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Blood coagulation factor Va abnormality associated with resistance to
activated protein C in venous thrombophilia
X Sun, B Evatt and JH Griffin
Department of Molecular and Experimental Medicine, Scripps Research
Institute, La Jolla, CA 92037.
A coagulation test abnormality, termed activated protein C (APC)
resistance, involving poor anticoagulant response to APC is currently the
most common laboratory finding among venous thrombophilic patients. Because
the anticoagulant activity of APC involves inactivation of factors Va and
VIIIa, studies were made to assess the presence of abnormal factors V or
VIII. Diluted aliquots of plasma from two unrelated patients with APC
resistance and thrombosis were added to either factor VIII-deficient or
factor V-deficient plasma and APC resistance assays were performed. The
results suggested that patients' factor V but not factor VIII rendered the
substrate plasma APC resistant. When factor V that had been partially
purified from normal or APC resistant patients' plasmas using
immunoaffinity chromatography was added to factor V-deficient plasma, APC
resistance assays showed that patients' factor V or factor Va, but not
normal factor V, rendered the substrate plasma resistant to APC. Studies of
the inactivation of each partially purified thrombin-activated factor Va by
APC suggested that half of the patients' factor Va was resistant to APC.
These results support the hypothesis that the APC resistance of some venous
thrombophilic plasmas is caused by abnormal factor Va.
Volume 83,
Issue 11,
pp. 3120-3125,
06/01/1994
Copyright © 1994 by The American Society of Hematology

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