Alpha-2-Macroglobulin Inhibits the Anticoagulant Action of Activated Protein C in Cord and Adult Plasma

Cvirn, Gerhard; Gallistl, Siegfried; Muntean, W.

doi:10.1159/000048038

Cited by 19 publications

(18 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another explanation for the diminished capability of the postexercise PPP samples to generate thrombin might be exercise-induced elevated levels of antithrombin (AT) or alpha 2-macroglobulin (a2-M), the two most efficient inhibitors of thrombin (4). A dose-dependent decrease of ETP in the presence of increasing amounts of AT and a2-M has been shown previously (13). In the present study AT and a2-M plasma levels were not determined.…”

Section: Discussionsupporting

confidence: 52%

Effects of a single bout of walking exercise on blood coagulation parameters in obese women

Lamprecht

Moussalli

Ledinski

et al. 2013

Journal of Applied Physiology

Self Cite

View full text Add to dashboard Cite

Obesity is associated with increased prevalence of thromboembolic events. We aimed to investigate whether obese women might benefit from vigorous aerobic exercise. Forty-two overweight and obese women performed a 30-min walking exercise test (treadmill ergometer) at an intensity of 70% of individual peak oxygen uptake. Blood samples were collected before and immediately after exercise. Thrombelastometry and platelet function measurements were performed on whole blood. Standard coagulation times, thrombin generation curves, markers of thrombin generation, fibrinolytic parameters, plasma levels of pro- and anticoagulatory factors, and microparticle procoagulant activity were determined in platelet-poor plasma samples. Thrombelastometry revealed a significant prolongation of clot formation time (P = 0.037) and a significant deceleration of fibrin build up (alpha angle, P = 0.034) after exercise. Calibrated automated thrombography revealed a significant exercise-induced decrease in endogenous thrombin potential (P = 0.039). Moreover, thrombin formation stopped earlier postexercise, reflected in shortened StartTail (P = 0.046). Significantly elevated tissue-plasminogen activator levels (P = 0.001) indicate an exercise-induced activation of the fibrinolytic system. White blood cell count increased significantly from pre- to postexercise (P = 0.045), indicating a mild exercise-induced leukocytosis. The results of this study demonstrate that vigorous aerobic exercise might be a suitable tool to protect obese women from thrombotic events. We show that a single bout of vigorous aerobic exercise is clearly associated with an activation of the fibrinolytic system and a decreased readiness of the postexercise samples to form a clot and to generate thrombin, the pivotal enzyme of hemostasis.

show abstract

Section: Discussionsupporting

confidence: 52%

Effects of a single bout of walking exercise on blood coagulation parameters in obese women

Lamprecht

Moussalli

Ledinski

et al. 2013

Journal of Applied Physiology

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, Cvirn et al. [13–15] have shown that high concentrations of α2MG in the presence of physiologic amounts of antithrombin suppress the anticoagulant action of APC, thereby enhancing the prothrombin activation and thrombin potential in cord and adult plasma. In the present study, prothrombin fragment f1.2 as a marker of thrombin generation was routinely investigated in patients and controls.…”

Section: Discussionmentioning

confidence: 99%

Role of elevated α2‐macroglobulin revisited: results of a case‐control study in children with symptomatic thromboembolism

Beheiri

Langer

Düring

et al. 2007

Journal of Thrombosis and Haemostasis

View full text Add to dashboard Cite

Summary. Objective: a 2 -Macroglobulin (a2MG) is a broadspectrum protease inhibitor that is known to neutralize athrombin, plasmin, and activated protein C, which suggests that it has anticoagulant as well as procoagulant properties. The present study was conducted to evaluate the role of a2MG in children with venous thromboembolism [VTE: paradoxical embolism causing ischemic stroke (IS) or deep-vein thrombosis (DVT)]. Methods: a2MG levels measured after acute VTE onset in white patients were compared with data obtained from age-and gender-matched healthy controls. In addition, to compare the rate of elevated a2MG and prothrombotic risk factors [factor V G1691A, prothrombin G20210A, raised lipoprotein (a)] between patients and controls and to evaluate the interaction between elevated a2MG levels and other thrombophilias, odds ratios (ORs) together with 95% confidence intervals (CIs) were estimated using a logistic regression model. The model was adjusted for age and fibrinogen. Results: a2MG levels were significantly higher in patients than in controls (320/139-524 vs. 302/109-406; P = 0.005). In the group of patients (IS n = 103; DVT n = 92), the risk of symptomatic thromboembolism was significantly increased with elevated a2MG levels, with a gradual increase per mg dL )1. In addition, when elevated a2MG levels > 90th percentile were compared with values below the cut-off, including established prothrombotic risk factors in the multivariate analysis, patients had a significantly increased OR/95% CI for fibrinogen-adjusted a2MG levels (IS, 5.9/1.9-18.3; DVT, 7.2/2.1-24.4). Conclusions: The procoagulant properties of elevated a2MG levels independently increase the odds of stroke and DVT in white children.

show abstract

“…By inhibiting the formation of thrombin, APC also acts as an indirect anti-inflammatory agent [9]. Several components of the haemostatic system have been shown to modulate the anticoagulant action of APC [10][11][12]. In this study we focus on the possible synergistic anticoagulant effects of rhAPC and unfractionated heparin (UH) or rhAPC and melagatran.…”

Section: Introductionmentioning

confidence: 99%

Recombinant human activated protein C, heparin and melagatran in umbilical cord versus adult plasma

Koestenberger¹,

Cvirn²,

Gallistl³

et al. 2005

Acta Paediatrica

Self Cite

View full text Add to dashboard Cite

show abstract

Alpha-2-Macroglobulin Inhibits the Anticoagulant Action of Activated Protein C in Cord and Adult Plasma

Cited by 19 publications

References 31 publications

Effects of a single bout of walking exercise on blood coagulation parameters in obese women

Effects of a single bout of walking exercise on blood coagulation parameters in obese women

Role of elevated α2‐macroglobulin revisited: results of a case‐control study in children with symptomatic thromboembolism

Recombinant human activated protein C, heparin and melagatran in umbilical cord versus adult plasma

Contact Info

Product

Resources

About