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Vitamin K-dependent proteins GAS6 and Protein S and TAM receptors in patients of systemic lupus erythematosus: correlation with common genetic variants and disease activity

Pedro Recarte-Pelz1, Dolors Tàssies2, Gerard Espinosa3, Begoña Hurtado1, Núria Sala4, Ricard Cervera3, Joan Carles Reverter2 and Pablo García de Frutos1*

Author Affiliations

1 Department of Cell Death and Proliferation, Institute of Biomedical Research of Barcelona (IIBB-CSIC, IDIBAPS), C/ Roselló 161 6°, Barcelona, 08036, Spain

2 Department of Hemotherapy and Hemostasis, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, C/ Villarroel 170, Barcelona, 08036, Spain

3 Department of Autoimmune Diseases, Institut Clínic de Medicina i Dermatologia, Hospital Clinic, C/ Villarroel 170, Barcelona, 08036, Spain

4 Translational Research Laboratory, Institut Català d'Oncologia (IDIBELL-ICO), Gran Via, km 2.7 s/n, L'Hospitalet de Llobregat, 08907, Spain

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Arthritis Research & Therapy 2013, 15:R41  doi:10.1186/ar4199

A correction for this article has been published in Arthritis Research & Therapy 2014, 16:404. This can be found at

Published: 12 March 2013



Growth arrest-specific gene 6 protein (GAS6) and protein S (ProS) are vitamin K-dependent proteins present in plasma with important regulatory functions in systems of response and repair to damage. They interact with receptor tyrosine kinases of the Tyro3, Axl and MerTK receptor tyrosine kinase (TAM) family, involved in apoptotic cell clearance (efferocytosis) and regulation of the innate immunity. TAM-deficient mice show spontaneous lupus-like symptoms. Here we tested the genetic profile and plasma levels of components of the system in patients with systemic lupus erythematosus (SLE), and compare them with a control healthy population.


Fifty SLE patients and 50 healthy controls with matched age, gender and from the same geographic area were compared. Genetic analysis was performed in GAS6 and the TAM receptor genes on SNPs previously identified. The concentrations of GAS6, total and free ProS, and the soluble forms of the three TAM receptors (sAxl, sMerTK and sTyro3) were measured in plasma from these samples.


Plasma concentrations of GAS6 were higher and, total and free ProS were lower in the SLE patients compared to controls, even when patients on oral anticoagulant treatment were discarded. Those parameters correlated with SLE disease activity index (SLEDAI) score, GAS6 being higher in the most severe cases, while free and total ProS were lower. All 3 soluble receptors increased its concentration in plasma of lupus patients.


The present study highlights that the GAS6/ProS-TAM system correlates in several ways with disease activity in SLE. We show here that this correlation is affected by common polymorphisms in the genes of the system. These findings underscore the importance of mechanism of regulatory control of innate immunity in the pathology of SLE.