1
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Moore GW. Thrombophilia Screening: Not So Straightforward. Semin Thromb Hemost 2024. [PMID: 38733983 DOI: 10.1055/s-0044-1786807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2024]
Abstract
Although inherited thrombophilias are lifelong risk factors for a first thrombotic episode, progression to thrombosis is multifactorial and not all individuals with inherited thrombophilia develop thrombosis in their lifetimes. Consequently, indiscriminate screening in patients with idiopathic thrombosis is not recommended, since presence of a thrombophilia does not necessarily predict recurrence or influence management, and testing should be selective. It follows that a decision to undertake laboratory detection of thrombophilia should be aligned with a concerted effort to identify any significant abnormalities, because it will inform patient management. Deficiencies of antithrombin and protein C are rare and usually determined using phenotypic assays assessing biological activities, whereas protein S deficiency (also rare) is commonly detected with antigenic assays for the free form of protein S since available activity assays are considered to lack specificity. In each case, no single phenotypic assay is capable of detecting every deficiency, because the various mutations express different molecular characteristics, rendering thrombophilia screening repertoires employing one assay per potential deficiency, of limited effectiveness. Activated protein C resistance (APCR) is more common than discrete deficiencies of antithrombin, protein C, and protein S and also often detected initially with phenotypic assays; however, some centres perform only genetic analysis for factor V Leiden, as this is responsible for most cases of hereditary APCR, accepting that acquired APCR and rare F5 mutations conferring APCR will go undetected if only factor V Leiden is evaluated. All phenotypic assays have interferences and limitations, which must be factored into decisions about if, and when, to test, and be given consideration in the laboratory during assay performance and interpretation. This review looks in detail at performance and limitations of routine phenotypic thrombophilia assays.
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Affiliation(s)
- Gary W Moore
- Specialist Haemostasis Laboratory, Cambridge Haemophilia and Thrombophilia Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Department of Natural Sciences, Middlesex University, London, United Kingdom
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2
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Kacar M, Bhatt M. A Case of a Pediatric Patient With Protein S Heerlen Polymorphism and Deep Venous Thrombosis. J Pediatr Hematol Oncol 2022; 44:e442-e443. [PMID: 34486549 DOI: 10.1097/mph.0000000000002299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/16/2021] [Indexed: 11/25/2022]
Abstract
Hereditary protein S (PS) deficiency is a rare autosomal dominant disorder with increased risk of venous thromboembolism. The PS Heerlen polymorphism at codon 501 of the PROS1 gene is considered a variant of uncertain significance. It has since been shown that PS Heerlen has a reduced half-life, resulting in reduced levels of free PS. We report a case of an adolescent female with May Thurner syndrome and heterozygous PS Heerlen mutation resulting in a mild PS deficiency and venous thromboembolism. With this nonmodifiable risk factor, the patient received prolonged anticoagulation with strong consideration for lifelong prophylaxis.
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Affiliation(s)
- Marija Kacar
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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3
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Khider L, Gendron N, Mauge L. Inherited Thrombophilia in the Era of Direct Oral Anticoagulants. Int J Mol Sci 2022; 23:1821. [PMID: 35163742 PMCID: PMC8837096 DOI: 10.3390/ijms23031821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/28/2022] [Accepted: 01/29/2022] [Indexed: 12/13/2022] Open
Abstract
Severe inherited thrombophilia includes rare deficiencies of natural anticoagulants (antithrombin and proteins C and S) and homozygous or combined factor V Leiden and FII G20210A variants. They are associated with a high thrombosis risk and can impact the duration of anticoagulation therapy for patients with a venous thromboembolism (VTE) event. Therefore, it is important to diagnose thrombophilia and to use adapted anticoagulant therapy. The widespread use of direct anticoagulants (DOACs) for VTE has raised new issues concerning inherited thrombophilia. Concerning inherited thrombophilia diagnosis, DOACs are directed toward either FIIa or FXa and can therefore interfere with coagulation assays. This paper reports DOAC interference in several thrombophilia tests, including the assessment of antithrombin, protein S, and protein C activities. Antithrombin activity and clot-based assays used for proteins C and S can be overestimated, with a risk of missing a deficiency. The use of a device to remove DOACs should be considered to minimize the risk of false-negative results. The place of DOACs in the treatment of VTE in thrombophilia patients is also discussed. Available data are encouraging, but given the variability in thrombosis risk within natural anticoagulant deficiencies, evidence in patients with well-characterized thrombophilia would be useful.
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Affiliation(s)
- Lina Khider
- Service de Médecine Vasculaire, Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP), F-75015 Paris, France;
- Innovative Therapies in Haemostasis, Université de Paris, INSERM, F-75006 Paris, France;
- Biosurgical Research Lab (Carpentier Foundation), AP-HP, F-75015 Paris, France
| | - Nicolas Gendron
- Innovative Therapies in Haemostasis, Université de Paris, INSERM, F-75006 Paris, France;
- Biosurgical Research Lab (Carpentier Foundation), AP-HP, F-75015 Paris, France
- Service d’Hématologie Biologique, Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP), F-75015 Paris, France
| | - Laetitia Mauge
- Service d’Hématologie Biologique, Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP), F-75015 Paris, France
- PARCC, Université de Paris, INSERM, F-75015 Paris, France
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4
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de la Morena-Barrio ME, Bravo-Pérez C, de la Morena-Barrio B, Orlando C, Cifuentes R, Padilla J, Miñano A, Herrero S, Marcellini S, Revilla N, Bernal E, Gómez-Verdú JM, Jochmans K, Herranz MT, Vicente V, Corral J, Lozano ML. A pilot study on the impact of congenital thrombophilia in COVID-19. Eur J Clin Invest 2021; 51:e13546. [PMID: 33738814 PMCID: PMC8250296 DOI: 10.1111/eci.13546] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/08/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022]
Affiliation(s)
- Maria Eugenia de la Morena-Barrio
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - Carlos Bravo-Pérez
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - Belen de la Morena-Barrio
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - Christelle Orlando
- Department of Haematology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Rosa Cifuentes
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - Jose Padilla
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - Antonia Miñano
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - Sonia Herrero
- Servicio de Hematología, Hospital General Universitario de Guadalajara, Guadalajara, Spain
| | | | - Nuria Revilla
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - Enrique Bernal
- Sección de Enfermedades Infecciosas, Hospital Reina Sofía, Murcia, Spain
| | | | - Kristin Jochmans
- Department of Haematology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | | | - Vicente Vicente
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - Javier Corral
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
| | - María Luisa Lozano
- Servicio de Hematología y Oncología Médica, Centro Regional de Hemodonación, Hospital Universitario Morales Meseguer, Universidad de Murcia, IMIB-Arrixaca, CIBERER, Murcia, Spain
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5
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A rare coding mutation in the MAST2 gene causes venous thrombosis in a French family with unexplained thrombophilia: The Breizh MAST2 Arg89Gln variant. PLoS Genet 2021; 17:e1009284. [PMID: 33465109 PMCID: PMC7846112 DOI: 10.1371/journal.pgen.1009284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/29/2021] [Accepted: 11/18/2020] [Indexed: 11/19/2022] Open
Abstract
Rare variants outside the classical coagulation cascade might cause inherited thrombosis. We aimed to identify the variant(s) causing venous thromboembolism (VTE) in a family with multiple relatives affected with unprovoked VTE and no thrombophilia defects. We identified by whole exome sequencing an extremely rare Arg to Gln variant (Arg89Gln) in the Microtubule Associated Serine/Threonine Kinase 2 (MAST2) gene that segregates with VTE in the family. Free-tissue factor pathway inhibitor (f-TFPI) plasma levels were significantly decreased in affected family members compared to healthy relatives. Conversely, plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in affected members than in healthy relatives. RNA sequencing analysis of RNA interference experimental data conducted in endothelial cells revealed that, of the 13,387 detected expressed genes, 2,354 have their level of expression modified by MAST2 knockdown, including SERPINE1 coding for PAI-1 and TFPI. In HEK293 cells overexpressing the MAST2 Gln89 variant, TFPI and SERPINE1 promoter activities were respectively lower and higher than in cells overexpressing the MAST2 wild type. This study identifies a novel thrombophilia-causing Arg89Gln variant in the MAST2 gene that is here proposed as a new molecular player in the etiology of VTE by interfering with hemostatic balance of endothelial cells.
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6
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Marlar RA, Gausman JN, Tsuda H, Rollins-Raval MA, Brinkman HJM. Recommendations for clinical laboratory testing for protein S deficiency: Communication from the SSC committee plasma coagulation inhibitors of the ISTH. J Thromb Haemost 2021; 19:68-74. [PMID: 33405382 DOI: 10.1111/jth.15109] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 09/01/2020] [Accepted: 09/08/2020] [Indexed: 11/26/2022]
Abstract
Hereditary deficiencies of protein S (PS) increase the risk of venous thrombosis; however, assessing the plasma levels of PS can be difficult because of its complex physiological interactions in plasma, sample-related preanalytical variables, and numerous acquired disease processes. Reliable laboratory assays are essential for accurate evaluation of PS when diagnosing a congenital deficiency based on the plasma phenotype alone. This report presents the current evidence-based recommendations for clinical PS assays as well as when to test for PS abnormalities.
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Affiliation(s)
- Richard A Marlar
- Department of Pathology, TriCore Reference Laboratories, University of New Mexico, Albuquerque, NM, USA
| | - Jana N Gausman
- OU Medicine, Inc, Laboratory, University of Oklahoma Medical Center, Oklahoma City, OK, USA
| | - Hiroko Tsuda
- Department of Nutritional Sciences, Nakamura Gakuen University, Fukuoka, Japan
| | - Marian A Rollins-Raval
- Department of Pathology, TriCore Reference Laboratories, University of New Mexico, Albuquerque, NM, USA
| | - Herm Jan M Brinkman
- Department of Molecular and Cellular Hemostasis, Sanquin Research, Amsterdam, The Netherlands
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7
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A novel rare c.-39C>T mutation in the PROS1 5'UTR causing PS deficiency by creating a new upstream translation initiation codon. Clin Sci (Lond) 2020; 134:1181-1190. [PMID: 32426810 DOI: 10.1042/cs20200403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/13/2020] [Accepted: 05/19/2020] [Indexed: 01/18/2023]
Abstract
Autosomal dominant inherited Protein S deficiency (PSD) (MIM 612336) is a rare disorder caused by rare mutations, mainly located in the coding sequence of the structural PROS1 gene, and associated with an increased risk of venous thromboembolism. To identify the molecular defect underlying PSD observed in an extended French pedigree with seven PSD affected members in whom no candidate deleterious PROS1 mutation was detected by Sanger sequencing of PROS1 exons and their flanking intronic regions or via an multiplex ligation-dependent probe amplification (MLPA) approach, a whole genome sequencing strategy was adopted. This led to the identification of a never reported C to T substitution at c.-39 from the natural ATG codon of the PROS1 gene that completely segregates with PSD in the whole family. This substitution ACG→ATG creates a new start codon upstream of the main ATG. We experimentally demonstrated in HeLa cells that the variant generates a novel overlapping upstream open reading frame (uORF) and inhibits the translation of the wild-type PS. This work describes the first example of 5'UTR PROS1 mutation causing PSD through the creation of an uORF, a mutation that is not predicted to be deleterious by standard annotation softwares, and emphasizes the need for better exploration of such type of non-coding variations in clinical genomics.
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8
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Thibord F, Hardy L, Ibrahim-Kosta M, Saut N, Pulcrano-Nicolas AS, Goumidi L, Civelek M, Eriksson P, Deleuze JF, Le Goff W, Trégouët DA, Morange PE. A Genome Wide Association Study on plasma FV levels identified PLXDC2 as a new modifier of the coagulation process. J Thromb Haemost 2019; 17:1808-1814. [PMID: 31271701 DOI: 10.1111/jth.14562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/01/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Factor V (FV) is a circulating protein primarily synthesized in the liver, and mainly present in plasma. It is a major component of the coagulation process. OBJECTIVE To detect novel genetic loci participating to the regulation of FV plasma levels. METHODS We conducted the first Genome Wide Association Study on FV plasma levels in a sample of 510 individuals and replicated the main findings in an independent sample of 1156 individuals. RESULTS In addition to genetic variations at the F5 locus, we identified novel associations at the PLXDC2 locus, with the lead PLXDC2 rs927826 polymorphism explaining ~3.7% (P = 7.5 × 10-15 in the combined discovery and replication samples) of the variability of FV plasma levels. In silico transcriptomic analyses in various cell types confirmed that PLXDC2 expression is positively correlated to F5 expression. SiRNA experiments in human hepatocellular carcinoma cell line confirmed the role of PLXDC2 in modulating factor F5 gene expression, and revealed further influences on F2 and F10 expressions. CONCLUSION Our study identified PLXDC2 as a new molecular player of the coagulation process.
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Affiliation(s)
- Florian Thibord
- Pierre Louis Doctoral School of Public Health, Sorbonne-Université, Paris, France
- Institut National pour la Santé et la Recherche Médicale (INSERM) Unité Mixte de Recherche en Santé (UMR_S) 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- INSERM UMR_S 1166, Université Pierre et Marie Curie (UPMC Univ Paris 06), Sorbonne Université, Paris, France
| | - Lise Hardy
- INSERM UMR_S 1166, Université Pierre et Marie Curie (UPMC Univ Paris 06), Sorbonne Université, Paris, France
- ICAN Institute of Cardiometabolism and Nutrition, Paris, France
| | - Manal Ibrahim-Kosta
- Laboratory of Haematology, La Timone Hospital, Marseille, France
- C2VN, Aix Marseille Univ, INSERM, INRA, Marseille, France
| | - Noémie Saut
- Laboratory of Haematology, La Timone Hospital, Marseille, France
- C2VN, Aix Marseille Univ, INSERM, INRA, Marseille, France
| | - Anne-Sophie Pulcrano-Nicolas
- Pierre Louis Doctoral School of Public Health, Sorbonne-Université, Paris, France
- INSERM UMR_S 1166, Université Pierre et Marie Curie (UPMC Univ Paris 06), Sorbonne Université, Paris, France
- ICAN Institute of Cardiometabolism and Nutrition, Paris, France
| | - Louisa Goumidi
- C2VN, Aix Marseille Univ, INSERM, INRA, Marseille, France
| | - Mete Civelek
- Department of Biomedical Engineering, Center for Public Health Genomics, University of Virginia, Charlottesville, Virginia
| | - Per Eriksson
- Department of Medicine, Cardiovascular Medicine Unit, BioClinicum, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Solna, Sweden
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, Direction de la Recherche Fondamentale, CEA, Evry, France
- CEPH, Fondation Jean Dausset, Paris, France
| | - Wilfried Le Goff
- INSERM UMR_S 1166, Université Pierre et Marie Curie (UPMC Univ Paris 06), Sorbonne Université, Paris, France
- ICAN Institute of Cardiometabolism and Nutrition, Paris, France
| | - David-Alexandre Trégouët
- Institut National pour la Santé et la Recherche Médicale (INSERM) Unité Mixte de Recherche en Santé (UMR_S) 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
- INSERM UMR_S 1166, Université Pierre et Marie Curie (UPMC Univ Paris 06), Sorbonne Université, Paris, France
| | - Pierre-Emmanuel Morange
- Laboratory of Haematology, La Timone Hospital, Marseille, France
- C2VN, Aix Marseille Univ, INSERM, INRA, Marseille, France
- CRB Assistance Publique - Hôpitaux de Marseille, HemoVasc (CRB AP-HM HemoVasc), Marseille, France
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9
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Lindström S, Brody JA, Turman C, Germain M, Bartz TM, Smith EN, Chen MH, Puurunen M, Chasman D, Hassler J, Pankratz N, Basu S, Guan W, Gyorgy B, Ibrahim M, Empana JP, Olaso R, Jackson R, Brækkan SK, McKnight B, Deleuze JF, O’Donnell CJ, Jouven X, Frazer KA, Psaty BM, Wiggins KL, Taylor K, Reiner AP, Heckbert SR, Kooperberg C, Ridker P, Hansen JB, Tang W, Johnson AD, Morange PE, Trégouët DA, Kraft P, Smith NL, Kabrhel C. A large-scale exome array analysis of venous thromboembolism. Genet Epidemiol 2019; 43:449-457. [PMID: 30659681 PMCID: PMC6520188 DOI: 10.1002/gepi.22187] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/26/2018] [Accepted: 12/11/2019] [Indexed: 01/12/2023]
Abstract
Although recent Genome-Wide Association Studies have identified novel associations for common variants, there has been no comprehensive exome-wide search for low-frequency variants that affect the risk of venous thromboembolism (VTE). We conducted a meta-analysis of 11 studies comprising 8,332 cases and 16,087 controls of European ancestry and 382 cases and 1,476 controls of African American ancestry genotyped with the Illumina HumanExome BeadChip. We used the seqMeta package in R to conduct single variant and gene-based rare variant tests. In the single variant analysis, we limited our analysis to the 64,794 variants with at least 40 minor alleles across studies (minor allele frequency [MAF] ~0.08%). We confirmed associations with previously identified VTE loci, including ABO, F5, F11, and FGA. After adjusting for multiple testing, we observed no novel significant findings in single variant or gene-based analysis. Given our sample size, we had greater than 80% power to detect minimum odds ratios greater than 1.5 and 1.8 for a single variant with MAF of 0.01 and 0.005, respectively. Larger studies and sequence data may be needed to identify novel low-frequency and rare variants associated with VTE risk.
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Affiliation(s)
- Sara Lindström
- Department of Epidemiology, University of Washington, Seattle, United States
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, United States
| | - Jennifer A. Brody
- Department of Medicine, University of Washington, Seattle, United States
| | - Constance Turman
- Department of Epidemiology Harvard TH Chan School of Public Health, Boston, United States
| | - Marine Germain
- University of Bordeaux, Inserm 1219, Bordeaux Population Health Research Center, Bordeaux, France
| | - Traci M. Bartz
- Department of Medicine, University of Washington, Seattle, United States
- Department of Biostatistics University of Washington, Seattle, United States
| | - Erin N. Smith
- Department of Pediatrics and Rady Children’s Hospital University of California, San Diego, La Jolla, United State
- Department of Clinical Medicine, UiT - The Arctic University of Norway, K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Tromsø, Norway
| | - Ming-Huei Chen
- Population Sciences Branch, National Heart, Lung and Blood Institute’s The Framingham Heart Study, Framingham, United States
| | - Marja Puurunen
- School of Medicine, Boston University, Boston, United States
| | - Daniel Chasman
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, United States
| | - Jeffrey Hassler
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, United States
| | - Nathan Pankratz
- Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, USA
| | - Saonli Basu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA
| | - Beata Gyorgy
- Team Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, UPMC Univ. Paris 06, INSERM, UMR_S 1166, Paris, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Manal Ibrahim
- Laboratory of Haematology, La Timone Hospital, Marseille, France
- Aix-Marseille University, INSERM, INSERM, INRA, C2VN, Marseille, France
- CRB Assistance Publique Hopitaux de Marseille HemoVasc, Marseille, France
| | - Jean-Philippe Empana
- Department of Epidemiology, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR_S 970, Paris, France
- Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Robert Olaso
- Centre National de Recherche en Génomique Humaine (CNRGH), Direction de la Recherche Fondamentale, CEA, Institut de Biologie François Jacob, Evry, France
| | | | - Sigrid K. Brækkan
- Department of Clinical Medicine, UiT - The Arctic University of Norway, K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Barbara McKnight
- Department of Biostatistics University of Washington, Seattle, United States
| | - Jean-Francois Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Direction de la Recherche Fondamentale, CEA, Institut de Biologie François Jacob, Evry, France
| | | | - Xavier Jouven
- Department of Epidemiology, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR_S 970, Paris, France
- Department of Cardiology, Georges Pompidou European Hospital, APHP, Paris, France
| | - Kelly A. Frazer
- Department of Pediatrics and Rady Children’s Hospital University of California, San Diego, La Jolla, United State
- Department of Clinical Medicine, UiT - The Arctic University of Norway, K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Tromsø, Norway
- Institute for Genomic Medicine, University of California, San Diego, La Jolla, United States
| | - Bruce M. Psaty
- Department of Epidemiology, University of Washington, Seattle, United States
- Department of Medicine, University of Washington, Seattle, United States
- Department of Health Services, University of Washington, Seattle, United States
- Kaiser Permanente Washington Research Institute, Kaiser Permanente Washington, Seattle, United States
| | - Kerri L. Wiggins
- Department of Medicine, University of Washington, Seattle, United States
| | | | - Alexander P. Reiner
- Department of Epidemiology, University of Washington, Seattle, United States
| | - Susan R. Heckbert
- Department of Epidemiology, University of Washington, Seattle, United States
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, United States
| | - Paul Ridker
- Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, United States
| | - John-Bjarne Hansen
- Department of Clinical Medicine, UiT - The Arctic University of Norway, K.G. Jebsen Thrombosis Research and Expertise Center (TREC), Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Weihong Tang
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, United States
| | - Andrew D. Johnson
- Population Sciences Branch, National Heart, Lung and Blood Institute’s The Framingham Heart Study, Framingham, United States
| | - Pierre-Emmanuel Morange
- Laboratory of Haematology, La Timone Hospital, Marseille, France
- Aix-Marseille University, INSERM, INSERM, INRA, C2VN, Marseille, France
- CRB Assistance Publique Hopitaux de Marseille HemoVasc, Marseille, France
| | - David A. Trégouët
- University of Bordeaux, Inserm 1219, Bordeaux Population Health Research Center, Bordeaux, France
| | - Peter Kraft
- Department of Epidemiology Harvard TH Chan School of Public Health, Boston, United States
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, United States
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, Seattle, United States
- Kaiser Permanente Washington Research Institute, Kaiser Permanente Washington, Seattle, United States
- Department of Veteran Affairs Office of Research and Development, Seattle Epidemiologic Research and Information Center, Seattle, United States
| | - Christopher Kabrhel
- Center for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General Hospital, Boston, United States
- Channing Network Medicine, Brigham and Women’s Hospital, Boston, United States
- Harvard Medical School, Boston, United States
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10
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Minor allele of the factor V K858R variant protects from venous thrombosis only in non-carriers of factor V Leiden mutation. Sci Rep 2019; 9:3750. [PMID: 30842582 PMCID: PMC6403374 DOI: 10.1038/s41598-019-40172-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 02/06/2019] [Indexed: 11/29/2022] Open
Abstract
Factor V serves an important role in the regulation of blood coagulation. The rs6025 (R534Q) and rs4524 (K858R) polymorphisms in the F5 gene, are known to influence the risk of venous thrombosis. While the rare Q534 (factor V Leiden) allele is associated with an increased risk of venous thrombosis, the minor R858 allele is associated with a lower risk of disease. However, no study has deeply examined the cumulative impact of these two variations on venous thrombosis risk. We study the association of these polymorphisms with the risk of venous thrombosis in 4 French case-control populations comprising 3719 patients and 4086 controls. We demonstrate that the Q534 allele has a dominant effect over R858. Besides, we show that in individuals not carrying the Q534 allele, the protective effect of the R858 allele acts in a dominant mode. Thrombin generation-based normalized activated protein C sensitivity ratio was lower in the 858R/R homozygotes than in the 858K/K homozygotes (1.92 ± 1.61 vs 2.81 ± 1.57, p = 0.025). We demonstrate that the R858 allele of the F5 rs4524 variant protects from venous thrombosis only in non-carriers of the Q534 allele of the F5 rs6025. Its protective effect is mediated by reduced factor VIII levels and reduced activated protein C resistance.
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Trégouët DA, Morange PE. What is currently known about the genetics of venous thromboembolism at the dawn of next generation sequencing technologies. Br J Haematol 2018; 180:335-345. [PMID: 29082522 DOI: 10.1111/bjh.15004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Venous thromboembolism (VTE) has a strong genetic component. This review summarizes what is known at the seventeen genes that are now well established to harbour VTE-associated genetic variants. In addition, it discusses additional candidate genes that deserve further validation before being claimed as VTE associated genes. Finally, several research strategies are briefly described to identify other molecular determinants of the disease.
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Affiliation(s)
- David-Alexandre Trégouët
- Department of Genomics & Pathophysiology of Cardiovascular Diseases, Sorbonne Universités, UPMC Univ. Paris 06, Institut National pour la Santé et la Recherche Médicale (INSERM), Unité Mixte de Recherche en Santé (UMR_S) 1166, Paris, France
- ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Pierre-Emmanuel Morange
- Laboratory of Haematology, La Timone Hospital, Marseille, France
- INSERM UMR_S 1062, Nutrition Obesity and Risk of Thrombosis, Aix-Marseille University, Marseille, France
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