname: Chantarangkul
authors.forename: Federica
authors.initials: F
authors.lastname: Villa
authors.forename: Savino
authors.initials: S
authors.lastname: Bruno
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vecchi
authors.forename: Roberto
authors.initials: R
authors.lastname: de Franchis
authors.forename: Cinzia
authors.initials: C
authors.lastname: Sei
authors.forename: Armando
authors.initials: A
authors.lastname: Tripodi
mesh_terms: D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000097:blood; D003424:Crohn Disease / Q000097:blood; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000097:blood; D011446:Prospective Studies; D013917:Thrombin / Q000378:metabolism*; D018180:Thrombomodulin / Q000097:blood; D013925:Thromboplastin / Q000032:analysis
chemical_list: D010743:Phospholipids; D018180:Thrombomodulin; D005169:Factor VIII; D002097:C-Reactive Protein; D013925:Thromboplastin; D013917:Thrombin