Coagulation status detection in breast cancer patients by using thrombelastography

Many cancer patients are known to present in a hypercoagulable state, meaning an increased risk of thrombosis. To investigate hypercoagulable state in breast cancer (BC) patients, their coagulation status was compared with a benign disease group (control). The BC patients were divided into earlier stage (stage I and stage Ⅱ ) and later stage (stage Ⅲ and stage Ⅳ ). Thrombelastography (TEG) and other traditional coagulation tests were performed. The results showed that prothrombin time (PT) was significantly shortened and the levels of D-dimer, fibrinogen (Fib) and platelets (PLT) were significantly increased in the traditional BC group test (P< 0.05). According to TEG detection, the average level of blood clot formation time (K) was significantly lower, while the Angle, MA and CI were significantly higher in the BC group than those in benign disease group (P< 0.05). There were 5 cases of lower extremity venous thrombosis in the breast cancer patients, coinciding with hypercoagulable state. The results showed that the BC patients had an increased hypercoagulable state, with hypercoagulability becoming more obvious in advanced stages. This study suggests that BC patients have an increased tendency for clot formation, and TEG monitoring could be a useful tool to predict the risk of thrombosis for clinical prevention and treatment.     

Anticoagulant activity of M-LAO, l-amino acid oxidase purified from Agkistrodon halys blomhoffii, through selective inhibition of factor IX

One of haemorrhagic toxins present in snake venoms is l-amino acid oxidase (LAO), which catalyzes the oxidative deamination of l-amino acids with the generation of hydrogen peroxide. Although it is widely accepted that LAO alters platelet function, the effects of LAO on human blood coagulation remain largely unknown. The present study demonstrated, for the first time, that M-LAO, LAO purified from the venom of Agkistrodon halys blomhoffii (Japanese mamushi), possesses an anticoagulant activity. Thrombelastography (TEG) showed that M-LAO significantly delayed the onset and the progress of the coagulation process. In addition, the enzyme prolonged the activated partial thromboplastin time (aPTT) dose-dependently, but had little effect on the prothrombin time (PT), suggesting that its principal activity was mediated in the intrinsic coagulation pathway. Furthermore, M-LAO reduced factor IX procoagulant activity in a dose-dependent manner and did not affect other coagulation factors. These results indicate that M-LAO has an anticoagulant activity that impairs the intrinsic clotting by inhibiting factor IX.