Thrombin activatable fibrinolysis inhibitor in Behcet's disease

Introduction: Thrombin activatable fibrinolysis inhibitor (TAFI) is a procarboxypeptidase downregulating plasmin formation, thereby causing a tendency for thrombosis development. Since, Behcet's disease (BD) is a systemic vasculitis, which is commonly complicated by arterial and venous thrombosis, we aimed to find out plasma TAR levels in BD, compared with healthy controls. We also searched whether plasma TAFI levels were significantly different between Behcet's subgroups with and without thrombosis. Materials and methods: In this study, 105 BD patients (M/F: 64/41; mean age 36 +/- 1 years), followed up by Ege University Rheurnatology Department were enrolled. The exclusion criteria were hemophilia, hyperlipidemia, diabetes mellitus, hepatic diseases, renal failure, antiphospholipid positivity, oral contraceptive use and pregnancy. Age- and sex-matched healthy controls (n=53) were also included. Plasma TAFI levels were measured by ELISA. Since TAFI is also an acute-phase reactant, we also measured other inflammatory markers such as C-reactive protein (CRP). Results: Plasma TAFI levels were significantly higher in Behcet's patients (91.1 +/- 7.4 ng/ml) compared with healthy controls (14.3 +/- 4.5 ng/ml) (P<0.001), but there were no significant difference between the subgroups with and without thrombosis. In BD, there was no correlation between plasma TAFI levels and CRP. Conclusions: Regardless of manifest thrombosis, plasma TAFI levels in BD were significantly higher than in healthy controls. High TAFI levels might possibly contribute to the thrombotic tendency in BD. Future studies investigating TAFI gene polymorphism and functional activity are clearly needed, to clarify the exact role of TAFI in Behcet's thrombosis. (C) 2004 Elsevier Ltd. All rights reserved.