Shedding Light on Hemostasis in Patients With Inflammatory Bowel Diseases

Lagrange, Jérémy; Lacolley, Patrick; Wahl, Denis; Peyrin–Biroulet, Laurent; Régnault, V.

doi:10.1016/j.cgh.2019.12.043

Cited by 21 publications

(15 citation statements)

References 113 publications

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“…This finding was thought to be a consequence of inflammation, but similar platelet aggregation has not been found in other inflammatory diseases, suggesting that it may be a specific characteristic of IBD 31 . Platelet reactivity in humans with IBD may be influenced by high circulating concentrations of von Willebrand factor 32,33 . Also, platelets in patients with IBD overexpress CD40 ligand, which mediates platelet activation 34 .…”

Section: Discussionmentioning

confidence: 65%

Coagulation status, fibrinolysis, and platelet dynamics in dogs with chronic inflammatory enteropathy

Wennogle

Olver

Shropshire

2021

Veterinary Internal Medicne

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Background: Coagulation status is poorly understood in dogs with chronic inflammatory enteropathy (CIE). Fibrinolytic activity and platelet dynamics have not been evaluated in CIE dogs. Objectives: To assess coagulation status and fibrinolysis in normoalbuminemic CIE dogs (CIE-N) and CIE dogs with protein-losing enteropathy (CIE-PLE) compared to healthy controls (HC). To evaluate thromboelastography (TEG) variable differences between groups and for correlations with clinicopathologic data. To report platelet dynamics in CIE dogs. Animals: Twenty-five client-owned dogs with CIE (n = 16 CIE-N; n = 9 CIE-PLE); 14 HC beagle dogs. Methods: All dogs had tissue factor + tissue plasminogen activator TEG. Nine of 25 CIE dogs had whole blood impedance platelet aggregometry. The TEG variables and coagulation data were compared between all CIE vs HC dogs, CIE-N dogs vs HC, and CIE-PLE dogs vs HC. Clinicopathologic and coagulation data were available for CIE dogs and assessed for correlation to TEG variables. Results: Dogs with CIE had higher maximum amplitude (MA; P < .001), longer clot lysis times (CLTs; P < .001), lower % lysis after 30 minutes (LY30; P < .001), and % lysis after 60 minutes (LY60; P < .001) compared to HC, suggesting hypercoagulability and hypofibrinolysis. When separated out, both CIE-N and CIE-PLE dogs had higher MA, longer CLT, and lower LY30 and LY60 compared to HC. Serum albumin and 25-hydroxyvitamin D (25[OH]D) concentrations, and plasma antithrombin and fibrinogen concentrations moderately correlated with MA. Conclusions and Clinical Importance: Normoalbuminemic and hypoalbuminemic CIE dogs were considered hypercoagulable based on TEG compared to HC. Some CIE dogs displayed hypofibrinolytic phenotypes on TEG.

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Section: Discussionmentioning

confidence: 65%

Coagulation status, fibrinolysis, and platelet dynamics in dogs with chronic inflammatory enteropathy

Wennogle

Olver

Shropshire

2021

Veterinary Internal Medicne

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“…In agreement with these findings, functional proteomic profiling has recently identified cathepsin G in UC mucosa but not in CD biopsies, highlighting thus significant differences in terms of proteolytic activities and protein profiles between the most common subtypes of IBD 91 . Seeing that gut inflammation and coagulation are two inter‐dependent processes, targeting such interface has been also a major focus of research related to IBD 92‐95 . In that setting, thrombin, a serine protease released upon tissue damage, seems as a potential candidate 96 .…”

Section: Serine Proteases In Gastrointestinal Inflammationmentioning

confidence: 71%

“…91 Seeing that gut inflammation and coagulation are two inter-dependent processes, targeting such interface has been also a major focus of research related to IBD. [92][93][94][95] In that setting, thrombin, a serine protease released upon tissue damage, seems as a potential candidate. 96 Thrombin converts plasma fibrinogen to fibrin at the coagulation cascade and promotes platelet aggregation through PAR-1 activation.…”

Section: Host-derived Serine Proteasesmentioning

confidence: 99%

Serine proteases at the cutting edge of IBD: Focus on gastrointestinal inflammation

et al. 2020

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Serine proteases have been long recognized to coordinate many physiological processes and play key roles in regulating the inflammatory response. Accordingly, their dysregulation has been regularly associated with several inflammatory disorders and suggested as a central mechanism in the pathophysiology of digestive inflammation. So far, studies addressing the proteolytic homeostasis in the gut have mainly focused on host serine proteases as candidates of interest, while largely ignoring the potential contribution of their bacterial counterparts. The human gut microbiota comprises a complex ecosystem that contributes to host health and disease. Yet, our understanding of microbially produced serine proteases and investigation of whether they are causally linked to IBD is still in its infancy. In this review, we highlight recent advances in the emerging roles of host and bacterial serine proteases in digestive inflammation. We also discuss the application of available tools in the gut to monitor disease‐related serine proteases. An exhaustive representation and understanding of such functional potential would help in closing existing gaps in mechanistic knowledge.

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“…Protein S deficiency is associated with a high risk of VTE ( 59 ) and PVST ( 60 ). Third, fibrinogen, which may contribute to the development of PVST ( 61 ), is increased in active IBD ( 62 ). Fourth, tissue plasminogen activator (t-PA) is released from storage sites in vascular endothelial cells as a result of inflammation in patients with IBD ( 6 ).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Risk Factors of Portal Venous System Thrombosis in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

et al. 2022

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BackgroundPatients with inflammatory bowel disease (IBD) may be at risk of developing portal venous system thrombosis (PVST) with worse outcomes. This study aims to explore the prevalence, incidence, and risk factors of PVST among patients with IBD.MethodsPubMed, Embase, and Cochrane Library databases were searched. All the eligible studies were divided according to the history of colorectal surgery. Only the prevalence of PVST in patients with IBD was pooled if the history of colorectal surgery was unclear. The incidence of PVST in patients with IBD after colorectal surgery was pooled if the history of colorectal surgery was clear. Prevalence, incidence, and risk factors of PVST were pooled by only a random-effects model. Subgroup analyses were performed in patients undergoing imaging examinations. Odds ratios (ORs) with 95% CIs were calculated.ResultsA total of 36 studies with 143,659 patients with IBD were included. Among the studies where the history of colorectal surgery was unclear, the prevalence of PVST was 0.99, 1.45, and 0.40% in ulcerative colitis (UC), Crohn's disease (CD), and unclassified IBD, respectively. Among the studies where all the patients underwent colorectal surgery, the incidence of PVST was 6.95, 2.55, and 3.95% in UC, CD, and unclassified IBD after colorectal surgery, respectively. Both the prevalence and incidence of PVST became higher in patients with IBD undergoing imaging examinations. Preoperative corticosteroids therapy (OR = 3.112, 95% CI: 1.017–9.525; p = 0.047) and urgent surgery (OR = 1.799, 95% CI: 1.079–2.998; p = 0.024) are significant risk factors of PVST in patients with IBD after colorectal surgery. The mortality of patients with IBD with PVST after colorectal surgery was 4.31% (34/789).ConclusionPVST is not rare, but potentially lethal in patients with IBD after colorectal surgery. More severe IBD, indicated by preoperative corticosteroids and urgent surgery, is associated with a higher risk of PVST after colorectal surgery. Therefore, screening for PVST by imaging examinations and antithrombotic prophylaxis in high-risk patients should be actively considered.Systematic Review RegistrationRegistered on PROSPERO, Identifier: CRD42020159579.

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Shedding Light on Hemostasis in Patients With Inflammatory Bowel Diseases

Cited by 21 publications

References 113 publications

Coagulation status, fibrinolysis, and platelet dynamics in dogs with chronic inflammatory enteropathy

Coagulation status, fibrinolysis, and platelet dynamics in dogs with chronic inflammatory enteropathy

Serine proteases at the cutting edge of IBD: Focus on gastrointestinal inflammation

Epidemiology and Risk Factors of Portal Venous System Thrombosis in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

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