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16-01-2024 | Anticoagulant | Original Article

Anticoagulant effects of protein C, protein S, and antithrombin levels on the protein C pathway in young children

Authors: Takashi Nakagawa, Kenichi Ogiwara, Hitoshi Tonegawa, Yukihiro Takahashi, Toshiya Nishikubo, Keiji Nogami

Published in: International Journal of Hematology | Issue 2/2024

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Abstract

The protein C (PC) pathway involves physiological anticoagulant factors (PC, protein S [PS], and factor V) and performs major anticoagulant functions in adults. Variations in overall PC pathway function due to dynamic changes in PC and PS in early childhood are poorly understood. We aimed to evaluate the contributions of PC pathway function during early childhood by measuring changes in plasma thrombin generation (TG) after administration of the PC activator protac. We evaluated correlations between anticoagulant factors and percentage of protac-induced coagulation inhibition (PiCi%). Before protac addition, TG in newborns (n = 35), infants (n = 42), young children (n = 35), and adults (n = 20) were 525 ± 74, 720 ± 96, 785 ± 53, and 802 ± 64 mOD/min, and PiCi% were 42.1 ± 9.9, 69.8 ± 11.0, 82.9 ± 4.4, and 86.9 ± 3.4%, respectively. The distribution of PiCi% on the two axes of TG (with or without protac) changed continuously with age and differed from that of warfarin-treated plasma and adult PC- or PS-deficient plasma. PiCi% increased dynamically during infancy and correlated with PS levels in newborns and PC levels in young children. Addition of PC or fresh frozen plasma equivalent to approximately 25% PC to PC-deficient plasma improved PiCi%. This automatic measurement requires only a small sample volume and is useful for analysis of developmental hemostasis.
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Metadata
Title
Anticoagulant effects of protein C, protein S, and antithrombin levels on the protein C pathway in young children
Authors
Takashi Nakagawa
Kenichi Ogiwara
Hitoshi Tonegawa
Yukihiro Takahashi
Toshiya Nishikubo
Keiji Nogami
Publication date
16-01-2024
Publisher
Springer Nature Singapore
Published in
International Journal of Hematology / Issue 2/2024
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-023-03699-4

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