caa a22 4500 475823990 CHVBK 20180406123826.0 cr unu---uuuuu 170329e20000401xx s 000 0 eng 10.1023/A:1018726930407 doi (NATIONALLICENCE)springer-10.1023/A:1018726930407 Decrease in Protein C Inhibitor Activity and Acquired APC Resistance During Normal Pregnancy [Elektronische Daten] [He Shu, Margareta Wramsby, Maria Bokarewa, Margareta Blombäck, Katarina Bremme] Background: Since protein C inhibitor (PCI) inhibits activated protein C (APC) and a number of proteases, one would expect lower concentrations of PCI in a hypercoagulable state due to increased consumption of the inhibitor. Normal pregnancy is associated with a state of activated hemostasis, where response to APC is depressed. We aimed to study whether PCI function varies during normal pregnancy, and assess the relationship between this inhibitor and acquired APC resistance. Methods: PCI activity in plasma was tested during pregnancy and postpartum in 28 healthy pregnant women without factor V Leiden Arg506 - Gln mutation and in 14 non-pregnant female controls. The PCI levels determined in the present study was compared to the APC ratio (APC-r), we investigated previously, in the same samples. Results: The levels of PCI in the pregnant group, as compared to that in the control group (4.74 ± 0.48), gradually decreased from the first to the third trimester, i.e., 3.30 ± 1.31 µg/mL in week 12 (p < 0.001), 2.66 ± 1.44 µg/mL in week 20 (p < 0.001), 1.92 ± 1.18 µg/mL in week 28 (p < 0.001), 1.30 ± 0.94 µg/mL in week 32 (p < 0.001) and 1.49 ± 1.12 µg/mL in week 37 (p < 0.001). After delivery, they rose to 5.02 ± 1.93 µg/mL, similar to that in the controls (p > 0.05). The values of APC-r showed the same tendency during gestation and postpartum. Conclusion: With advance of normal pregnancy, decreasing PCI function corresponds to increasing APC resistance, probably due to that activated hemostasis acts as a link connecting the two variables. Kluwer Academic Publishers, 2000 Shu He Department of Laboratory Medicine/Coagulation Research, Karolinska Institutet, Stockholm, Sweden aut Wramsby Margareta Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden aut Bokarewa Maria Department of Laboratory Medicine/Coagulation Research, Karolinska Institutet, Stockholm, Sweden aut Blombäck Margareta Department of Laboratory Medicine/Coagulation Research, Karolinska Institutet, Stockholm, Sweden aut Bremme Katarina Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden aut Journal of Thrombosis and Thrombolysis Kluwer Academic Publishers 9/3(2000-04-01), 277-281 0929-5305 9:3<277 2000 9 11239 https://doi.org/10.1023/A:1018726930407 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1018726930407 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shu He Department of Laboratory Medicine/Coagulation Research, Karolinska Institutet, Stockholm, Sweden aut NATIONALLICENCE 700 1- Wramsby Margareta Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden aut NATIONALLICENCE 700 1- Bokarewa Maria Department of Laboratory Medicine/Coagulation Research, Karolinska Institutet, Stockholm, Sweden aut NATIONALLICENCE 700 1- Blombäck Margareta Department of Laboratory Medicine/Coagulation Research, Karolinska Institutet, Stockholm, Sweden aut NATIONALLICENCE 700 1- Bremme Katarina Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden aut NATIONALLICENCE 773 0- Journal of Thrombosis and Thrombolysis Kluwer Academic Publishers 9/3(2000-04-01), 277-281 0929-5305 9:3<277 2000 9 11239 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer