title: The effects of thrombomodulin and activated protein C on the pathogenesis of multiple sclerosis.
abstract: BACKGROUND
  Various molecules of the coagulation cascade are thought to have varying roles in the pathophysiology of multiple sclerosis (MS). We aimed to find new information about the effects of the coagulation cascade molecules to develop new therapeutic strategies for MS.
  
  
  METHODS
  Patients with MS were chosen from among patients who were followed up at our hospital. We examined the thrombomodulin (TM) and activated protein C (APC) serum levels in patients with MS and the healthy controls. The patient groups were determined as relapsing-remitting MS (RRMS) or secondary progressive MS (SPMS) according to the McDonald criteria and between ages of 18 and 70.
  
  
  RESULTS
  A total of 244 participants, 122 patients with multiple sclerosis and 122 healthy volunteers were included in the study. There was no statistically significant difference in the APC and TM levels between the patients and the healthy controls (p>0.05), between the patients with RRMS and SPMS (p>0.05), and between the first day of acute relapse and 10th day of methylprednisolone therapy in the patients with RRMS (p=0.334; p=0.363). We detected a statistically positive correlation only between the expanded disability status scale (EDSS) scores and TM levels in the patient group (p=0.009).
  
  
  CONCLUSIONS
  Treatment with methylprednisolone decreases EDSS score in RRMS relapse. The increase in EDSS is related to level of TM. The changes in level of TM and APC may be indicator for prognosis of MS or treatment modalities to MS.
authors.affiliation: Istanbul Medeniyet University, Goztepe Education and Research Hospital, Department of Neurology, Istanbul, Turkey.
authors.forename: Ece
authors.initials: E
authors.lastname: Balkuv
authors.affiliation: Istanbul Medeniyet University, Goztepe Education and Research Hospital, Department of Neurology, Istanbul, Turkey.
authors.forename: Asuman Orhan
authors.initials: AO
authors.lastname: Varoglu
authors.affiliation: Bahcesehir University, School of Medicine, Department of Neurology, Istanbul, Turkey.
authors.forename: Nihal
authors.initials: N
authors.lastname: Isik
authors.affiliation: Istanbul Medeniyet University, Goztepe Education and Research Hospital, Department of Biochemistry, Istanbul, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Isbilen
authors.affiliation: Istanbul Medeniyet University, Goztepe Education and Research Hospital, Department of Biochemistry, Istanbul, Turkey.
authors.forename: Saadettin
authors.initials: S
authors.lastname: Duruyen
authors.affiliation: Istanbul Medeniyet University, Goztepe Education and Research Hospital, Department of Neurosurgery, Istanbul, Turkey. Electronic address: drrecepbasaran@gmail.com.
authors.forename: Recep
authors.initials: R
authors.lastname: Basaran
authors.affiliation: Istanbul Medeniyet University, Goztepe Education and Research Hospital, Department of Neurology, Istanbul, Turkey.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Kocer
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000097:blood* / Q000188:drug therapy; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000097:blood* / Q000188:drug therapy; D011486:Protein C / Q000378:metabolism*; D018180:Thrombomodulin / Q000097:blood*
chemical_list: D000893:Anti-Inflammatory Agents; D011486:Protein C; D018180:Thrombomodulin; D008775:Methylprednisolone
keywords: Activated protein C; Coagulation cascade factor; Multiple sclerosis; Neuroinflammation; Neuroprotection; Thrombomodulin