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The Effect of Plasminogen Activator Inhibitor-1 -675 4G/5G Polymorphism on Familial Mediterranean Fever (FMF) Disease

Biotechnology Institute, Ankara University, Ankara, Turkey, ozel{at}medicine.ankara.edu.tr

Mesiha Ekim, MD

Pediatric Nephrology Department Ankara University Faculty of Medicine, Ankara, Turkey

Nejat Akar, MD

Pediatric Molecular Genetics Department Ankara University Faculty of Medicine, Ankara, Turkey

Familial Mediterranean fever (FMF) is an autosomal recessive disease that is the most common of a rare group of disorders collectively termed familial hereditary periodic fever syndromes, also known as autoinflammatory syndromes. FMF is predominantly affecting people of Mediterranean descent and clinically characterized by intermittent attacks of fever with peritonitis and abdominal pain, pleuritis, arthritis, or erysipelas-like rashes. Amyloidosis due to chronic inflammation progressing to renal failure is one of the most serious potential complications of this disease.

Patients with inflammatory diseases, such as systemic lupus erythematosus and rheumatoid arthritis, and conditions with chronic subclinical inflammation, like obesity and diabetes mellitus, are now considered to have an increased risk of atherosclerotic cardiovascular complications. FMF is also an inflammatory disease, and it is accepted that even during attack-free periods significant inflammatory reaction continues. However, whether this inflammatory process causes premature atherosclerosis is not known due to a lack of data.

Different studies have investigated the association between the fibrinolytic and inflammatory process parameters. PAI-1 is paracrine secretion of pro- and antiinflammatory cytokines, thereby playing a possible role in the adiposity-related inflammation and atherosclerosis. The patients with IRS have higher values of fibrinogen, factor VII, VIII, Von Willebrand factor and Plasminogen Activator Inhibitor (PAI) compared to control subjects. So that we aimed in this study to investigate whether FMF patients with/without amyloidosis and with M694V homozygote mutation, have increased risk for atherosclerotic cardiovascular complications and to determine the strength of association between MEFV gene-mutation types. To our knowledge, this is the first case control and cross-sectional study in the pediatric age groups.

Key Words: plasminogen activator-1 • familial Mediterranean fever • amyloidosis • atherosclerosis

This version was published on August 1, 2009

Clinical and Applied Thrombosis/Hemostasis, Vol. 15, No. 4, 443-447 (2009)
DOI: 10.1177/1076029608325540


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