The Contact Activation System (CAS) in cord blood: Measurement of CAS components and comparison with mother's blood. A pilot study.

INTRODUCTION: Classical reference data concerning the coagulation system and fibrinolysis in fetuses and newborns date back to the 1990 s. Since that time a number of methodological or other improvements have been implemented, which may cast some doubt on timeliness of the data. The study objective was to measure the levels of Contact Activation System (CAS) components by antigen, i.e. factors XII and XI (FXII, FXI), prekallikrein (PK) and high molecular weight kininogen (HMWK) in cord blood and maternal blood. MATERIAL AND METHODS: The study group consisted of 35 healthy parturient women with an uneventful pregnancy and birth. The samples of cord blood and maternal blood were obtained immediately after delivery, before clumping the umbilical cord. The CAS components were measured by immunoenzymatic method (ELISA). RESULTS: The median concentrations of CAS components in cord blood plasma and mother's plasma were as follow: FXII: 1.02 (0.60- 2.58) ng/mg protein vs. 0.94 (0.66-1.86) ng/mg protein (p>0.05); FXI: 2.71(0.03-8.0) ng/mg protein vs. 0.92 (0.03-10.44) ng/mg protein (p>0.05); PK: 168.78 (104.28-261.16) pg/mg protein vs. 113.44 (79.94-146.70) pg/mg protein (p>0.05); HMWK: 2169.45 (1530.64- 2539.83) ng/mg protein vs. 2857.96 (2541.52-3161.04) ng/mg protein (p<0.001). CONCLUSIONS: 1. The antigen levels of the three contact factors, i.e. FXII, FXI and PK in the cord blood of full-term and healthy fetuses were similar to those observed in mother's blood immediately after delivery. Only high molecular weight kininogen was found to be lower (accounting for 84% of the values noted in mothers). 2. Based on our measurements, we claim that the cited reference data concerning the contact factors in full-term and healthy newborns are underestimated; hence, new reference values need to be determined for each antigen and activity contact factor level.

New observations on procoagulant properties of amniotic fluid: microparticles (MPs) and tissue factor-bearing MPs (MPs-TF), comparison with maternal blood plasma.

INTRODUCTION: Microparticles (MPs) are submicron fragments of the cell membrane affecting many biological processes, e.g. coagulation. The aim of the study was to determine (i) MPs and (ii) tissue factor bearing MPs (MPs-TF) in the amniotic fluid and in blood plasma of parturient women, as well as to assess (iii) TF and TFPI. MATERIAL AND METHODS: The study group consisted of 38 women laboring at term, whereas the control group included 20 non-pregnant women. ELISA method was used to evaluate MPs, MPs-TF, TF and TFPI. RESULTS: The levels of MPs and MPs-TF were significantly higher in the amniotic fluid than in blood plasma of parturient women: the level of MPs was 41.08 times higher (medians: 246.48 nM PS vs. 6.00 nM PS, respectively, p<0.001), and the level of MPs-TF was 18.59 times higher (medians: 90.16pg/ml vs. 4.85pg/ml, respectively) (p<0.001). CONCLUSIONS: 1. Microparticles (MPs) and tissue factor-bearing MPs (MPs-TF) are constituent components of amniotic fluid. 2. It is reasonable to assume that these components together with tissue factor (TF) and its inhibitor (TFPI) can participate in life-threatening coagulation disturbances in amniotic fluid embolism, and to take into consideration their impact on fetal development.

[Bayesian network as a tool to study health behaviors of students from selected schools of Suwalki, Bialystok and Grodno]. / Siec bayesowska jako narzedzie do badania postaw prozdrowotnych studentów z wybranych uczelni Suwalk, Bialegostoku i Grodna.

UNLABELLED: A research project targeting college students of the eastern region was carried for the second straight year. The main objective of the study was to analyze the relation between smoking, drinking alcohol and drug use and students attitude towards health beaviours. The study drew attention to aspects of the importance of family ties. MATERIAL AND METHODS: In the academic year 2011/2012 in studies involving a total student 416 ie Suwalki -138 people, Bialystok 141 people and from Grodno 137 person. All surveys were carried out using a questionnaire PAV-10 - questionnaire consisting of questions single-and multiple-choice and specifications, using the same methodology for all virtual research teams. To establish a joint survey of the three universities online database system used LimeSurvey polls. Statistical analysis was performed in SPSS and Excel. In this work the Bayesian network was use to assess the health behaviours among students and to analyze the differences in responses between selected universities. The study showed that the problem of active substances exists for all the analyzed schools and should be the base for the preparation of "the recovery plan". Among men, it is clearly a more serious one, as indicated by the number of the students answers. especially disturbing are the answers to the questions concerning the frequency of alcohol consumption. It is interesting result was obtained using the Bayesian network approach: there is a close correlation between the absence of the mother and the weight the responder was giving to components such as: career, travel, their health, and the health of their loved ones. It was clearly demonstrated that students without a mother value the most the health (their own and of their loved ones).

Microparticles (MPs), tissue factor (TF) and tissue factor inhibitor (TFPI) in cord blood plasma. A preliminary study and literature survey of procoagulant properties of MPs.

OBJECTIVES: In the working hypothesis we assumed that the procoagulant activity of microparticles (MPs) is associated with the concentration of tissue factor (TF) and its inhibitor (TFPI), and that these three components together affect fetal hemostasis. The aim of the study was to check whether MPs are present in the cord blood, to compare their concentration with that in the maternal blood, as well as to measure the concentrations of TF antigen and TFPI antigen in the cord blood and maternal blood. STUDY DESIGN: The study group consisted of 28 healthy parturient women who gave normal delivery, and their 28 babies. Blood from the umbilical vein was collected immediately after delivery, still prior to omphalotomy, whereas mother's blood was obtained from the antecubital vein. The concentration of MPs as well as TF antigen and TFPI antigen were measured using ELISA method. RESULTS: The level of MPs in cord blood plasma was found to be 6.25 times higher than in the mother's blood plasma (median: 26.76 nM PS; range: 22.90-34.41 nM PS vs. median: 4.26 nM PS; range: 2.68-5.37 nM PS respectively, p=0.0022), whereas the level of TF antigen was 1.94 times higher in the fetus than in the mother (median: 238.03 pg/ml; range: 192.25-283.10 pg/ml vs. median: 122.4 pg/ml, range: 52.71-176.74 pg/ml, respectively, p=0.0012). On the other hand, the level of TFPI antigen was lower in cord blood plasma than in maternal blood plasma, accounting for 33.95% of the value noted in the mother (median: 30.04 ng/ml, range: 24.84-35.12 ng/ml vs. median: 88.48 ng/ml; range: 78.64-107.20 ng/ml, respectively, p<0.0001). There was no correlation between MP concentration and the levels of TF as well as TFPI in fetal blood and maternal blood. CONCLUSIONS: Microparticles (MPs) are constituent components of cord blood plasma; their concentration is significantly higher than that in mother's blood plasma. In the fetus, MPs may play a role of a powerful procoagulant, thus facilitating thrombin generation (TF-dependent thrombin generation, which may take place on their surface); this hypothesis is based on literature data and our own evidence.

A comparative study of the protein C system in mother's blood, cord blood and amniotic fluid.

Activated protein C (APC) is an important anticoagulant which plays a role in pathophysiology of pregnancy, e.g. in maintenance of the uteroplacental circulation and development of the fetus as well as in pathogenesis of preeclampsia. The study objective was to compare the levels of the respective components of the protein C system (protein C, PC; protein S, PS; thrombomodulin, TM) as well as thrombin activatable fibrinolysis inhibitor - TAFI in mother's blood, cord blood and amniotic fluid. The study group consisted of 136 healthy parturients at term, divided into subgroups of 30-35. The immunoenzymatic method (ELISA) was used to measure the antigens of the components studied. The concentrations of PC and PS antigens were the highest in the mother's blood plasma (135.11+/-1.05% and 92.0+/-13.24%, respectively), lower in cord blood plasma (57.60+/-10.32% and 33.19+/-4.96%, respectively) and the lowest in amniotic fluid (6.75+/-3.50% and 2.40+/-1.64%, respectively); the differences between the levels of that of mother, fetus and amniotic fluid were statistically significant (p< or =0.0001). The TM and TAFI antigen concentrations were the highest in cord blood plasma (11.35+/-3.71 ng/ml and 91.50 (median; range: 71.76-160.77) ng/ml, respectively) and lower in maternal plasma (4.51+/-0.71 ng/ml and 55.46 - median; range: 39.77-68.54 ng/ml, respectively); the differences between the levels of that of cord blood plasma and maternal plasma were statistically significant (p< or =0.0001). Of the three protein C system components, PC and PS occur in relatively high concentrations in maternal blood, being lower in fetal blood and the lowest in amniotic fluid. On the other hand, as an exception, the concentrations of TM and TAFI are the highest in fetus blood.

Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the placenta and myometrium.

BACKGROUND: Placental abruption is mainly due to the rupture of the uterine spiral arteries, but adjacent tissues are also damaged and substances derived from disintegrated placenta and myometrium probably cause coagulation disturbances, such as hypofibrinogenemia and disseminated intravascular coagulation (DIC). AIM: To measure whether placenta and myometrium are significant sources of tissue factor (TF) and tissue factor pathway inhibitor (TFPI), the components of key role in the initiation of coagulation. MATERIALS AND METHODS: Strips of placenta and myometrium were obtained from 48 women delivered by cesarean section at term. TF and TFPI concentrations were measured by immunoenzymatic method (ELISA) in tissue homogenates. MAIN RESULTS: Concentration of TF in placenta and myometrium was 31 (25-37) and 7.4 (4.9-11.4) ng/mg of total protein, respectively. In the plasma of the same women, it was 0.004ng/mg of total protein. TFPI concentration was 13 (10-17) ng/mg of total protein in placenta, 4.5 (3.1-7.3) ng/mg in myometrium, and 0.70 (0.50-0.80) ng/mg in blood plasma protein. CONCLUSION: The levels of TF in placenta and myometrium, over TF in blood plasma may be clinically significant in obstetrics, for instance, in the etiology of DIC in placental abruption. The concentration of TFPI-natural inhibitor of TF-seems to be too low to prevent initiation of coagulation.