Pleiotropic anticoagulant functions of protein S, consequences for the clinical laboratory. Communication from the SSC of the ISTH
(2021) In Journal of Thrombosis and Haemostasis 19(1). p.281-286- Abstract
Hereditary deficiencies of protein S (PS) increase the risk of thrombosis. However, assessing the plasma levels of PS is complicated by its manifold physiological interactions, while the large inter-individual variability makes it problematic to establish reliable cut-off values. PS has multiple physiological functions, with only two appearing to have significant anticoagulant properties: the activated protein C (APC) and tissue factor pathway inhibitor alpha (TFPIα) cofactor activities. Current clinical laboratory investigations for deficiency in PS function rely only on the APC-dependent activity. This communication presents an argument for reclassifying the qualitative PS deficiencies to differentiate the two major anticoagulant... (More)
Hereditary deficiencies of protein S (PS) increase the risk of thrombosis. However, assessing the plasma levels of PS is complicated by its manifold physiological interactions, while the large inter-individual variability makes it problematic to establish reliable cut-off values. PS has multiple physiological functions, with only two appearing to have significant anticoagulant properties: the activated protein C (APC) and tissue factor pathway inhibitor alpha (TFPIα) cofactor activities. Current clinical laboratory investigations for deficiency in PS function rely only on the APC-dependent activity. This communication presents an argument for reclassifying the qualitative PS deficiencies to differentiate the two major anticoagulant functions of PS. Reliable assays are necessary for accurate evaluation of PS function when making a specific diagnosis of PS deficiency based on the anticoagulant phenotype alone. This report emphasizes the pleiotropic anticoagulant functions of PS and presents evidence-based recommendations for their implementation in the clinical laboratory.
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- author
- Brinkman, Herm Jan M. ; Ahnström, Josefin LU ; Castoldi, Elisabetta ; Dahlbäck, Björn LU and Marlar, Richard A.
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- protein S, protein S deficiency
- in
- Journal of Thrombosis and Haemostasis
- volume
- 19
- issue
- 1
- pages
- 6 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85098780534
- pmid:33405384
- ISSN
- 1538-7933
- DOI
- 10.1111/jth.15108
- language
- English
- LU publication?
- yes
- id
- 22aac6b2-5ba7-4ee9-9063-503c442f9cfc
- date added to LUP
- 2021-01-13 12:53:04
- date last changed
- 2024-04-18 00:01:30
@article{22aac6b2-5ba7-4ee9-9063-503c442f9cfc, abstract = {{<p>Hereditary deficiencies of protein S (PS) increase the risk of thrombosis. However, assessing the plasma levels of PS is complicated by its manifold physiological interactions, while the large inter-individual variability makes it problematic to establish reliable cut-off values. PS has multiple physiological functions, with only two appearing to have significant anticoagulant properties: the activated protein C (APC) and tissue factor pathway inhibitor alpha (TFPIα) cofactor activities. Current clinical laboratory investigations for deficiency in PS function rely only on the APC-dependent activity. This communication presents an argument for reclassifying the qualitative PS deficiencies to differentiate the two major anticoagulant functions of PS. Reliable assays are necessary for accurate evaluation of PS function when making a specific diagnosis of PS deficiency based on the anticoagulant phenotype alone. This report emphasizes the pleiotropic anticoagulant functions of PS and presents evidence-based recommendations for their implementation in the clinical laboratory.</p>}}, author = {{Brinkman, Herm Jan M. and Ahnström, Josefin and Castoldi, Elisabetta and Dahlbäck, Björn and Marlar, Richard A.}}, issn = {{1538-7933}}, keywords = {{protein S; protein S deficiency}}, language = {{eng}}, number = {{1}}, pages = {{281--286}}, publisher = {{Wiley-Blackwell}}, series = {{Journal of Thrombosis and Haemostasis}}, title = {{Pleiotropic anticoagulant functions of protein S, consequences for the clinical laboratory. Communication from the SSC of the ISTH}}, url = {{http://dx.doi.org/10.1111/jth.15108}}, doi = {{10.1111/jth.15108}}, volume = {{19}}, year = {{2021}}, }