Background: Deep vein thrombosis (DVT) may lead to serious complication;
the pulmonary embolism; one of the most serious conditions that cause morbidity
and mortality worldwide. sEPCR circulates in the plasma and has high affinity
to bind protein C and activated protein C (APC). This binding interferes with
the anticoagulant function of APC and results in increased risk for DVT. The
aim of this study is to explore the role of sEPCR as a risk factor for DVT in
Sudanese individuals. Methods: A total of 100 Sudanese DVT patients and 100
apparently healthy individuals were recruited for this study.
EDTA-anticoagulated venous blood samples were collected from all participants.
Plasma sEPCR levels were measured by enzyme linked immunosorbent Assay (ELISA).
All results were analyzed using SPSS. Results: The plasma level of sEPCR was
higher in DVT group than in healthy individuals, while male patients showed
higher level when compared to females. Age correlates positively with sEPCR,
whilst BMI and ethnicity showed no effect on the level of sEPCR. Individuals in
the top quartiles of showed to increased risk of DVT when compared to those in
the lower quartile. Conclusion: It can be concluded that elevated sEPCR level
increases the risk to develop DVT in Sudanese. The level of the soluble
receptor is influenced by the gender of individual more than by his/her
ethnicity or body mass index. Results are also indicative of a much higher risk
in those with sEPCR level more than 120 ng/ml when compared to those with lower
levels.
Cite this paper
Abuagla, H. A. , Ahmed, A. O. , Bolad, A. K. and Adam, K. M. (2015). Relation between the Level of Soluble Endothelial Protein C Receptor and the Risk of Deep Venous Thrombosis in Sudanese. Open Access Library Journal, 2, e2241. doi: http://dx.doi.org/10.4236/oalib.1102241.
Kesieme, E., Kesieme, C., Jebbin, N., Irekpita, E. and Dongo, A. (2011) Deep Vein Thrombosis: A Clinical Review. Journal of Blood Medicine, 2, 59-69. http://dx.doi.org/10.2147/JBM.S19009
Fukudome, K. and Esmon, C.T. (1994) Identification, Cloning, and Regulation of a Novel Endothelial
Cell Protein C/Activated Protein C Receptor. The Journal
of Biological Chemistry, 269, 26486-26491.
Kurosawa, S.,
Stearns-Kurosawa, D.J., Hidari, N. and Esmon, C.T. (1997) Identification of Functional Endothelial Protein C Receptor in Human
Plasma. Journal of Clinical Investigation, 100, 411-418. http://dx.doi.org/10.1172/JCI119548
Saposnik, B., Reny, J.L., Gaussem, P., Emmerich, J., Aiach, M. and Gandrille, S. (2004) A Haplotype of the EPCR Gene Is Associated with Increased Plasma
Levels of sEPCR and Is a Candidate Risk Factor for Thrombosis. Blood, 103, 1311-1318. http://dx.doi.org/10.1182/blood-2003-07-2520
de Willige, U.S., Marion, V., Rosendaal, F.R., Vos, H.L., De Visser, M.C. and Bertina, R.M. (2004) Haplotypes of the EPCR Gene, Plasma sEPCR Levels and the Risk of Deep
Venous Thrombosis. Journal of Thrombosis
and Haemostasis, 2, 1305-1310. http://dx.doi.org/10.1046/j.1538-7836.2004.00855.x
Karabiyik, A., Yilmaz, E., Egin, Y. and Akar, N.
(2012) The Effects of Endothelial Protein C
Receptor Gene Polymorphisms on the Plasma sEPCR Level in Venous Thrombosis
Patients. Turkish Journal of Haematology, 29, 55-62.
Ducros, E., Mirshahi, S.S., Faussat, A.M., Mirshahi, P., Dimicoli, S., Tang, R., et al. (2012) Soluble Endothelial Protein C Receptor (sEPCR) Is Likely a
Biomarker of Cancer-Associated Hypercoagulability in Human Hematologic Malignancies. Cancer Medicine, 1, 261-267. http://dx.doi.org/10.1002/cam4.11
Abd-Elghfaar, A.A., Ismail, M.M., Farweez, B.A. and Elmasry, R.F.
(2013) Influence of Soluble Endothelial Protein C
Receptor (sEPCR) on Hypercoagulable State of Haemodialysis Patients. International Journal of Science and
Research, 4, 1123-1128.
Stearns-Kurosawa, D.J., Swindle, K., D’Angelo, A., Della, V.P., Fattorini, A., Caron, N., et al. (2002) Plasma Levels of Endothelial Protein C Receptor Respond to
Anticoagulant Treatment. Blood, 99, 526-530. http://dx.doi.org/10.1182/blood.V99.2.526
Yin, G., Jin, X., Ming, H., Zheng, X. and Zhang, D. (2012) Endothelial Cell Protein C
Receptor Gene 6936A/G Polymorphism Is Associated with Venous Thromboembolism. Experimental and Therapeutic Medicine, 3, 989-992.
Chen, X.D., Tian, L., Zheng, C.F., Li, M., Jin, W., Wang, X.H., et al. (2010) Relationship between Endothelial Protein C Receptor Gene
6936A/G Polymorphisms and Deep Venous Thrombosis. Chinese Journal of Hematology, 31, 607- 609.
Wang, X.Z. (2008) Association between Gene
Polymorphism of Endothelial Cell Protein C Receptor and Thrombotic Disease in
Chinese Han Population of Hubei District. Huazhong University of Science
and Technology, Wuhan.
Navarro, S., Medina, P., Mira, Y., Estelles, A., Villa, P., Ferrando, F., et al. (2008) Haplotypes of the EPCR Gene, Prothrombin Levels, and the Risk of
Venous Thrombosis in Carriers of the Prothrombin G20210A Mutation. Haematologica, 93, 885-891. http://dx.doi.org/10.3324/haematol.12448
Xu, J., Qu, D., Esmon, N.L. and Esmon, C.T.
(2000) Metalloproteolytic Release of Endothelial
Cell Protein C Receptor. Journal of
Biological Chemistry, 275, 6038-6044. http://dx.doi.org/10.1074/jbc.275.8.6038
Gu, J.M., Katsuura, Y., Ferrell, G.L., Grammas, P. and Esmon, C.T.
(2000) Endotoxin and Thrombin Elevate Rodent Endothelial
Cell Protein C Receptor mRNA Levels and Increase Receptor Shedding in Vivo. Blood, 95, 1687-1693.
Pintao, M.C., Roshani, S., De Visser, M.C., Tieken, C., Tanck, M.W., Wichers, I.M., et al. (2011) High Levels of Protein C Are Determined by PROCR Haplotype 3. Journal of Thrombosis and Haemostasis, 9, 969-976. http://dx.doi.org/10.1111/j.1538-7836.2011.04256.x
Qu, D., Wang, Y., Esmon, N.L. and Esmon, C.T.
(2007) Regulated Endothelial Protein C Receptor
Shedding Is Mediated by Tumor Necrosis Factor-Alpha Converting Enzyme/ADAM17. Journal of Thrombosis and Haemostasis, 5, 395-402. http://dx.doi.org/10.1111/j.1538-7836.2007.02347.x
Guitton, C., Gerard, N., Quillard, T. and Charreau, B.
(2011) Circulating Endothelial Cell Protein C
Receptor: Endothelial Regulation and Cumulative Impact of Gender and A3
Haplotype. Journal of Vascular Research, 48, 336-346. http://dx.doi.org/10.1159/000322582
Stearns-Kurosawa, D.J., Burgin, C., Parker, D., Comp, P. and Kurosawa, S. (2003) Bimodal Distribution of Soluble
Endothelial Protein C Receptor Levels in Healthy Populations. Journal of Thrombosis and Haemostasis, 1, 855-856. http://dx.doi.org/10.1046/j.1538-7836.2003.t01-4-00115.x
Orhon, F.S., Ergun, H., Egin, Y., Ulukol, B., Baskan, S. and Akar, N.
(2010) Soluble Endothelial Protein C Receptor
Levels in Healthy Population. Journal of
Thrombosis and Haemostasis, 29, 46-51. http://dx.doi.org/10.1007/s11239-009-0329-z
Auerswald, G., Scharrer, I., Kurth, A., Schramm, W., Oldenburg, J., Schramm, W., et al. (2007) 36th Hemophilia Symposium Hamburg 2005: Epidemiology; Hemophilia
Therapy—Management
of Bleedings and Inhibitors; Orthopedic Treatment in Hemophiliacs;
Hemostaseologic Diagnosis; Pediatric Hemostaseology; Free Lectures. Springer, Berlin
Heidelberg.
Yamagishi, K., Cushman, M., Heckbert, S.R., Tsai, M.Y. and Folsom, A.R.
(2009) Lack of Association of Soluble Endothelial
Protein C Receptor and PROCR 6936A/G Polymorphism with the Risk of Venous
Thromboembolism in a Prospective Study. British
Journal of Haematology, 145, 221-226. http://dx.doi.org/10.1111/j.1365-2141.2009.07612.x