Crucial role of the protein C pathway in governing microvascular inflammation in inflammatory bowel disease

Franco Scaldaferri, Miquel Sans, Stefania Vetrano, Cristina Graziani, Raimondo De Cristofaro, Bruce Gerlitz, Alessandro Repici, Vincenzo Arena, Alberto Malesci, Julian Panes, Brian W. Grinnell, Silvio Danese

Research output: Contribution to journalArticlepeer-review


Endothelial protein C receptor (EPCR) and thrombomodulin (TM) are expressed at high levels in the resting microvasculature and convert protein C (PC) into its activated form, which is a potent anticoagulant and antiinflammatory molecule. Here we provide evidence that in Crohn disease (CD) and ulcerative colitis (UC), the 2 major forms of inflammatory bowel disease (IBD), there was loss of expression of endothelial EPCR and TM, which in turns caused impairment of PC activation by the inflamed mucosal microvasculature. In isolated human intestinal endothelial cells, administration of recombinant activated PC had a potent antiinflammatory effect, as demonstrated by downregulated cytokine-dependent cell adhesion molecule expression and chemokine production as well as inhibited leukocyte adhesion. In vivo, administration of activated PC was therapeutically effective in ameliorating experimental colitis as evidenced by reduced weight loss, disease activity index, and histological colitis scores as well as inhibited leukocyte adhesion to the inflamed intestinal vessels. The results suggest that the PC pathway represents a new system crucially involved in governing intestinal homeostasis mediated by the mucosal microvasculature. Restoring the PC pathway may represent a new therapeutic approach to suppress intestinal inflammation in IBD.

Original languageEnglish
Pages (from-to)1951-1960
Number of pages10
JournalJournal of Clinical Investigation
Issue number7
Publication statusPublished - Jul 2 2007

ASJC Scopus subject areas

  • Medicine(all)


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