New Research Explains Blood Clotting Issues in Inflammatory bowel Disease

inflammatory bowel disease (IBD), where the immune system attacks the gut, is a painful, long-lasting condition that affects three million Americans.IBD is becoming more common, and there is currently no cure. IBD can also be perilous: up to 8% of people with the disease develop blood clots, which can lead to heart attack and stroke.

New research has found why blood clotting goes wrong in IBD-and identified drugs that can definitely help blood clotting return to normal in human cells and in animal models of IBD.

“We think we can use these findings to reduce inflammation and the risk of blood clots,” says Aaron Petrey, PhD, assistant professor of microbiology and immunology at university of utah Health, and senior author of the study. “This could save lives.”

The results are published in Blood.

Clotting with the brakes off

Most IBD research has looked at immune cells. But blood cells called platelets also play a key role in IBD symptoms. In healthy people, platelets clump together to form clots when thereS an injury to stop bleeding, and they don’t form clots otherwise. But in people with IBD, platelets react too easily, ready to form clots with very little cause.

Surprisingly, platelets from IBD patients weren’t clotting in the usual way, says Rebecca Mellema, PhD, postdoctoral researcher in pathology and the first author of the study.”It’s fully different from what we would expect.”

“Blood vessels normally send a signal to platelets to stay quiet and not form a clot yet,” Petrey explains.”When there’s an injury or inflammation, that signal changes and tells them to form a clot. That process is broken in IBD patients.”

IBD platelets seem to clot more often because they don’t have enough of a protein called layilin, the researchers found. In healthy people, layilin acts like a brake for clotting: it can tell the difference between healthy and injured blood vessels and stops platelets from clotting unless there’s an injury.