Levels of Soluble Endothelial Protein C Receptor (sEPCR) in Patients with Vascular Involvement in Behçet’s Disease

Project no. 32632 · Status: Kapanmış (Yayın bekleniyor) · 2024

Summary

<p>Behçet’s&nbsp;disease&nbsp;is&nbsp;a&nbsp;multisystemic&nbsp;vasculitis&nbsp;that&nbsp;can&nbsp;affect&nbsp;small,&nbsp;medium,&nbsp;and&nbsp;large&nbsp;vessels&nbsp;of&nbsp;both&nbsp;the&nbsp;venous&nbsp;and&nbsp;arterial&nbsp;systems,&nbsp;and&nbsp;is&nbsp;also&nbsp;characterized&nbsp;by&nbsp;oral&nbsp;and&nbsp;genital&nbsp;ulcerations,&nbsp;skin&nbsp;lesions,&nbsp;arthritis,&nbsp;and&nbsp;involvement&nbsp;of&nbsp;the&nbsp;ocular,&nbsp;gastrointestinal,&nbsp;and&nbsp;central&nbsp;nervous&nbsp;systems&nbsp;(CNS).&nbsp;Its&nbsp;high&nbsp;propensity&nbsp;for&nbsp;thrombosis&nbsp;is&nbsp;a&nbsp;key&nbsp;feature&nbsp;that&nbsp;distinguishes&nbsp;it&nbsp;from&nbsp;other&nbsp;inflammatory&nbsp;vascular&nbsp;disorders.&nbsp;Vascular&nbsp;involvement&nbsp;is&nbsp;more&nbsp;common&nbsp;under&nbsp;the&nbsp;age&nbsp;of&nbsp;50,&nbsp;particularly&nbsp;in&nbsp;males,&nbsp;and&nbsp;tends&nbsp;to&nbsp;follow&nbsp;a&nbsp;more&nbsp;severe&nbsp;course.&nbsp;Veins&nbsp;are&nbsp;affected&nbsp;more&nbsp;frequently&nbsp;than&nbsp;arteries.&nbsp;Arterial&nbsp;disease&nbsp;typically&nbsp;presents&nbsp;with&nbsp;aneurysms&nbsp;and&nbsp;less&nbsp;commonly&nbsp;with&nbsp;in&nbsp;situ&nbsp;thrombosis.</p><p>The&nbsp;protein&nbsp;C&nbsp;pathway&nbsp;is&nbsp;a&nbsp;natural&nbsp;anticoagulant&nbsp;system.&nbsp;In&nbsp;addition&nbsp;to&nbsp;its&nbsp;anticoagulant&nbsp;activity,&nbsp;activated&nbsp;protein&nbsp;C&nbsp;(APC)&nbsp;can&nbsp;reduce&nbsp;inflammatory&nbsp;responses&nbsp;by&nbsp;limiting&nbsp;the&nbsp;expression&nbsp;of&nbsp;inflammatory&nbsp;mediators&nbsp;and&nbsp;suppressing&nbsp;leukocyte&nbsp;extravasation&nbsp;into&nbsp;tissues.&nbsp;Activation&nbsp;of&nbsp;protein&nbsp;C&nbsp;by&nbsp;the&nbsp;thrombin–thrombomodulin&nbsp;complex&nbsp;is&nbsp;enhanced&nbsp;when&nbsp;protein&nbsp;C&nbsp;binds&nbsp;to&nbsp;the&nbsp;endothelial&nbsp;cell&nbsp;protein&nbsp;C&nbsp;receptor&nbsp;(EPCR).&nbsp;This&nbsp;receptor&nbsp;is&nbsp;primarily&nbsp;expressed&nbsp;on&nbsp;the&nbsp;endothelial&nbsp;cells&nbsp;of&nbsp;large&nbsp;vessels&nbsp;and&nbsp;plays&nbsp;a&nbsp;crucial&nbsp;role&nbsp;in&nbsp;enhancing&nbsp;protein&nbsp;C&nbsp;activation&nbsp;and&nbsp;modulating&nbsp;the&nbsp;functions&nbsp;of&nbsp;the&nbsp;protein&nbsp;C&nbsp;pathway.&nbsp;A&nbsp;soluble&nbsp;form&nbsp;of&nbsp;EPCR&nbsp;circulates&nbsp;in&nbsp;plasma.&nbsp;Soluble&nbsp;EPCR&nbsp;(sEPCR)&nbsp;binds&nbsp;protein&nbsp;C&nbsp;and&nbsp;APC&nbsp;with&nbsp;high&nbsp;affinity;&nbsp;however,&nbsp;its&nbsp;binding&nbsp;to&nbsp;APC&nbsp;inhibits&nbsp;the&nbsp;anticoagulant&nbsp;activity&nbsp;of&nbsp;APC.</p><p>In&nbsp;previous&nbsp;studies,&nbsp;sEPCR&nbsp;levels&nbsp;have&nbsp;been&nbsp;found&nbsp;to&nbsp;be&nbsp;elevated&nbsp;in&nbsp;patients&nbsp;with&nbsp;Behçet’s&nbsp;disease&nbsp;compared&nbsp;to&nbsp;healthy&nbsp;controls.&nbsp;The&nbsp;aim&nbsp;of&nbsp;this&nbsp;study&nbsp;is&nbsp;to&nbsp;measure&nbsp;sEPCR&nbsp;levels&nbsp;in&nbsp;patients&nbsp;with&nbsp;vascular&nbsp;involvement&nbsp;of&nbsp;Behçet’s&nbsp;disease.</p><p>The&nbsp;study&nbsp;will&nbsp;include&nbsp;30&nbsp;patients&nbsp;with&nbsp;vascular&nbsp;involvement&nbsp;who&nbsp;presented&nbsp;to&nbsp;the&nbsp;Rheumatology&nbsp;outpatient&nbsp;clinic&nbsp;of&nbsp;the&nbsp;Department&nbsp;of&nbsp;Internal&nbsp;Medicine&nbsp;at&nbsp;Ege&nbsp;University&nbsp;and&nbsp;were&nbsp;diagnosed&nbsp;with&nbsp;Behçet’s&nbsp;disease&nbsp;according&nbsp;to&nbsp;the&nbsp;International&nbsp;Study&nbsp;Group&nbsp;(ISG)&nbsp;criteria.&nbsp;As&nbsp;control&nbsp;groups,&nbsp;30&nbsp;age-&nbsp;and&nbsp;sex-matched&nbsp;patients&nbsp;with&nbsp;Takayasu&nbsp;arteritis,&nbsp;30&nbsp;patients&nbsp;with&nbsp;non-vascular&nbsp;Behçet’s&nbsp;disease,&nbsp;and&nbsp;30&nbsp;healthy&nbsp;volunteers&nbsp;will&nbsp;be&nbsp;included.&nbsp;Demographic&nbsp;characteristics,&nbsp;disease&nbsp;duration,&nbsp;type&nbsp;of&nbsp;involvement&nbsp;in&nbsp;Behçet’s&nbsp;disease&nbsp;(ocular/mucocutaneous/vascular/neurological/articular),&nbsp;treatments&nbsp;received,&nbsp;and&nbsp;sEPCR&nbsp;levels&nbsp;will&nbsp;be&nbsp;evaluated.</p><p>The&nbsp;data&nbsp;will&nbsp;be&nbsp;analyzed&nbsp;using&nbsp;SPSS&nbsp;21.&nbsp;Continuous&nbsp;variables&nbsp;will&nbsp;be&nbsp;presented&nbsp;as&nbsp;mean&nbsp;±&nbsp;standard&nbsp;deviation,&nbsp;while&nbsp;categorical&nbsp;variables&nbsp;will&nbsp;be&nbsp;expressed&nbsp;as&nbsp;number&nbsp;and&nbsp;percentage.&nbsp;A&nbsp;p-value&nbsp;&lt;&nbsp;0.05&nbsp;will&nbsp;be&nbsp;considered&nbsp;statistically&nbsp;significant.</p>

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