title: A low balance between microparticles expressing tissue factor pathway inhibitor and tissue factor is associated with thrombosis in Behçet's Syndrome.
abstract: Thrombosis is common in Behçet's Syndrome (BS), and there is a need for better biomarkers for risk assessment. As microparticles expressing Tissue Factor (TF) can contribute to thrombosis in preclinical models, we investigated whether plasma microparticles expressing Tissue Factor (TF) are increased in BS. We compared blood plasma from 72 healthy controls with that from 88 BS patients (21 with a history of thrombosis (Th+) and 67 without (Th-). Using flow cytometry, we found that the total plasma MP numbers were increased in BS compared to HC, as were MPs expressing TF and Tissue Factor Pathway Inhibitor (TFPI) (all p < 0.0001). Amongst BS patients, the Th+ group had increased total and TF positive MP numbers (both p ≤ 0.0002) compared to the Th- group, but had a lower proportion of TFPI positive MPs (p < 0.05). Consequently, the ratio of TFPI positive to TF positive MP counts (TFPI/TF) was significantly lower in Th+ versus Th- BS patients (p = 0.0002), and no patient with a TFPI/TF MP ratio >0.7 had a history of clinical thrombosis. We conclude that TF-expressing MP are increased in BS and that an imbalance between microparticulate TF and TFPI may predispose to thrombosis.
authors.affiliation: Vascular Sciences Section, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Khan
authors.affiliation: Vascular Sciences Section, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: N L
authors.initials: NL
authors.lastname: Ambrose
authors.affiliation: Centre for Haematology, Department of Medicine, Imperial College, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Ahnström
authors.affiliation: Vascular Sciences Section, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: A P
authors.initials: AP
authors.lastname: Kiprianos
authors.affiliation: Department of Ophthalmology, King's College, London, UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Stanford
authors.affiliation: Institute of Child Heath, University College, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Eleftheriou
authors.affiliation: Institute of Child Heath, University College, London, UK.
authors.forename: P A
authors.initials: PA
authors.lastname: Brogan
authors.affiliation: Vascular Sciences Section, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: J C
authors.initials: JC
authors.lastname: Mason
authors.affiliation: Vascular Sciences Section, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Johns
authors.affiliation: Centre for Haematology, Department of Medicine, Imperial College, London, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Laffan
authors.affiliation: Vascular Sciences Section, National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: D O
authors.initials: DO
authors.lastname: Haskard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001528:Behcet Syndrome / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D055252:Cell-Derived Microparticles / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods; D013925:Thromboplastin / Q000378:metabolism*; D013927:Thrombosis / Q000378:metabolism*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D013925:Thromboplastin