Proteina S

La proteina S è una glicoproteina vitaminica K-dipendente. Risulta sintetizzata nel fegato e all’interno delle cellule epiteliali. Nel circolo ematico, la proteina S è presente sia in forma libera (40% circa), che legata (60%):

• La forma libera della proteina S è la variante ATTIVA e serve come cofattore per la proteina C;
• La forma legata della proteina S è la variante INATTIVA; si trova nel plasma in forma associata con la proteina legante il C4b (molecola trasportatrice o carrier di C4b, componente regolatrice del sistema del complemento).

I valori fisiologici della proteina S nel sangue sono compresi  tra 15 e 30 mg/L, ma l’esame fornisce un valore espresso in percentuale sul valore di riferimento

• Uomini: 65-160%
• Donne:
  • con meno di 50 anni: 50-160%
  • con 50 anni o più: 65-160%

La proteina S non libera risulta legata a C4bBP, una proteina del sistema del complemento e solo la proteina S libera ha un ruolo di cofattore della  PCA.

La proteina S volge un ruolo fondamentale nella coagulazione del sangue. Agisce in qualità di cofattore per la proteina C attivata, un anticoagulante endogeno che inibisce i fattori della coagulazione Va e VIIIa.

Un deficit di questo parametro può derivare da insufficienza epatica, trattamento anticoagulante, carenza di vitamina K, assunzione di estroprogestinici o alti livelli di estradiolo per l’induzione dell’ovulazione.

Bassi valori di proteina S espongono il paziente al rischio di trombosi  e tromboembolismo venoso profondo ed embolia polmonare.

In genere un valore elevato di proteina S libera non ha alcun significato clinico patologico.

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