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Etscheid M, Hanschmann KM, Sandset PM, Kanse SM. Development of a Factor VII Activating Protease (FSAP) generation assay and its application in studying FSAP in venous thrombosis. Thromb Res 2022; 220:24-34. [DOI: 10.1016/j.thromres.2022.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022]
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Khialani D, Vasan S, Cushman M, Dahm AEA, Sandset PM, Rossouw J, van Hylckama Vlieg A. Venous thrombosis with oral postmenopausal hormone therapy: Roles of activated protein C resistance and tissue factor pathway inhibitor. J Thromb Haemost 2021; 19:1729-1737. [PMID: 33774921 DOI: 10.1111/jth.15319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Oral postmenopausal hormone therapy (HT) increases the risk of venous thrombosis (VT). We postulated that activated protein C (APC) resistance induced by HT is one of the mechanisms causing VT, and also assessed the role of one of the main determinants of APC resistance (i.e., tissue factor pathway inhibitor [TFPI]). METHODS We performed a nested case-control study embedded within two Women's Health Initiative hormone trials. Women were randomized to hormone therapy or placebo. Biomarkers were measured at baseline and after 1 year in 217 cases and 817 controls. RESULTS Increased APC resistance and decreased TFPI at baseline were associated with VT (odds ratio 1.20-2.06). However, women with such prothrombotic profile at baseline did not have further increased risk of VT when randomized to HT compared with placebo. Although there was no change in APC resistance or TFPI in placebo group after 1 year, HT group showed prothrombotic changes in the biomarkers (i.e., an increase in APC resistance) (mean [standard deviation] 0.39 [0.54]) and decrease in TFPI (-0.21 [0.50]: free TFPI, -0.24 [0.22]: TFPI activity -0.22 [0.20]: total TFPI). However, HT induced prothrombotic change in biomarkers did not increase risk of VT. CONCLUSION Women with prothrombotic levels of APC resistance and TFPI at baseline were not at increased risk of VT when randomized to HT compared with placebo. This suggests that testing for these biomarkers before starting HT is not required. HT led to prothrombotic change in these biomarkers after one year, but this did not relate to increased risk of VT.
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Affiliation(s)
- Deeksha Khialani
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sowmya Vasan
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Anders Erik Astrup Dahm
- Department of Haematology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Per Morten Sandset
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Haematology, Oslo University Hospital, Oslo, Norway
| | - Jacques Rossouw
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
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Tissue factor pathway inhibitor and bleeding tendency: can hormonal state explain the differences? Blood Adv 2021; 5:2516-2517. [PMID: 34086862 DOI: 10.1182/bloodadvances.2021004651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/26/2021] [Indexed: 11/20/2022] Open
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Del Río JP, Molina S, Hidalgo-Lanussa O, Garcia-Segura LM, Barreto GE. Tibolone as Hormonal Therapy and Neuroprotective Agent. Trends Endocrinol Metab 2020; 31:742-759. [PMID: 32507541 DOI: 10.1016/j.tem.2020.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/24/2020] [Indexed: 12/11/2022]
Abstract
Tibolone (TIB), a selective tissue estrogenic activity regulator (STEAR) in clinical use by postmenopausal women, activates hormonal receptors in a tissue-specific manner. Estrogenic activity is present mostly in the brain, vagina, and bone, while the inactive forms predominate in the endometrium and breast. Conflicting literature on TIB's actions has been observed. While it has benefits for vasomotor symptoms, bone demineralization, and sexual health, a higher relative risk of hormone-sensitive cancer has been reported. In the brain, TIB can improve mood and cognition, neuroinflammation, and reactive gliosis. This review aims to discuss the systemic effects of TIB on peri- and post-menopausal women and its role in the brain. We suggest that TIB is a hormonal therapy with promising neuroprotective properties.
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Affiliation(s)
- Juan Pablo Del Río
- Reproductive Health Research Institute, Santiago, Chile; Translational Psychiatry Laboratory, Clínica Psiquiátrica Universitaria, Hospital Clínico, Universidad de Chile, Santiago, Chile; Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | | | - Oscar Hidalgo-Lanussa
- Departamento de Nutrición y Bioquímica, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Luis Miguel Garcia-Segura
- Instituto Cajal, CSIC, Madrid, Spain; Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - George E Barreto
- Department of Biological Sciences, School of Natural Sciences, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
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Relationship between sex hormone binding globulin and blood coagulation in women on postmenopausal hormone treatment. Blood Coagul Fibrinolysis 2019; 30:17-23. [DOI: 10.1097/mbc.0000000000000784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Piróg M, Jach R, Kacalska-Janssen O. Differential effect of the ultra-low dose and standard estrogen plus dydrogesterone therapy on thrombin generation and fibrinolysis in postmenopausal women. Acta Obstet Gynecol Scand 2017; 96:1438-1445. [DOI: 10.1111/aogs.13239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 09/26/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Magdalena Piróg
- Department of Gynecological Endocrinology; Jagiellonian University Medical College; Krakow Poland
| | - Robert Jach
- Department of Gynecological Endocrinology; Jagiellonian University Medical College; Krakow Poland
| | - Olga Kacalska-Janssen
- Department of Gynecological Endocrinology; Jagiellonian University Medical College; Krakow Poland
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Effects of tibolone on fibrinogen and antithrombin III: A systematic review and meta-analysis of controlled trials. Pharmacol Res 2017; 124:64-73. [DOI: 10.1016/j.phrs.2017.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 11/21/2022]
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Ali HO, Arroyo AB, González-Conejero R, Stavik B, Iversen N, Sandset PM, Martínez C, Skretting G. The role of microRNA-27a/b and microRNA-494 in estrogen-mediated downregulation of tissue factor pathway inhibitor α. J Thromb Haemost 2016; 14:1226-37. [PMID: 26999003 DOI: 10.1111/jth.13321] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/04/2016] [Indexed: 12/01/2022]
Abstract
UNLABELLED Essentials Estrogens are known to influence the expression of microRNAs in breast cancer cells. We looked at microRNAs in estrogenic regulation of tissue factor pathway inhibitor α (TFPIα). Estrogen upregulated microRNA-27a/b and microRNA-494 through the estrogen receptor α. MicroRNA-27a/b and microRNA-494 are partly involved in estrogenic downregulation of TFPIα. SUMMARY Background Tissue factor pathway inhibitor (TFPI) has been linked to breast cancer pathogenesis. We have recently reported TFPI mRNA levels to be downregulated by estrogens in a breast cancer cell line (MCF7) through the estrogen receptor α (ERα). Accumulating evidence also indicates that activation of ERα signaling by estrogens may modulate the expression of target genes indirectly through microRNAs (miRNAs). Objectives To examine if miRNAs are involved in the estrogenic downregulation of TFPIα. Methods Computational analysis of the TFPI 3'-untranslated region (UTR) identified potential binding sites for miR-19a/b, miR-27a/b, miR-494, and miR-24. Transient overexpression or inhibition of the respective miRNAs was achieved by transfection of miRNA mimics or inhibitors. Direct targeting of TFPI 3'-UTR by miR-27a/b and miR-494 was determined by luciferase reporter assay in HEK293T cells. Effects of 17α-ethinylestradiol (EE2) and fulvestrant on relative miR-27a/b, miR-494, and TFPI mRNA levels in MCF7 cells were determined by qRT-PCR and secreted TFPIα protein by ELISA. Transient knockdown of ERα was achieved by siRNA transfection. Results EE2 treatment lead to a significant increase in miR-19a, miR-27a/b, miR-494, and miR-24 mRNA levels in MCF7 cells through ERα. miR-27a/b and miR-494 mimics lead to reduced TFPI mRNA and protein levels. Luciferase assay showed direct targeting of miR-27a/b and miR-494 on TFPI mRNA. Impaired estrogen-mediated downregulation of TFPI mRNA was detected in anti-miR-27a/b and anti-miR-494 transfected cells. Conclusions Our results provide evidence that miR-27a/b and miR-494 regulate TFPIα expression and suggest a possible role of these miRNAs in the estrogen-mediated downregulation of TFPIα.
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Affiliation(s)
- H O Ali
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - A B Arroyo
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - R González-Conejero
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - B Stavik
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - N Iversen
- Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - P M Sandset
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C Martínez
- Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación, IMIB-Arrixaca, University of Murcia, Murcia, Spain
| | - G Skretting
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
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Ali HO, Stavik B, Myklebust CF, Andersen E, Dahm AEA, Iversen N, Sandset PM, Skretting G. Oestrogens Downregulate Tissue Factor Pathway Inhibitor through Oestrogen Response Elements in the 5'-Flanking Region. PLoS One 2016; 11:e0152114. [PMID: 26999742 PMCID: PMC4801176 DOI: 10.1371/journal.pone.0152114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 03/09/2016] [Indexed: 11/21/2022] Open
Abstract
Oestrogens influence the pathology and development of hormone-sensitive breast cancers. Tissue factor pathway inhibitor (TFPI) has been shown to be associated with breast cancer pathogenesis. Recently, we found TFPI mRNA levels to be significantly reduced by oestrogens in a breast cancer cell line (MCF7), a process mediated through the oestrogen receptor alpha (ERα). The aim of the present study was to investigate the mechanism(s) by which oestrogens may regulate TFPI at the transcriptional level. The TFPI 5’-flanking region contains three oestrogen response element (ERE) half-sites at positions -845, -769 and -50. Constructs containing the wild type or mutated ERE half-sites of the TFPI 5’-flanking region were generated in a luciferase reporter gene vector and transiently co-transfected with an ERα expression vector into HEK293 cells and subsequently treated with oestrogens. We found that luciferase activity was significantly downregulated after oestrogen stimulation in cells transfected with the wild type construct, an effect that was abolished by mutating either ERE half-sites. Electrophoretic mobility shift assay suggested direct and specific interaction of ERα with the ERE half-sites in the TFPI 5’-flanking region. Chromatin immunoprecipitation showed that ERα was recruited to the region -899 to -578 of the TFPI 5’-flanking region in vivo, where the ERE half-sites -845 and -769 are located. Our results indicate that ERα can interact with all three ERE half-sites in the TFPI 5’-flanking region and thus participate in the repression of oestrogen mediated TFPI transcription in breast cancer cells.
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Affiliation(s)
- Huda Omar Ali
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Benedicte Stavik
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Christiane Filion Myklebust
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Elisabeth Andersen
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anders E. A. Dahm
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Haematology, Akershus University Hospital, Nordbyhagen, Norway
| | - Nina Iversen
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Per Morten Sandset
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Grethe Skretting
- Department of Haematology, Oslo University Hospital, Oslo, Norway
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
- * E-mail:
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Johnson KC, Aragaki AK, Jackson R, Reiner A, Sandset PM, Rosing J, Dahm AEA, Rosendaal F, Manson JE, Martin LW, Liu S, Kuller LH, Cushman M, Rossouw JE. Tissue Factor Pathway Inhibitor, Activated Protein C Resistance, and Risk of Coronary Heart Disease Due To Combined Estrogen Plus Progestin Therapy. Arterioscler Thromb Vasc Biol 2016; 36:418-24. [PMID: 26681757 PMCID: PMC4732914 DOI: 10.1161/atvbaha.115.306905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/23/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine whether tissue factor pathway inhibitor or acquired activated protein C (APC) resistance influences the increased risk of coronary heart disease (CHD) due to estrogen plus progestin therapy. APPROACH AND RESULTS Prospective nested case-control study of 205 cases of CHD and 481 matched controls in the Women's Health Initiative randomized trial of estrogen plus progestin therapy. After multivariable covariate adjustment, both baseline tissue factor pathway activity (P=0.01) and APC resistance (P=0.004) were associated positively with CHD risk. Baseline tissue factor pathway activity and APC resistance singly or jointly did not significantly modify the effect of estrogen plus progestin on CHD risk. Compared with placebo, estrogen plus progestin decreased tissue factor pathway inhibitor activity and increased APC resistance but these changes did not seem to modify or mediate the effect of estrogen plus progestin on CHD risk. CONCLUSIONS Tissue factor pathway inhibitor activity and APC resistance are related to CHD risk in women, but may not explain the increased CHD risk due to estrogen plus progestin therapy. The data from this study do not support the clinical use of measuring these hemostatic factors to help stratify risk before hormone therapy. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000611.
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Affiliation(s)
- Karen C Johnson
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.).
| | - Aaron K Aragaki
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Rebecca Jackson
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Alex Reiner
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Per Morten Sandset
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Jan Rosing
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Anders E A Dahm
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Frits Rosendaal
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - JoAnn E Manson
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Lisa W Martin
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Simin Liu
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Lewis H Kuller
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Mary Cushman
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
| | - Jacques E Rossouw
- From the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN (K.C.J.); Fred Hutchinson Cancer Research Center, Seattle, WA (A.K.A., A.R.); Ohio State University Medical Center, Columbus, OH (R.J.); Oslo University Hospital and University of Oslo, Oslo, Norway (P.M.S., A.E.A.D.); Maastrich University, Maastrich, The Netherlands (J.R.); University of Leiden, Leiden, The Netherlands (F.R.); Brigham and Women's Hospital, Harvard University, Boston, MA (J.E.M.); George Washington University, Washington, DC (L.W.M.); Brown University, Providence, RI (S.L.); University of Pittsburgh, PA (L.H.K.); University of Vermont, Burlington, VT (M.C.); and National Heart, Lung, and Blood Institute, Bethesda, MD (J.E.R.)
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Ali HO, Stavik B, Dørum E, Iversen N, Sandset PM, Skretting G. Oestrogen induced downregulation of TFPI expression is mediated by ERα. Thromb Res 2014; 134:138-43. [DOI: 10.1016/j.thromres.2014.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/04/2014] [Accepted: 04/04/2014] [Indexed: 11/26/2022]
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12
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Rühl H, Schröder L, Müller J, Fimmers R, Sukhitashvili S, Welz J, Kuhn WC, Oldenburg J, Rudlowski C, Pötzsch B. Tamoxifen induces resistance to activated protein C. Thromb Res 2014; 133:886-91. [DOI: 10.1016/j.thromres.2014.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 12/21/2013] [Accepted: 02/04/2014] [Indexed: 11/28/2022]
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Abstract
There is now compelling evidence that use of oral contraceptives and postmenopausal hormonal therapies containing various estrogens is associated with a weak, but clinically relevant risk of both arterial and venous thrombosis. The increased risk is related to type and dose of both estrogen and combined progestagen and mode of delivery. Treatment induces mainly subtle changes in individual components of the coagulation and fibrinolytic systems, but the overall effect is the induction of a prothrombotic phenotype. This brief review summarizes some of the mechanisms responsible the prothrombotic effects of such treatment.
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Affiliation(s)
- Per Morten Sandset
- Oslo University Hospital Rikshospitalet, Department of Haematology and Research Institute of Internal Medicine, University of Oslo, Oslo, Norway.
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Ando H, Otoda T, Ookami H, Nagai Y, Inano A, Takamura T, Ushijima K, Hosohata K, Matsushita E, Saito T, Kaneko S, Fujimura A. Dosing time-dependent effect of raloxifene on plasma plasminogen activator inhibitor-1 concentrations in post-menopausal women with osteoporosis. Clin Exp Pharmacol Physiol 2013; 40:227-32. [DOI: 10.1111/1440-1681.12055] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 01/10/2013] [Accepted: 01/11/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Hitoshi Ando
- Division of Clinical Pharmacology; Department of Pharmacology; School of Medicine; Jichi Medical University; Shimotsuke; Japan
| | | | - Hitoshi Ookami
- Department of Orthopedics; Shin-Kaminokawa Hospital; Kaminokawa; Japan
| | | | - Akihiro Inano
- Hokuriku Clinical Research Supporting Center; Kanazawa; Japan
| | - Toshinari Takamura
- Department of Disease Control and Homeostasis; Kanazawa University Graduate School of Medical Science; Kanazawa; Japan
| | - Kentarou Ushijima
- Division of Clinical Pharmacology; Department of Pharmacology; School of Medicine; Jichi Medical University; Shimotsuke; Japan
| | - Keiko Hosohata
- Division of Clinical Pharmacology; Department of Pharmacology; School of Medicine; Jichi Medical University; Shimotsuke; Japan
| | - Eiki Matsushita
- Department of Internal Medicine; Kahoku Central Hospital; Tsubata; Japan
| | | | - Shuichi Kaneko
- Department of Disease Control and Homeostasis; Kanazawa University Graduate School of Medical Science; Kanazawa; Japan
| | - Akio Fujimura
- Division of Clinical Pharmacology; Department of Pharmacology; School of Medicine; Jichi Medical University; Shimotsuke; Japan
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Kendler DL, Palacios S, Cox DA, Stock J, Alam J, Dowsett SA, Zanchetta J. Arzoxifene versus raloxifene: effect on bone and safety parameters in postmenopausal women with osteoporosis. Osteoporos Int 2012; 23:1091-101. [PMID: 21374068 DOI: 10.1007/s00198-011-1587-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Accepted: 01/26/2011] [Indexed: 11/26/2022]
Abstract
UNLABELLED Arzoxifene increased bone mineral density and decreased bone turnover to a significantly greater extent than raloxifene. The hot flush incidence was lower with arzoxifene than raloxifene. INTRODUCTION To assess the effect of arzoxifene versus raloxifene on change in lumbar spine (LS) bone mineral density (BMD) in postmenopausal women with osteoporosis. METHODS In this 12-month study (NEXT trial), participants were randomly assigned to arzoxifene 20 mg/day (N = 158) or raloxifene 60 mg/day (N = 162). All received daily calcium and vitamin D. Change in LS BMD was assessed by DXA. Secondary objectives included assessment of femoral neck (FN) and total hip BMD, serum bone turnover markers, and safety. RESULTS Treatment groups were similar at baseline (mean age 63 years, mean LS BMD T-score -2.9). At 12 months, the increase in LS BMD with arzoxifene was greater than with raloxifene (+2.75% vs. +1.66%), as was FN and total hip BMD (P < 0.05). For LS and FN, this effect was also evident at 6 months. Arzoxifene reduced bone turnover to a greater extent than raloxifene at 3, 6, and 12 months (P < 0.05). The proportion of women reporting ≥ 1 adverse event did not differ between treatment groups, nor did vaginal bleeding. No cases of endometrial polyps, hyperplasia, or cancer were reported. Nasopharyngitis and bronchitis were reported more frequently with arzoxifene versus raloxifene (10.1% vs. 2.5%, and 5.1% vs. 0%, respectively) and new/worsening hot flushes were reported less frequently with arzoxifene (7.0% vs. 16.7%) (P < 0.05). CONCLUSIONS Arzoxifene increased BMD and suppressed bone turnover to a greater extent than raloxifene and resulted in a lower incidence of new/worsening hot flushes. Based on subsequent findings from a fracture outcome study, this difference did not translate into improved fracture efficacy.
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Affiliation(s)
- D L Kendler
- University of British Columbia, 600-1285 West Broadway, Vancouver, BC, Canada V6H 3X8.
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17
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Interaction between oral estrogen plus progestogen therapy and ABO blood groups on coagulation activation in postmenopausal women. Menopause 2012; 19:339-45. [DOI: 10.1097/gme.0b013e31822b721f] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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19
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Dahm AEA, Eilertsen AL, Goeman J, Olstad OK, Ovstebø R, Kierulf P, Mowinckel MC, Skretting G, Sandset PM. A microarray study on the effect of four hormone therapy regimens on gene transcription in whole blood from healthy postmenopausal women. Thromb Res 2012; 130:45-51. [PMID: 22217510 DOI: 10.1016/j.thromres.2011.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2011] [Revised: 11/09/2011] [Accepted: 12/02/2011] [Indexed: 01/20/2023]
Abstract
BACKGROUND Postmenopausal hormone therapy is associated with many diseases and conditions, e.g., cardiovascular diseases and asthma, but the underlying molecular mechanisms are incompletely understood. The aim of the current study was to investigate the effect of four different postmenopausal hormone therapy regimens on gene transcription. MATERIALS AND METHODS Twenty-four healthy postmenopausal women (six women in four groups) were randomly allocated to conventional-dose 17β-estradiol/norethisterone acetate (NETA), low-dose 17β-estradiol/NETA, tibolone, or raloxifene hydrochloride. RNA was isolated from whole blood before and after 6weeks of treatment. The changes in mRNA were assessed with a microarray chip. RESULTS The genes FKBP5, IL13RA1, TPST1, and TLR2 were up-regulated and among the most significantly changed genes in the groups treated with conventional-dose 17β-estradiol/NETA and tibolone. Up-regulation of TPST1 was associated with reduction of tissue factor pathway inhibitor in plasma. Nine biological pathways were associated with conventional-dose 17β-estradiol/NETA, most significantly the pathways for asthma, toll-like receptor signaling, cell adhesion molecules, and MAPK signaling. Transcriptional changes with false discovery rate below 0.10 were found in 10 genes in the conventional-dose 17β-estradiol/NETA group, 7 genes in the tibolone group, and zero genes in the women on low-dose 17β-estradiol/NETA. No genes or pathways were associated with raloxifene treatment. CONCLUSIONS The difference between low-dose and conventional-dose17β-estradiol/NETA indicates an effect of dose on transcriptional response. Several genes and pathways related to cell adhesion molecules and immunity related cell surface receptors were influenced by conventional-dose 17β-estradiol/NETA.
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Affiliation(s)
- Anders E A Dahm
- Department of Haematology, Oslo University Hospital, Oslo, Norway.
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20
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Progestogens and venous thromboembolism among postmenopausal women using hormone therapy. Maturitas 2011; 70:354-60. [DOI: 10.1016/j.maturitas.2011.10.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 10/03/2011] [Indexed: 01/09/2023]
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21
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Hellebrekers BWJ, Kooistra T. Pathogenesis of postoperative adhesion formation. Br J Surg 2011; 98:1503-16. [DOI: 10.1002/bjs.7657] [Citation(s) in RCA: 148] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2011] [Indexed: 01/13/2023]
Abstract
Abstract
Background
Current views on the pathogenesis of adhesion formation are based on the ‘classical concept of adhesion formation’, namely that a reduction in peritoneal fibrinolytic activity following peritoneal trauma is of key importance in adhesion development.
Methods
A non-systematic literature search (1960–2010) was performed in PubMed to identify all original articles on the pathogenesis of adhesion formation. Information was sought on the role of the fibrinolytic, coagulatory and inflammatory systems in the disease process.
Results
One unifying concept emerged when assessing 50 years of studies in animals and humans on the pathogenesis of adhesion formation. Peritoneal damage inflicted by surgical trauma or other insults evokes an inflammatory response, thereby promoting procoagulatory and antifibrinolytic reactions, and a subsequent significant increase in fibrin formation. Importantly, peritoneal inflammatory status seems a crucial factor in determining the duration and extent of the imbalance between fibrin formation and fibrin dissolution, and therefore in the persistence of fibrin deposits, determining whether or not adhesions develop.
Conclusion
Suppression of inflammation, manipulation of coagulation as well as direct augmentation of fibrinolytic activity may be promising antiadhesion treatment strategies.
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Affiliation(s)
- B W J Hellebrekers
- Department of Obstetrics and Gynaecology, Haga Teaching Hospital, The Hague, The Netherlands
| | - T Kooistra
- TNO Prevention and Health, Department of Biosciences, Gaubius Laboratory, Leiden, The Netherlands
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Regnault V, Perret-Guillaume C, Kearney-Schwartz A, Max JP, Labat C, Louis H, Wahl D, Pannier B, Lecompte T, Weryha G, Challande P, Safar ME, Benetos A, Lacolley P. Tissue Factor Pathway Inhibitor. Arterioscler Thromb Vasc Biol 2011; 31:1226-32. [DOI: 10.1161/atvbaha.110.221911] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
To investigate in women older than 60 whether aortic stiffness or pulse pressure (PP) is associated with selected procoagulant or anticoagulant factors and to examine whether pulsatile stretch influences these factors in human vascular smooth muscle cells (VSMCs) in vitro.
Methods and Results—
Aortic pulse wave velocity (PWV) and carotid PP were studied in 123 apparently healthy postmenopausal women. PWV, PP, von Willebrand factor, and free tissue factor pathway inhibitor (TFPI), but not mean arterial pressure, increased with age. Free TFPI and PWV were positively correlated, even after adjustment for age and PP and other confounding parameters. In vitro, 5% or 10% pulsatile stretch (at 1 Hz) enhanced TFPI synthesis and secretion by VSMCs in a time-independent manner (1 to 48 hours) without changes in protein level of smooth muscle myosin heavy chain. Application of 5% static stretch had no effect.
Conclusion—
In postmenopausal women, free TFPI increases as vascular wall function deteriorates and PP increases. These findings are supported by the increase in TFPI synthesized by VSMCs in response to cyclic stress in vitro. They suggest that VSMCs require pulsatility to interfere with the coagulation process and highlight the relevance of plasma free TFPI levels to cardiovascular diseases.
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Affiliation(s)
- Veronique Regnault
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Christine Perret-Guillaume
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Anna Kearney-Schwartz
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Jean-Pierre Max
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Carlos Labat
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Huguette Louis
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Denis Wahl
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Bruno Pannier
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Thomas Lecompte
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Georges Weryha
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Pascal Challande
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Michel E. Safar
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Athanase Benetos
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
| | - Patrick Lacolley
- From Institut National de la Santé et de la Recherche Médicale, U961, Vandoeuvre-les-Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., A.B., P.L.); Nancy Université, Nancy, France (V.R., J.-P.M., C.L., H.L., D.W., T.L., G.W., A.B., P.L.); Geriatric Department (C.P.-G., A.K.-S., A.B.) and Endocrinology Department (G.W.), Nancy Hospital, Nancy, France; Manhes Hospital, Fleury-Merogis, France (B.P.); University Pierre and Marie Curie, University of Paris 06, Centre National de la Recherche
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Opstad TB, Eilertsen AL, Høibraaten E, Skretting G, Sandset PM. Tissue factor pathway inhibitor polymorphisms in women with and without a history of venous thrombosis and the effects of postmenopausal hormone therapy. Blood Coagul Fibrinolysis 2011; 21:516-21. [PMID: 20453636 DOI: 10.1097/mbc.0b013e32833a06cd] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Postmenopausal hormone therapy is associated with marked reduction in tissue factor pathway inhibitor (TFPI) levels, and low TFPI levels have been associated with increased risk of venous thrombosis. Polymorphisms in the TFPI gene may affect the expression of TFPI. We aimed to investigate the influences of such polymorphisms on plasma TFPI levels and to investigate the effect of hormone therapy. Four single nucleotide polymorphisms in the TFPI gene (the -287T/C and the -399C/T polymorphisms in the 5' upstream region, and the intron 7 -33T/C and the exon 9 874G/A polymorphisms) were studied with regard to frequency, phenotype, and their influence on hormone therapy in postmenopausal women with a history of venous thrombosis (n = 138), in healthy postmenopausal women (n = 202), and in normal controls (n = 212). The frequencies of the -287C and the -33C variants were nonsignificantly lower in cases than in controls, and the polymorphisms were associated with slightly higher levels of free TFPI antigen (-287C; P = 0.076) and higher TFPI activity (-33C; P < 0.001). The -399T variant showed equal distribution in cases and controls, but was associated with lower levels of TFPI activity (P = 0.036). Conventional-dose hormone therapy induced significant reductions in TFPI levels irrespective of genotypes. In healthy women treated with low-dose hormone therapy, the reduction in TFPI levels was less pronounced with the -287C variant (P = 0.054). Our study indicates that polymorphisms in the TFPI gene may be of importance for plasma TFPI levels and for the effects of hormone therapy.
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Affiliation(s)
- Trine B Opstad
- Department of Hematology, Oslo University Hospital, Ulleval, Kirkeveien 166, Oslo, Norway
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van Hylckama Vlieg A, Middeldorp S. Hormone therapies and venous thromboembolism: where are we now? J Thromb Haemost 2011; 9:257-66. [PMID: 21114755 DOI: 10.1111/j.1538-7836.2010.04148.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- A van Hylckama Vlieg
- Leiden University Medical Center, Department of Clinical Epidemiology, Leiden, The Netherlands.
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25
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Renoux C, Dell'Aniello S, Suissa S. Hormone replacement therapy and the risk of venous thromboembolism: a population-based study. J Thromb Haemost 2010; 8:979-86. [PMID: 20230416 DOI: 10.1111/j.1538-7836.2010.03839.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
SUMMARY BACKGROUND Hormone replacement therapy (HRT) using oral estrogen alone or combined with a progestogen is associated with an increased risk of venous thromboembolism (VTE) in postmenopausal women. This risk may differ for tibolone and transdermal HRT. METHODS Among the United Kingdom's General Practice Research Database, we identified the cohort of all women aged 50-79 between 1 January 1987 and 1 March 2008. Using a nested case-control approach, all incident cases of VTE occurring during the study period were identified and matched with up to 10 controls selected from the cohort members. Rate ratios (RR) of VTE with current use of tibolone, transdermal and oral HRT were estimated using conditional logistic regression. RESULTS The cohort of 955 582 postmenopausal women included 23 505 cases of VTE matched with 231 562 controls. The risk of VTE was not increased with current use of transdermal estrogen alone (RR 1.01; 95% CI, 0.89-1.16) or combined with a progestogen (RR 0.96; 95% CI, 0.77-1.20), or with current use of tibolone (RR 0.92; 95% CI: 0.77-1.10), relative to non-use. On the other hand, the risk was increased with current use of oral estrogen (RR 1.49; 95% CI, 1.37-1.63) and oral estrogen-progestogen (RR 1.54; 95% CI, 1.44-1.65), and increased with estrogen dosage. The risks with oral formulations were particularly elevated during the first year of use but disappeared 4 months after discontinuation. CONCLUSION Transdermal HRT and tibolone were not associated with an increased risk of VTE in postmenopausal women.
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Affiliation(s)
- C Renoux
- McGill Pharmacoepidemiology Research Unit, Department of Epidemiology and Biostatistics, Jewish General Hospital, McGill University, Montreal, QC, Canada
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26
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Skouby SO, Sidelmann JJ, Nilas L, Gram J, Jespersen J. The effect of continuous combined conjugated equine estrogen plus medroxyprogesterone acetate and tibolone on cardiovascular metabolic risk factors. Climacteric 2009; 11:489-97. [DOI: 10.1080/13697130802455150] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Sandset PM, Høibraaten E, Eilertsen AL, Dahm A. Mechanisms of thrombosis related to hormone therapy. Thromb Res 2009; 123 Suppl 2:S70-3. [PMID: 19217481 DOI: 10.1016/s0049-3848(09)70015-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Combined oral contraceptives and combined oral postmenopausal hormone therapy are associated with a weak, but clinically significant risk of arterial and venous thrombosis (VT). The effects are related to dose of estrogen and type of progestin. The main effects are increase in markers of activated coagulation, reduction in coagulation inhibitors, and acquired activated protein C resistance. Reduction in tissue factor pathway inhibitor (TFPI) is probably an important mechanism, which predicts activation of coagulation and acquired resistance to activated protein C. Coagulation markers should be used as intermediate or surrogate markers in early pharmacodynamic studies to evaluate the risk associated with new formulations.
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Affiliation(s)
- Per Morten Sandset
- Oslo University Hospital at Ullevål, Department of Hematology, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
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