Open AccessIncreased inflammation and endothelial markers in patients with late severe post-thrombotic syndrome
Author(s) -
Luis Fernando Bittar,
Letícia Queiroz da Silva,
Fernanda Andrade Orsi,
Kiara Cristina Senger Zapponi,
Bruna de Moraes Mazetto,
Erich Vinícius De Paula,
Silmara Aparecida de Lima Montalvão,
Joyce Maria AnnichinoBizzacchi
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0227150
Subject(s) - medicine , post thrombotic syndrome , endothelial dysfunction , thrombosis , d dimer , gastroenterology , pathophysiology , deep vein , inflammation , population , venous thrombosis , endothelial activation , matrix metalloproteinase , immunology , environmental health
Post-thrombotic syndrome (PTS) is a limiting long-term complication present in 20–50% of patients with deep venous thrombosis (DVT) of the lower limbs. A panel of biomarkers with potential relevance to enhance knowledge on the pathophysiology of PTS was investigated. Methods This case-control study included 93 patients with DVT in the lower limbs, 31 with severe PTS (cases) and 62 with mild/no PTS (controls), over 24 months after an acute episode. Thirty-one healthy individuals (HI) with no history of DVT were included as a reference to the population. FVIII activity, D-dimer, inflammatory cytokines, endothelial dysfunction markers, matrix metalloproteinases, and their inhibitors, tissue remodeling and growth factor levels were evaluated. The classification of PTS was, by the Villalta scale. Results Patients with severe PTS showed elevated levels of CRP, sICAM-1, sE-selectin, and decreased MMP-9 and MCP-1 levels when compared to patients with mild/no PTS. Moreover, DVT patients presented higher levels of FVIII and D-dimer when compared to HI. Conclusions DVT patients present an inflammatory status, endothelial dysfunction and altered proteolysis MMPs activity, even a long time after the acute thrombotic episode, which is more significant in severe PTS. These results suggest a possible role of these mediators in the maintenance and worsening of PTS severity.