title: Thrombin generation assay: interactions between chronic inflammation and haemostasis in patients with autoimmune diseases.
abstract: OBJECTIVE
  Growing evidences show a direct link between inflammation and activation of haemostasis. That could increase thrombotic and cardiovascular risk in patients with active autoimmune diseases such as rheumatoid arthritis (RA) and systemic sclerosis (SSc). The aim of this study was to evaluate a possible hypercoagulable condition in RA and SSc patients, using the thrombin generation assay (TGA).
  
  
  METHODS
  TGA was assessed in 44 RA [33 with active disease (actRA) and 11 inactive (non-actRA)], 25 SSc patients and 41 healthy controls using a fluorimetric technique and the TGA RB Low reagent. The Lag time (tLag), the time to thrombin peak (tPeak), the maximal concentration of formed thrombin (Peak), the velocity of thrombin generation (velocity) and the total amount of thrombin generated (AUC) were determined.
  
  
  RESULTS
  As compared to the control group, tLag was found to be significantly reduced both in patients with actRA (p=0.0001) and non-actRA (p=0.01); tPeak was found to be reduced in actRA patients (p=0.0002). Similarly, as compared to healthy subjects, Peak and AUC were found to be increased in actRA patients (p=0.01; p=0.002), as well as D-dimer (p=0.01). Analysing SSc vs RA, a higher Peak and AUC were detected in RA patients.
  
  
  CONCLUSIONS
  The TGA profile identified in actRA patients (decreased tLag and tPeak combined with higher thrombin peak and greater AUC) reflects a hypercoagulable state that could make patients more susceptible to develop a cardiovascular disease.
authors.affiliation: Dept. of Rare, Immunologic, Haematologic and Immunohaematologic Diseases, Centre of Research of Immunopathology and Rare Diseases, Coordinating Centre of Piemonte and Valle d'Aosta Network for Rare Diseases, Giovanni Bosco Hosp. and Univ. of Turin, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Solfietti
authors.affiliation: Dept. of Rare, Immunologic, Haematologic and Immunohaematologic Diseases, Centre of Research of Immunopathology and Rare Diseases, Coordinating Centre of Piemonte and Valle d'Aosta Network for Rare Diseases, Giovanni Bosco Hosp. and Univ. of Turin, Italy.
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Binello
authors.affiliation: Dept. of Rare, Immunologic, Haematologic and Immunohaematologic Diseases, Centre of Research of Immunopathology and Rare Diseases, Coordinating Centre of Piemonte and Valle d'Aosta Network for Rare Diseases, Giovanni Bosco Hosp. and Univ. of Turin, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Stella
authors.affiliation: Dept. of Rare, Immunologic, Haematologic and Immunohaematologic Diseases, Centre of Research of Immunopathology and Rare Diseases, Coordinating Centre of Piemonte and Valle d'Aosta Network for Rare Diseases, Giovanni Bosco Hosp. and Univ. of Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Bazzan
authors.affiliation: Dept. of Rare, Immunologic, Haematologic and Immunohaematologic Diseases, Centre of Research of Immunopathology and Rare Diseases, Coordinating Centre of Piemonte and Valle d'Aosta Network for Rare Diseases, Giovanni Bosco Hosp. and Univ. of Turin, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Salierno
authors.affiliation: Dept. of Rare, Immunologic, Haematologic and Immunohaematologic Dis., Ctr.of Res.of Immunopathology and Rare Diseases, Coordinating Centre of Piemonte and Valle d'Aosta Network for Rare Dis.; and SCDU Nephrol.& Dialysis, Giovanni Bosco Hosp.,Turin, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Roccatello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D001327:Autoimmune Diseases / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D005470:Fluorometry; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012595:Scleroderma, Systemic / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D013917:Thrombin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D013917:Thrombin