Increased inflammation and endothelial markers in patients with late severe post-thrombotic syndrome

Autoři: Luis Fernando Bittar aff001;  Letícia Queiroz da Silva aff001;  Fernanda Loureiro de Andrade Orsi aff001;  Kiara Cristina Senger Zapponi aff001;  Bruna de Moraes Mazetto aff001;  Erich Vinícius de Paula aff001;  Silmara Aparecida de Lima Montalvão aff001;  Joyce Maria Annichino-Bizzacchi aff001
Působiště autorů: Hematology and Hemotherapy Center, University of Campinas, Campinas, São Paulo, Brazil aff001
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227150



Post-thrombotic syndrome (PTS) is a limiting long-term complication present in 20–50% of patients with deep venous thrombosis (DVT) of the lower limbs. A panel of biomarkers with potential relevance to enhance knowledge on the pathophysiology of PTS was investigated.


This case-control study included 93 patients with DVT in the lower limbs, 31 with severe PTS (cases) and 62 with mild/no PTS (controls), over 24 months after an acute episode. Thirty-one healthy individuals (HI) with no history of DVT were included as a reference to the population. FVIII activity, D-dimer, inflammatory cytokines, endothelial dysfunction markers, matrix metalloproteinases, and their inhibitors, tissue remodeling and growth factor levels were evaluated. The classification of PTS was, by the Villalta scale.


Patients with severe PTS showed elevated levels of CRP, sICAM-1, sE-selectin, and decreased MMP-9 and MCP-1 levels when compared to patients with mild/no PTS. Moreover, DVT patients presented higher levels of FVIII and D-dimer when compared to HI.


DVT patients present an inflammatory status, endothelial dysfunction and altered proteolysis MMPs activity, even a long time after the acute thrombotic episode, which is more significant in severe PTS. These results suggest a possible role of these mediators in the maintenance and worsening of PTS severity.

Klíčová slova:

Biomarkers – Cytokines – Deep vein thrombosis – Endothelial cells – Inflammation – Thrombosis – Metalloproteases – Epidermal growth factor


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