Chemotherapy for breast cancer decreases plasma protein C and protein S.

1988 ◽  
Vol 6 (2) ◽  
pp. 276-281 ◽  
Author(s):  
J S Rogers ◽  
A J Murgo ◽  
J A Fontana ◽  
P C Raich
Keyword(s):  
Breast Cancer ◽  
Plasma Protein ◽  
Plasma Levels ◽  
Protein C ◽  
Protein S ◽  
Factor Vii ◽  
C Protein ◽  
S Factor ◽  
Free Plasma ◽  
Thrombotic Tendency

An increased incidence of thromboembolic events has been described in women receiving chemotherapy for breast cancer. The etiology of this enhanced thrombotic state has not been defined. We performed serial coagulation studies in 15 women during 1 monthly cycle of cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy for breast cancer; seven adjuvant and eight metastatic. Plasma protein C levels were measured by anticoagulant, amidolytic, and antigenic techniques. Antigen levels of both total and free plasma protein S were quantitated by immunoelectrophoresis. Plasma levels of protein C, an important vitamin K-dependent inhibitor of blood coagulation and a profibrinolytic agent, and protein S, a cofactor for protein C, decreased 1 and 2 weeks after initiation of chemotherapy compared with pretreatment values. Plasma levels of factor VII and fibrinogen also decreased. The changes in protein C and protein S may contribute to the enhanced thrombotic tendency described in this setting. Possible mechanisms for the decreases in plasma protein C, protein S, factor VII, and fibrinogen are discussed.

Treatment of Hereditary Protein C Deficiency with Stanozolol

1987 ◽  
Vol 57 (01) ◽  
pp. 020-024 ◽  
Author(s):  
A W Broekmans ◽  
J Conard ◽  
R G van Weyenberg ◽  
M H Horellou ◽  
C Kluft ◽  
...  
Keyword(s):  
Plasma Protein ◽  
Protein C ◽  
Protein S ◽  
Fold Increase ◽  
Factor Ix ◽  
Factor Vii ◽  
Type I ◽  
Factor V ◽  
Factor X ◽  
Protein C Deficiency

SummaryFive type I protein C deficient male patients received 5 mg stanozolol b.i.d. during 4 weeks. After four weeks of treatment plasma protein C activity increased from 0.42 to 0.74 U/ml and protein C antigen from 0.49 to 0.75 U/ml. This approximately 1.6 fold increase in plasma protein C was accompanied by an increase in factor II antigen (1.5 fold), factor V activity (1.6 fold), factor X antigen (1.1 fold), antithrombin III antigen (1.3 fold) and heparin cofactor II antigen (1.5 fold), while the concentration of factor VII, factor VIII, and factor IX activity, and of protein S antigen remained unchanged. Prothrombin fragment F1+2, measured in two patients, increased 1.3 fold. In addition to its effect on procoagulant and anticoagulant factors stanozolol had profibrinolytic effects, reflected in an increase in tPA activity and in the concentration of plasminogen. These data indicate that in type I protein C deficient patients stanozolol increases the concentrations of both procoagulant and anticoagulant factors and favours fibrinolysis. The efficacy of stanozolol in preventing thrombotic disease in type I protein C deficient patients, however, remains to be established. During the four weeks of stanozolol treatment no thrombotic manifestations were observed in the protein C deficient patients.

Increased Levels of Activated Factor VII and Decreased Plasma Protein S Activity and Circulating Thrombomodulin during Use of Oral Contraceptives

1996 ◽  
Vol 76 (05) ◽  
pp. 729-734 ◽  
Author(s):  
Peter Quehenberger ◽  
Uta Loner ◽  
Stylianos Kapiotis ◽  
Sylvia Handler ◽  
Barbara Schneider ◽  
...  
Keyword(s):  
Blood Coagulation ◽  
Plasma Protein ◽  
Plasma Levels ◽  
Protein S ◽  
Factor Vii ◽  
Activation Markers ◽  
Treatment Groups ◽  
Activated Factor Vii ◽  
Inhibitory Components ◽  
Protein S Activity

SummaryIn the present study the effect of oral contraceptive (OC) treatment on selected factors involved in the activation, i.e. circulating activated factor VII (cFVIIa), and in the inhibition of blood coagulation, i.e. plasma protein S activity and circulating thrombomodulin (cTM), were for the first time measured in OC users in a prospective study. Beside other coagulation variables, these parameters were measured during treatment with three low estrogen formulations containing different gestagen components (norgestimate, gestodene). During OC treatment increases in the activation markers prothrombin fragment F1+2 and D-Dimer were found, suggesting an increased activation of blood coagulation and fibrinolysis. Along with elevated plasma levels of FVII antigen, cFVIIa was also found increased in all three treatment groups, while inhibitory components of blood coagulation, plasma protein S activity and cTM, significantly and similarily decreased during treatment in all three treatment groups. We conclude that low dose estrogen pills induce similar changes in the plasma levels of main regulatory components of blood coagulation, despite differences in their gestagen components. Increased levels of activators and decreased activities of inhibitors may contribute to arterial and venous thrombotic complications seen in predisposed OC users.

scholarly journals The roles of factor Va and protein S in formation of the activated protein C/protein S/factor Va inactivation complex

2019 ◽  
Vol 17 (12) ◽  
pp. 2056-2068 ◽  
Author(s):  
Magdalena Gierula ◽  
Isabelle I. Salles‐Crawley ◽  
Salvatore Santamaria ◽  
Adrienn Teraz‐Orosz ◽  
James T. B. Crawley ◽  
...  
Keyword(s):  
Protein C ◽  
Activated Protein C ◽  
Protein S ◽  
C Protein ◽  
Factor Va ◽  
S Factor

scholarly journals Venous Thrombosis and Changes of Hemostatic Variables during Cross-Sex Hormone Treatment in Transsexual People

2003 ◽  
Vol 88 (12) ◽  
pp. 5723-5729 ◽  
Author(s):  
A. W. F. T. Toorians ◽  
M. C. L. G. D. Thomassen ◽  
S. Zweegman ◽  
E. J. P. Magdeleyns ◽  
G. Tans ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Plasma Protein ◽  
Plasma Levels ◽  
Protein C ◽  
Ethinyl Estradiol ◽  
Protein S ◽  
Hormone Treatment ◽  
Moderate Increase ◽  
Thrombotic Risk ◽  
Apc Resistance

Abstract The incidence of venous thrombosis associated with estrogen treatment in male-to-female (M→F) transsexuals is considerably higher with administration of oral ethinyl estradiol (EE) than with transdermal (td) 17-β-estradiol (E2). To find an explanation for the different thrombotic risks of oral EE and td E2 use, we compared the effects of treatment of M→F transsexuals with cyproterone acetate (CPA) only, and with CPA in combination with td E2, oral EE, or oral E2 on a number of hemostatic variables [activated protein C (APC) resistance and plasma levels of protein S, protein C, and prothombin], all of which are documented risk factors for venous thrombosis. APC resistance was determined by quantification of the effect of APC on the amount of thrombin generated during tissue factor-initiated coagulation; plasma levels of total and free protein S were determined by standard ELISA; and levels of prothrombin and protein C were determined with functional assays after complete activation of the zymogens with specific snake venom proteases. CPA-only, td-E2+CPA, or oral-E2+CPA treatment produced rather small effects on hemostatic variables, whereas oral EE treatment resulted in a large increase in APC resistance from 1.2 ± 0.8 to 4.1 ± 1 (P < 0.001), a moderate increase in plasma protein C (9%; P = 0.012), and a large decrease in both total and free plasma protein S (30%; P < 0.005). The large differential effect of oral EE and oral E2 indicates that the prothrombotic effect of EE is due to its molecular structure rather than to a first-pass liver effect (which they share). Moreover, these differences may explain why M→F transsexuals treated with oral EE are exposed to a higher thrombotic risk than transsexuals treated with td E2. Testosterone administration to female-to-male transsexuals had an antithrombotic effect.

High Levels of Plasma Protein C in Nephrotic Syndrome

1985 ◽  
Vol 53 (01) ◽  
pp. 005-007 ◽  
Author(s):  
I Pabinger-Fasching ◽  
K Lechner ◽  
H Niessner ◽  
P Schmidt ◽  
E Balzar ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Plasma Protein ◽  
Protein C ◽  
Inverse Correlation ◽  
Elevated Plasma ◽  
Significant Inverse Correlation ◽  
At Iii ◽  
Thrombotic Tendency ◽  
Protein C Activity

SummaryIn patients with severe nephrotic syndrome determinations of plasma protein C : Ag levels (8 patients: 5 adults, 3 children) and protein C activity (3 out of 8 patients) revealed significantly elevated plasma protein C concentrations. Furthermore we observed a significant inverse correlation of protein C : Ag to AT III : Ag levels. No protein C : Ag could be detected in the urine of two patients studied. We conclude from our data, that changes of plasma protein C do not contribute to the high thrombotic tendency in nephrotic syndrome.

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