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P265 Decreased plasma ADAMTS13 antigen and ADAMTS13 activity as a risk factor for hypercoagulability in patients with ulcerative colitis.

D. Owczarek1, D. Cibor*2, K. Salapa1, T. Rodacki1, R. Domagala-Rodacka3, T. Mach2, A. Undas1

1Jagiellonian University Medical College, Cracow, Poland, Insitute of Cardiology, Cracow, Poland, 2Jagiellonian University Medical College, Cracow, Poland, Gastroenterology, Hepatology and Infectious Diseases, Cracow, Poland, 3Master , of Pharmacy, Cracow, Poland

Background

The etiopathogenesis of thrombosis in patients with inflammatory bowel disease (IBD) is multifactorial and not fully explained. Von Willebrand factor (vWF) occurs in plasma as different size multimeres. High molecular weight (HMW) multimeres are broken down by metaloproteinase 13 (A Disintegrin And Metaloprotease with ThromboSpondin-type1 motif 13 - ADAMTS13) into smaller multimeres which are less active in hemostasis. A proper level and activity of ADAMTS13 protects platelets hyperagregation and in consequence clots creation.

Methods

47 patients with ulcerative colitis (UC), 38 with Crohn's disease and 50 healthy controls were involved in the study. In all patients detailed medical history including duration of the disease, smoking habits, occurrence of thromboembolic complications, location and activity of the disease has been taken. vWF antigen concentration (vWF:Ag), vWF ristocetin cofactor activity (vWF:RCo), vWF collagen binding test (vWF:CB), ADAMTS13 antigen concentration (ADAMTS13:Ag) and ADAMTS13 activity were measured in all subjects.

Results

Plasma vWF:Ag was higher in CD and UC patients than in controls (166, 145, 111 IU/dL respectively, for both p<0.0001). vWF:CB was lower only in UC patients as compared to the controls (p<0.000). In UC patients both ADAMTS13:Ag and ADAMTS13 activity were lower in comparison to the controls (for both p<0.0001) as well were lower than in CD group (for both p<0.0001). In UC group the disease activity inversely correlated with ADAMTS13:Ag (r=-0.76, p<0.0001) and ADAMTS13 activity (r=-0.81, p<0.0001) but such a relation was not observed in the CD group. In UC patients we observed inverse correlations of ADAMTS13Ag and ADAMTS13 activity with white blood cells, C-reactive protein and fibrinogen. In the CD group only ADAMTS13 activity inversely correlated with C-reactive protein and fibrinogen.

Conclusion

This study is the first to show that ADAMTS13Ag and ADAMTS13 activity are decreased in UC with comparison to CD. Low plasma ADAMTS13Ag and ADAMTS13 activity may be a risk factor for hypercoagulability in patients with UC. In UC patients ADAMTS13Ag and ADAMTS13 activity correlate with disease activity and inflammatory markers. They might be also a marker of exacerbated UC, but not CD.