Abstract
Introduction : Thromboembolic complications due to hypercoagulable states arecommon in thalassemic patients, mostly adults. The change in theendothelial cell from resting to procoagulant state could be associatedwith expression of adhesion molecules and selectins. Subsequently,endothelial cell injury can alter hemostasis by promoting fibrin-clotformation.Objective : To determine plasma levels of endothelial, coagulation and fibrinolysismarkers (soluble intercellular adhesion molecules (sICAM-1), vascularendothelial growth factor (VEGF), soluble endothelial selectin (sESelectin),factor VIII activity (FVIII: C) and D-dimer) in children withthalassemia.Design/Methods : This is a cross sectional study. Plasma samples from 120 childrenwith thalassemia (30 with non-splenectomized alpha-thalassemia (NSA),65 with non-splenectomized beta-thalassemia major (NSB) and 25 withsplenectomized beta-thalassemia major (SB) aged 1 to 16 years oldwere assayed for sICAM-1, VEGF, sE-Selectin, FVIII:C and D-dimer,whereas samples from thirty-five healthy children served as controls.Results : Plasma levels of sICAM-1 were significantly elevated in patients withNSA, NSB and SB compared to controls (324.7 ± 83.9; p ≤0.001,277.5 ± 99.6; p ≤0.001and 422.3 ± 128.9; p ≤ 0.001 vs. 150.9 ± 41.9 ng/ml, respectively). Plasma E-selectin levels were significantlyincreased in NSA and SB versus controls (60.4 ± 32.8; p = 0.008,63.9 ± 34.2; p = 0.003 vs. 39.5 ± 11.3 ng/ml, respectively). PlasmaVEGF levels were elevated; however, the statistical difference was notsignificant. Plasma D-dimer levels were significantly increased in SBversus controls (365.5 ± 200 vs. 200.6 ± 54.1 ng/ml; p = 0.02,respectively). On the contrary, FVIII: C levels were significantlydecreased in NSA and NSB versus controls (57.8 ± 13.5; p ≤ 0.001,67.4 ± 23.9; p ≤ 0.001 vs. 96.7 ± 27.7 ng/ml, respectively). ComparingNSB to SB patients, SB patients had significantly higher plasmaconcentrations of sICAM-1, E-selectin and D-dimer than NSB patients(p ≤ 0.001, p = 0.003 and p = 0.005, respectively).Conclusion : There is evidence of endothelial cell activation and alteration ofcoagulation and fibrinolysis in children with thalassemia which increasesthe risk of thromboembolic complications.
DOI
10.58837/CHULA.CMJ.54.5.3
First Page
419
Last Page
427
Recommended Citation
Sosothikul, D; Kittikalayawong, Y; Bupachart, C; and Seksarn, P.
(2010)
"Activation of endothelial cell, coagulation and fibrinolysisin children with beta- and alpha-thalassemia,"
Chulalongkorn Medical Journal: Vol. 54:
Iss.
5, Article 3.
DOI: https://doi.org/10.58837/CHULA.CMJ.54.5.3
Available at:
https://digital.car.chula.ac.th/clmjournal/vol54/iss5/3