Thrombin Generating Capacity and Phenotypic Association in ABO Blood Groups.

Romy M. W. Kremers,Raed Al Dieri,Leonie Pelkmans,Abdulrahman B. O. Mohamed,H. Bas de Laat,Salwa Hindawi,H. Coenraad Hemker,Dana Huskens,Toshiyuki Miyata

doi:10.1371/journal.pone.0141491

Romy M. W. Kremers, Raed Al Dieri + Show 7 more

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https://doi.org/10.1371/journal.pone.0141491

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Abstract

Individuals with blood group O have a higher bleeding risk than non-O blood groups. This could be explained by the lower levels of FVIII and von Willebrand Factor (VWF) levels in O individuals. We investigated the relationship between blood groups, thrombin generation (TG), prothrombin activation and thrombin inactivation. Plasma levels of VWF, FVIII, antithrombin, fibrinogen, prothrombin and α2Macroglobulin (α2M) levels were determined. TG was measured in platelet rich (PRP) and platelet poor plasma (PPP) of 217 healthy donors and prothrombin conversion and thrombin inactivation were calculated. VWF and FVIII levels were lower (75% and 78%) and α2M levels were higher (125%) in the O group. TG is 10% lower in the O group in PPP and PRP. Less prothrombin was converted in the O group (86%) and the thrombin decay capacity was lower as well. In the O group, α2M plays a significantly larger role in the inhibition of thrombin (126%). In conclusion, TG is lower in the O group due to lower prothrombin conversion, and a larger contribution of α2M to thrombin inactivation. The former is unrelated to platelet function because it is similar in PRP and PPP, but can be explained by the lower levels of FVIII.

Highlights

The hemostatic system should keep blood in a fluid state under normal conditions and minimize blood loss via the arrest of bleeding at sites of vascular injury
No significant difference in the plasma levels of prothrombin, fibrinogen or AT was seen between the ABO blood groups (Fig 1) and α2M levels were higher in blood group O than in the non-O group (122%, p = 0.001)
A likely explanation for the elevated thrombin generation (TG) in non O groups is that non-O individuals are known to have significantly higher levels of both von Willebrand Factor (VWF) and FVIII than O individuals [9, 11]

Summary

Introduction

The hemostatic system should keep blood in a fluid state under normal conditions and minimize blood loss via the arrest of bleeding at sites of vascular injury. It is a complex web of reactions in which dozens of components play a role. Serious haemorrhage threatens if the hemostatic system fails. A close relationship exists between ABO blood type and the risk of venous thromboembolism [1,2,3], coronary heart disease [1, 4] and atherosclerosis [5, 6].

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