Study of the change and role of protein C system in ulcerate colitis

Hypercoagulable state and thrombosis are major lethal causes of ulcerate colitis(UC). The aim of the present study is to explore the change and role of protein C(PC) system in UC thrombosis. 4% dextran sulfate sodium(DSS) was used to induce the UC model, and the body weight, the length of colon, and the weight of spleen were measured after intake of DSS as drinking water for 1 week. The macroscore and microscore were examined. The quantity of macrophage in colon smooth muscle was observed by immunofluorescence, and TNF-α and IL-6 levels in plasma were evaluated by ELISA. Intravital microscopy was applied to observe colonic mucosal microvascular circulation, activities of PC and protein S(PS) were determined by immunoturbidimetry, endothelial cell protein C receptor(EPCR) and thrombomodulin(TM) expressions were detected by immunohistochemistry. In vitro, TNF-α and IL-6 levels were tested in supernatant of macrophage separated from colonic tissue. After stimulation of mouse colonic mucosa microvascular endothelial cells by TNF-α and IL-6 respectively, the activities of PC, PS, activated protein C(APC) were evaluated, and the expressions of EPCR and TM were detected by Western blotting. The results revealed that compared with control, the DSS mouse showed weight loss(P 0.05), a shortened colon(P 0.05), and swelled spleen(P 0.05), accompanied by higher histological score(P 0.05), as well as infiltration of macrophages, elevated TNF-α and IL-6 levels in plasma(P 0.01). The intravital microscopy results revealed that compared with control, DSS mice showed significantly enhanced adhesion of leukocytes and colonic mucosal microvascular endothelial cells(P 0.01), meanwhile, decreased activity of PC and PS in plasma(P 0.01 or P 0.05), and down-regulated expression of EPCR(P 0.01). The degree of inflammation was negatively correlated with the PC activity. In vitro, TNF-α and IL-6 levels were increased in the supernatant of macrophages from DSS mice colonic tissue(P 0.05), and after incubation of TNF-α or IL-6 with colonic mucosal microvascular endothelial cells, the APC activity was decreased(P 0.05 or P 0.01), and expression of EPCR was down regulated(P 0.05). These results suggest that PC system is inhibited in UC mouse. Presumably, the mechanism may be due to the secretion of cytokines from macrophages and subsequential influence on the function of endothelia cells. Furthermore, enhancement of PC system activity may serve as a new strategy for the treatment of UC.