Influence of Corticosteroids on Coagulation Factors: Study of Patients with Immune Thrombocytopenia and Human Liver Cancer HepG2 Cells

Abstract

Background: The relation between corticosteroids and thrombosis continues to remain uncertain. We investigated the effects of methylprednisolone (m-PSL) treatment on coagulation factors in patients before and after pulse steroid therapy for immune thrombocytopenia (ITP) and studied the m-PSL-induced changes in mRNA expression of various coagulation factor genes using HepG2 cells.
Materials and Methods: m-PSL (30 mg/kg/dose) was administered intravenously for 3 days to patients with ITP (n=3). The changes in fibrinogen levels and activities of prothrombin, FV, FVII, FVIII, FIX, FX, FXI, and FXII before treatment and one day after the end of treatment were analyzed. Furthermore, the mRNA expression of coagulation factor genes in the cultured HepG2 cell treated with m-PSL (100μM) was also analyzed by RT-PCR.
Results: An increase in FVIII: C (p=.00064) was observed in the patients with ITP after the m-PSL pulse therapy. However, in the experiments in which cultured HepG2 cells were treated with m-PSL, there was no increase in the expression of the coagulation factor genes, including the FVIII gene. However, the expression of FXI mRNA alone was decreased significantly (p=.044).
Discussion: The results of the increased FVIII: C after m-PSL treatment suggested the induction of the hypercoagulable state and supported finding of previous reports. However, the relation of the coagulation factors between the activity changes of the patients with ITP and the mRNA expression in HepG2 cells was inconsistent. Further investigations to clarify the mechanism underlying the hypercoagulable state after m-PSL treatment is necessary.