Protein Z levels and anti-protein Z antibodies in patients with arterial and venous thrombosis☆
Received 28 February 2007; received in revised form 27 June 2007; accepted 5 July 2007.
Abstract
Introduction
The thrombotic risk associated with protein Z (PZ) deficiency is unclear. Anti-protein Z (anti-PZ) has been described as a risk factor in unexplained embryo demise. The aim of our study was to evaluate a possible PZ deficiency and presence of anti-PZ antibodies on thrombotic diseases.
Material and methods
We performed a case-control study on 114 patients with preexisting arterial or venous thrombosis (50 and 64, respectively). Thrombosis was studied based on etiology (creating factor risk subgroups) and on specific thrombotic disease.
Results
PZ levels of patients were significantly lower compared to controls (1709+−761.3 ng/mL vs. 2437+−964.7 ng/mL P=0.001). The high arterial risk factor subgroup showed the lowest PZ level (1267.5+−609 ng/mL) whereas the rest of arterial and venous etiological subgroups presented similar PZ levels. Patients with peripheral artery disease had the lowest PZ level (1022+−966 ng/mL). The rest of arterial and venous thrombotic diseases presented similar PZ levels. A significant increased risk for arterial and venous thrombosis for the lowest (<1685 ng/mL) quartile of PZ has been founded (OR:52, P=0.001 and OR:18, P=0.007, respectively). Anti-PZ antibodies were negative in the majority of patients, although mean anti-PZ IgG antibody levels in the arterial thrombosis group were significantly higher compared to venous thrombosis and control groups (P=0.05 and P=0.005, respectively).
Conclusions
The results suggest that both arterial and venous thrombotic events are related to low PZ levels and that low PZ concentrations are associated with thrombosis in our study. In arterial thrombosis our findings strengthen previous studies that related low PZ levels to atherosclerotic disease. Anti-PZ antibodies do not seem to play a potent role in thrombosis.
aDepartment of Internal Medicine, Research Unit for Autoimmune Diseases, Spain
bDepartment of Haematology, Haemostasis Unit, Vall d’Hebrón University Hospital, Universidad Autónoma de Barcelona, Barcelona, Spain
Corresponding author. Department of Internal Medicine, Vall d’Hebrón University Hospital, Paseo Vall d’Hebrón 119-129, 08035 Barcelona, Spain. Tel.: +34 93 274 61 67; fax: +34 93 489 40 45.
☆ Author’s contributions: José Pardos-Gea (designed research, performed research, collected data, analyzed data, wrote the paper); José Ordi-Ros (designed research, performed research, revised content); Silvia Serrano, Eva Balada, Inmaculada Nicolau (designed research, contributed vital new reagents and analytical tools); Miquel Vilardell (designed research, revised content).
ABSTRACT