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Wang L, Ran L, Tian Y, Jin Y, Yi J, He X. Effect of thrombomodulin gene polymorphisms on venous thromboembolism: An analysis of evidence involving 6,629 patients. Vascular 2024; 32:374-384. [PMID: 36278273 DOI: 10.1177/17085381221135698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
BACKGROUD The association between thrombomodulin gene (THBD) c.1418 C>T polymorphisms and the risk of venous thromboembolism (VTE) is controversial. The purpose of this meta-analysis was to evaluate THBD c.1418 C>T polymorphisms and the risk of VTE. METHODS Computer searches were performed on the CNKI, Wanfang database, VIP database, PubMed, Embase, Web of Science, and Cochrane Library databases. The retrieval time limit was from the establishment of the database to June 2022. Case-control studies and cohort studies of THBD c.1418 C>T polymorphisms associated with VTE were included. The literature was screened according to inclusion and exclusion criteria, data extraction and literature quality evaluation. Meta-analysis was performed using STATA 14.0 software. RESULTS A total of 12 literature were included, including 2980 cases in the case group and 3649 cases in the control group. The meta-analysis results showed no significant association of the THBD c.1418 C> T polymorphisms with the occurrence of VTE (T vs C: OR = 1.17, 95%CI = 0.93-1.48; TT vs CT+CC: OR = 1.00, 95%CI = 0.75-1.33; TT+CT vs CC: OR = 1.22, 95%CI = 0.94-1.59). Subgroup analyses revealed an increased risk of VTE in Asian populations due to THBD c.1418 C>T polymorphisms (T vs C: OR = 1.48, 95%CI = 1.06-2.07; TT vs CT+CC: OR = 1.80, 95%CI = 1.13-2.85; TT+CT vs CC: OR = 1.58, 95%CI = 1.07-2.32). THBD c.1418 C>T polymorphisms increased the risk of DVT (T vs C: OR = 1.51, 95%CI = 1.24-1.85; TT vs CT+CC: OR = 1.85, 95%CI = 1.10-3.12; TT+CT vs CC: OR = 1.64, 95%CI = 1.28-2.11). THBD c.1418 C>T polymorphisms reduced the risk of VTE in non-Asian populations (TT vs CT+CC: OR = 0.66, 95%CI = 0.45-0.98). CONCLUSION THBD c.1418 C>T polymorphisms is associated with VTE in Asian population, which may be a factor in the occurrence of VTE in Asian population. THBD c.1418 C>T polymorphisms increases the risk of DVT. Given the limitations of this meta-analysis, the conclusions require being further supported by large-scale and high-quality studies.
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Affiliation(s)
- Lang Wang
- Nursing Department, Zhuzhou Central Hospital, Zhuzhou, China
| | - Luqin Ran
- Department of Oncology, Chongqing General Hospital, Chomgqing, China
| | - Yanzhen Tian
- Nursing Department, Zhuzhou Central Hospital, Zhuzhou, China
| | - Yunrui Jin
- Department of Oncology, Chongqing General Hospital, Chomgqing, China
| | - Jinhua Yi
- Operating Theater, Zhuzhou Central Hospital, Zhuzhou, China
| | - Xiaoyuan He
- Nursing Department, Zhuzhou Central Hospital, Zhuzhou, China
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2
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Sachs UJ, Kirsch-Altena A, Müller J. Markers of Hereditary Thrombophilia with Unclear Significance. Hamostaseologie 2022; 42:370-380. [PMID: 36549289 DOI: 10.1055/s-0042-1757562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Thrombophilia leads to an increased risk of venous thromboembolism. Widely accepted risk factors for thrombophilia comprise deficiencies of protein C, protein S, and antithrombin, as well as the factor V "Leiden" mutation, the prothrombin G20210A mutation, dysfibrinogenemia, and, albeit less conclusive, increased levels of factor VIII. Besides these established markers of thrombophilia, risk factors of unclear significance have been described in the literature. These inherited risk factors include deficiencies or loss-of-activity of the activity of ADAMTS13, heparin cofactor II, plasminogen, tissue factor pathway inhibitor (TFPI), thrombomodulin, protein Z (PZ), as well as PZ-dependent protease inhibitor. On the other hand, thrombophilia has been linked to the gain-of-activity, or elevated levels, of α2-antiplasmin, angiotensin-converting enzyme, coagulation factors IX (FIX) and XI (FXI), fibrinogen, homocysteine, lipoprotein(a), plasminogen activator inhibitor-1 (PAI-1), and thrombin-activatable fibrinolysis inhibitor (TAFI). With respect to the molecular interactions that may influence the thrombotic risk, more complex mechanisms have been described for endothelial protein C receptor (EPCR) and factor XIII (FXIII) Val34Leu. With focus on the risk for venous thrombosis, the present review aims to give an overview on the current knowledge on the significance of the aforementioned markers for thrombophilia screening. According to the current knowledge, there appears to be weak evidence for a potential impact of EPCR, FIX, FXI, FXIII Val34Leu, fibrinogen, homocysteine, PAI-1, PZ, TAFI, and TFPI on the thrombotic risk.
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Affiliation(s)
- Ulrich J Sachs
- Department of Thrombosis and Haemostasis, Giessen University Hospital, Giessen, Germany.,Institute for Clinical Immunology, Transfusion Medicine and Haemostasis, Justus Liebig University, Giessen, Germany
| | - Anette Kirsch-Altena
- Department of Thrombosis and Haemostasis, Giessen University Hospital, Giessen, Germany
| | - Jens Müller
- Institute for Experimental Haematology and Transfusion Medicine, Bonn University Hospital, Bonn, Germany
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3
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Mehic D, Tolios A, Hofer S, Ay C, Haslacher H, Downes K, Haimel M, Pabinger I, Gebhart J. Thrombomodulin in patients with mild to moderate bleeding tendency. Haemophilia 2021; 27:1028-1036. [PMID: 34628704 PMCID: PMC9293080 DOI: 10.1111/hae.14433] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/27/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
Introduction A massive increase of soluble thrombomodulin (sTM) due to variants in the thrombomodulin gene (THBD) has recently been identified as a novel bleeding disorder. Aim To investigate sTM levels and underlying genetic variants as a cause for haemostatic impairment and bleeding in a large number of patients with a mild to moderate bleeding disorder (MBD), including patients with bleeding of unknown cause (BUC). Patients and methods In 507 MBD patients, sTM levels, thrombin generation and plasma clot formation were measured and compared to 90 age‐ and sex‐matched healthy controls. In patients, genetic analysis of the THBD gene was performed. Results No difference in sTM levels between patients and controls was found overall (median ([IQR] 5.0 [3.8‐6.3] vs. 5.1 [3.7‐6.4] ng/ml, p = .762), and according to specific diagnoses of MBD or BUC, and high sTM levels (≥95th percentile of healthy controls) were not overrepresented in patients. Soluble TM levels had no impact on bleeding severity or global tests of haemostasis, including thrombin generation or plasma clot formation. In the THBD gene, no known pathogenic or novel disease‐causing variants affecting sTM plasma levels were identified in our patient cohort. Conclusion TM‐associated coagulopathy appears to be rare, as it was not identified in our large cohort of patients with MBD. Soluble TM did not arise as a risk factor for bleeding or altered haemostasis in these patients.
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Affiliation(s)
- Dino Mehic
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Alexander Tolios
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.,Institute of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria.,Institute for Artificial Intelligence and Decision Support, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Stefanie Hofer
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Cihan Ay
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Kate Downes
- Department of Haematology, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.,Cambridge Biomedical Campus, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Matthias Haimel
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria
| | - Ingrid Pabinger
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Johanna Gebhart
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
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4
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Zhang P, Gong K, Zhang L, Xiao L, Guo S, Li Y, Zhang J. The associations between THBD c.1418C>T polymorphism and lower extremity deep vein thrombosis or endothelial progenitor cell. INT ANGIOL 2021; 40:381-387. [PMID: 34236150 DOI: 10.23736/s0392-9590.21.04596-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Studies have shown that the thrombomodulin gene (THBD) c.1418C>T polymorphism is associated with a variety of cardiovascular diseases. However, the study of THBD c.1418C>T polymorphism in deep vein thrombosis (DVT) is rare. This study aimed to reveal the correlation between the THBD c.1418C>T mutation and the occurrence of DVT, and to reveal partial molecular mechanism of endothelial progenitor cells (EPCs) participating in the onset of DVT. METHODS Whole blood samples of patients with lower extremity DVT (n = 100) and normal volunteers (n = 100) were collected to analyze the distribution of genotype of THBD c.1418C>T polymorphism using PCR and DNA sequencing. The pCMV6-entry vectors containing wild-type (WT) or mutated THBD cDNA (p. Ala473Val) were transfected into bone marrow derived EPCs. And the successful transfection of recombinant THBD and the stable expression of p. Ala473Val variant were determined by ELISA, respectively. Wound healing assay and Transwell migration assay were used to determine the migration ability of EPCs, and the cell angiogenesis ability was determined by tube formation assay. Western blotting was used to detect the expression level of related proteins. RESULTS The frequencies of CC, CT and TT genotypes were 56%, 36%, 8% in patients with lower extremity DVT and 72%, 25%, 3% in controls group, respectively, and THBD c.1418C>T polymorphism was related with increased risk of DVT, especially in women. High level of p. Ala473Val variant inhibited the EPCs migration, the p. Ala473Val variant significantly decreased the activation of protein C and the expressions of VEGFRs and MMP1, MMP2, MMP3. Furthermore, p. Ala473Val variant also weaken the angiogenesis of EPCs and decreased the expression level of VE-cadherin, Flk-1, eNOS, and TIE-2. CONCLUSIONS THBD c.1418C>T polymorphism is related with the lower extremity DVT, this may partially because of the inhibition of migration and angiogenesis of EPCs.
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Affiliation(s)
- Peng Zhang
- Department of General Surgery, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Kunmei Gong
- Department of General Surgery, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Lili Zhang
- Department of General Surgery, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Le Xiao
- Department of General Surgery, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Shikui Guo
- Department of General Surgery, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Yu Li
- Department of General Surgery, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China.,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
| | - Jian Zhang
- Department of General Surgery, the First People's Hospital of Yunnan Province, Kunming, Yunnan, China - .,The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China
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5
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Wei M, Xue X, Pan Y, Wu Y. Relationship between thrombomodulin gene polymorphism and susceptibility to venous thromboembolism: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25001. [PMID: 33725974 PMCID: PMC7982147 DOI: 10.1097/md.0000000000025001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Previous studies displayed that thrombomodulin gene polymorphisms are closely associated with venous thromboembolism (VTE), while the results are inconsistent. Therefore, we conducted a meta-analysis to accurately determine the association between thrombomodulin gene polymorphism and the risk of VTE. METHODS Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, EmBase, and Web of Science databases were searched, and the time to build the database was set until January 2021. The association between thrombomodulin gene polymorphism and the risk of VTE was evaluated. Meta-analysis was performed with STATA 16.0 software, and the odds ratio and its 95% confidence interval were applied to estimate the relationship between thrombomodulin gene polym'orphism and the risk of VTE. RESULTS The results of this meta-analysis will be submitted to a peer-reviewed journal for publication. CONCLUSION This meta-analysis will summarize the relationship between thrombomodulin genepolymorphism and VTE risk. ETHICS AND DISSEMINATION Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/UEHJP.
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Affiliation(s)
| | | | | | - Yan Wu
- Department of Pharmacy, Xiashayuan District of Sir Run Run Shaw Hospital affiliated to Medical College of Zhejiang University, Hangzhou, Zhejiang Province, China
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6
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Tang N, Pan Y, Xu C, Li D. Characteristics of emergency patients with markedly elevated D-dimer levels. Sci Rep 2020; 10:7784. [PMID: 32385325 PMCID: PMC7210267 DOI: 10.1038/s41598-020-64853-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/23/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Markedly elevated D-dimer levels can occur in emergency patients with various clinical situations, and is likely to indicate the presence of coagulopathy, rapid differential diagnosis was crucial for them. METHODS D-dimer was detected in consecutive 813 patients entering the emergency department of our hospital, for the patients with D-dimer levels above 5.0 µg/mL, the final diagnoses and 28-day mortality were confirmed, and the levels of thrombomodulin (TM), thrombin-antithrombin complex (TAT) and plasmin-antiplasmin complex (PAP) on admission were detected. RESULTS There were 148 emergency patients with D-dimer levels higher than 5.0 µg/mL mainly due to sepsis, malignancy, trauma, venous thromboembolism (VTE), cerebrovascular accident, and so on. Both of the TM and TAT levels among these diagnoses were significantly different (p < 0.001). The elevated TM (>13.3 TU/mL) had a predictive value of 96.0% for excluding VTE, and the normal TM had a predictive value of 90.4% for excluding sepsis. The overall 28-day mortality of these patients with D-dimer >5.0 ug/mL was 14.2%, the TAT level on admission was independently associated with 28-day mortality (odds ratio 1.014, 95% CI 1.001-1.027, P = 0.030). CONCLUSIONS The medical emergencies associated with markedly elevated D-dimer levels were revealed, specific markers of endothelial dysfunction and thrombin generation measured by automatic analyzer have the potential to distinguish diagnoses and predict outcomes in these patients.
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Affiliation(s)
- Ning Tang
- Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Yinyin Pan
- Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chao Xu
- Department of Clinical Laboratory, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dengju Li
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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7
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Rachakonda SP, Dai H, Penack O, Blau O, Blau IW, Radujkovic A, Müller-Tidow C, Kumar R, Dreger P, Luft T. Single Nucleotide Polymorphisms in CD40L Predict Endothelial Complications and Mortality After Allogeneic Stem-Cell Transplantation. J Clin Oncol 2018; 36:789-800. [DOI: 10.1200/jco.2017.76.4662] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Purpose Endothelial vulnerability is a potential risk factor for complications after allogeneic stem-cell transplantation (alloSCT). The CD40/CD40 ligand (CD40L) axis contributes to inflammatory diseases and is upregulated in endothelial cells upon activation, suggesting a role in alloSCT biology. Here, we studied single nucleotide polymorphisms (SNPs) in the CD40L gene in recipients of alloSCT. Patients and Methods Three CD40L SNPs (rs3092920, rs3092952, rs3092936) were analyzed for association with transplant-associated thrombotic microangiopathy, overall nonrelapse mortality (NRM), and NRM after acute graft-versus-host disease in 294 recipients of alloSCT without statin-based endothelial prophylaxis (SEP). The significant genotype was then put into perspective with established thrombomodulin ( THBD) gene polymorphisms. Findings were validated in an independent cohort without SEP and in an additional 344 patients who received SEP. Results The rs3092936 CC/CT genotype was associated with an increased risk of transplant-associated thrombotic microangiopathy ( P = .001), overall NRM ( P = .03), and NRM after acute graft-versus-host disease ( P = .01). The rs3092936 CC/CT genotype was largely mutually exclusive of high-risk THBD SNPs. Both CD40L and THBD SNPs predicted adverse overall survival (OS) and overall NRM to a similar extent in training cohort (OS, P = .04; NRM, P < .001) and validation cohort (OS, P = .01; NRM, P = .001) without SEP. In contrast, SEP completely abolished the influence of the high-risk CD40L and THBD SNPs ( P = .40). Conclusion An increased risk of endothelial complications can be predicted before alloSCT by genetic markers in the recipient’s genome. The normalization of mortality risks in patients treated with SEP suggests a way of overcoming the negative effect of high-risk genotypes and warrants further clinical validation.
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Affiliation(s)
- Sivaramakrishna P. Rachakonda
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Hao Dai
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Olaf Penack
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Olga Blau
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Igor Wolfgang Blau
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Aleksandar Radujkovic
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Carsten Müller-Tidow
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Rajiv Kumar
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Peter Dreger
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
| | - Thomas Luft
- Sivaramakrishna P. Rachakonda, Hao Dai, and Rajiv Kumar, German Cancer Research Centre; Sivaramakrishna P. Rachakonda, Aleksandar Radujkovic, Carsten Müller-Tidow, Peter Dreger, and Thomas Luft, University Hospital Heidelberg, Heidelberg; and Olaf Penack, Olga Blau, and Igor Wolfgang Blau, Charité University Medicine Berlin, Berlin, Germany
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8
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Quintero-Ronderos P, Mercier E, Gris JC, Esteban-Perez C, Moreno-Ortiz H, Fonseca DJ, Lucena E, Vaiman D, Laissue P. THBD sequence variants potentially related to recurrent pregnancy loss. Reprod Biol Endocrinol 2017; 15:92. [PMID: 29195508 PMCID: PMC5709961 DOI: 10.1186/s12958-017-0311-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/22/2017] [Indexed: 01/13/2023] Open
Abstract
Recurrent pregnancy loss (RPL) is a frequently occurring disease, which is classified as idiopathic in more than 50% of cases. THBD, the endothelial cell receptor for thrombin, has been associated with distinct biological processes and considered a coherent RPL-related candidate gene. In the present study, we have sequenced the complete coding region of THBD in 262 patients affected by RPL. Bioinformatics analysis and screening of controls strongly suggested that the THBD-p.Trp153Gly mutation might be related to RPL aetiology. It could be used, after its validation by functional assays, as a molecular marker for diagnostic/prognostic purposes.
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Affiliation(s)
- Paula Quintero-Ronderos
- 0000 0001 2205 5940grid.412191.eCenter For Research in Genetics and Genomics-CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 N° 63C, -69 Bogotá, Colombia
| | - Eric Mercier
- 0000 0004 0593 8241grid.411165.6Department of Haematology, University Hospital, Nîmes, France
- 0000 0001 2097 0141grid.121334.6Faculty of Pharmacy and Biological Sciences and Research Team EA 2992, University of Montpellier, Montpellier, France
| | - Jean-Christophe Gris
- 0000 0004 0593 8241grid.411165.6Department of Haematology, University Hospital, Nîmes, France
- 0000 0001 2097 0141grid.121334.6Faculty of Pharmacy and Biological Sciences and Research Team EA 2992, University of Montpellier, Montpellier, France
| | - Clara Esteban-Perez
- Department of Reproductive Genetics, Fertility and Sterility Colombian Center, Bogotá, Colombia
| | - Harold Moreno-Ortiz
- Department of Reproductive Genetics, Fertility and Sterility Colombian Center, Bogotá, Colombia
| | - Dora Janeth Fonseca
- 0000 0001 2205 5940grid.412191.eCenter For Research in Genetics and Genomics-CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 N° 63C, -69 Bogotá, Colombia
| | - Elkin Lucena
- Department of Reproductive Genetics, Fertility and Sterility Colombian Center, Bogotá, Colombia
| | - Daniel Vaiman
- 0000 0001 2112 9282grid.4444.0Institut Cochin, Université Paris Descartes, CNRS (UMR 8104), Paris, France
- 0000000121866389grid.7429.8Inserm, U1016, Paris, France
| | - Paul Laissue
- 0000 0001 2205 5940grid.412191.eCenter For Research in Genetics and Genomics-CIGGUR, GENIUROS Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 N° 63C, -69 Bogotá, Colombia
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9
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Franchini M, Martinelli I, Mannucci PM. Uncertain thrombophilia markers. Thromb Haemost 2017; 115:25-30. [DOI: 10.1160/th15-06-0478] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 07/03/2015] [Indexed: 11/05/2022]
Abstract
SummaryThe development of venous thromboembolism (VTE), which includes deep-vein thrombosis and pulmonary embolism, may be associated with inherited or acquired risk factors that can be measured in plasma or DNA testing. The main inherited thrombophilias include the plasma deficiencies of the natural anticoagulants antithrombin, protein C and S; the gain-of-function mutations factor V Leiden and prothrombin G20210A; some dysfibrinogenaemias and high plasma levels of coagulation factor VIII. Besides these established biomarkers, which usually represent the first-level laboratory tests for thrombophilia screening, a number of additional abnormalities have been less consistently associated with an increased VTE risk. These uncertain causes of thrombophilias will be discussed in this narrative review, focusing on their clinical impact and the underlying pathogenetic mechanisms. Currently, there is insufficient ground to recommend their inclusion within the framework of conventional thrombophilia testing.
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10
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Sane M, Granér M, Laukkanen JA, Harjola VP, Mustonen P. Plasma levels of haemostatic factors in patients with pulmonary embolism on admission and seven months later. Int J Lab Hematol 2017; 40:66-71. [PMID: 28868636 DOI: 10.1111/ijlh.12729] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 07/20/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION With the exception of D-dimer, not much is known about the plasma levels of haemostatic factors during acute venous thromboembolism (VTE) compared to their basic levels in a stable phase. The goal of this study was to examine how plasma levels of factor V, VIII, XIIIa, von Willebrand factor antigen (vWF:Ag), fibrinogen, thrombomodulin evolve from the point of diagnosis of acute VTE to the end of standard treatment period. METHODS Sixty-three consecutive patients (mean 57, range 18-86 years, 33 females) with acute pulmonary embolism (PE) were included. Laboratory samples were collected upon arrival (acute phase) and seven months later (stable phase). Fifteen similar aged individuals served as controls. RESULTS Plasma levels of factor XIIIa (87.5% vs 117.7%, P < .001) and soluble thrombomodulin (36.6 vs 47.5 ng/L, P < .001) were lower, whereas plasma levels of vWF:Ag (2.66 vs 2.01 IU/mL, P < .001) and fibrinogen (4.3 vs 3.9 g/L, P < .05) were higher on admission compared to the stable phase. In the stable phase, vWF:Ag (2.01 vs 1.43 IU/mL, P < .01) and soluble thrombomodulin (47.5 vs 38.0 ng/mL, P < .05), but not FXIIIa levels, were higher in PE patients compared to healthy controls. CONCLUSION This study confirms the concept of FXIIIa consumption during acute phase of VTE by showing its intraindividual normalization during the follow-up. vWF:Ag, known to be associated with the risk of VTE, was constantly elevated in the majority of the patients. Soluble thrombomodulin levels were lower in acute phase compared to stable phase, a finding which significance needs to be evaluated in the future.
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Affiliation(s)
- M Sane
- Department of Internal Medicine, Jyväskylä Central Hospital, Jyvaskyla, Finland
| | - M Granér
- Heart and Lung Center, Cardiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J A Laukkanen
- Department of Internal Medicine, Jyväskylä Central Hospital, Jyvaskyla, Finland.,Department of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - V-P Harjola
- Emergency Medicine, University of Helsinki, Helsinki, Finland.,Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland
| | - P Mustonen
- Department of Internal Medicine, Jyväskylä Central Hospital, Jyvaskyla, Finland
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11
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Hu B, Wang QY, Tang L, Hu Y. Association of thrombomodulin c.1418C > T polymorphism and venous thromboembolism. Gene X 2017; 628:56-62. [DOI: 10.1016/j.gene.2017.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 06/30/2017] [Accepted: 07/10/2017] [Indexed: 01/11/2023] Open
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12
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Failure to replicate thrombomodulin genetic variant predictors of venous thromboembolism in African Americans. Blood 2017; 130:688-690. [PMID: 28619983 DOI: 10.1182/blood-2017-03-771329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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13
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A Thrombomodulin Gene Polymorphism (C1418T) Is Associated with Early Outcomes in Patients Undergoing Coronary Artery Bypass Graft Surgery with a Conventional Cardiopulmonary Bypass during Hospitalization. MEDICINES 2017; 4:medicines4020022. [PMID: 28930238 PMCID: PMC5590058 DOI: 10.3390/medicines4020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/20/2017] [Accepted: 04/20/2017] [Indexed: 11/17/2022]
Abstract
Background: Thrombomodulin (TM) is a type of cell membrane-bound anticoagulant protein cofactor in the thrombin-mediated activation of protein C. Previous evidence has shown an association between TM polymorphisms and systemic inflammation. Conventional cardiopulmonary bypass (CPB), beating-heart CPB, and off-pump techniques have been widely used in cardiac surgery. However, these techniques may also cause systemic inflammatory responses in the patients. Whether TM polymorphisms are associated with systemic inflammation after cardiac surgery is still unclear. Methods: We analyzed the TM gene C1418T polymorphisms in 347 patients who underwent coronary artery bridge graft (CABG) surgery using allele-specific primers in a PCR assay. The clinical data during the hospital stay were collected and tested for correlations with the TM gene C1418T polymorphisms. Results: We separated the patients into two groups based on their TM C1418T genotype (CC genotype group and CT/TT genotype group). The days spent in an intensive care unit (ICU) and the incidence of fever in the ICU were significantly lower in the beating-heart CPB and off-pump groups than in the conventional CPB group. Additionally, the TM gene C1418T polymorphisms did not affect the early outcomes in patients in the beating-heart CPB and off-pump groups. Interestingly, in the conventional CPB group, patients with the CC genotype had a lower rate of fever, shorter duration of fever, and delay of ICU when compared with the CT/TT genotype. Conclusion: Surgeons may use a patient’s TM gene C1418T polymorphism to predict the strength of systemic inflammation and speculate on early outcomes during hospitalization before conventional CPB is performed.
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14
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Ahmad A, Sundquist K, Zöller B, Svensson PJ, Sundquist J, Memon AA. Thrombomodulin gene c.1418C>T polymorphism and risk of recurrent venous thromboembolism. J Thromb Thrombolysis 2017; 42:135-41. [PMID: 26743062 DOI: 10.1007/s11239-015-1328-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Thrombomodulin gene (THBD) is a critical cofactor in protein C anticoagulant system. THBD c.1418C>T polymorphism is reported to be associated with higher risk of primary venous thromboembolism (VTE) but its role in VTE recurrence is unknown. The aim of this study was to investigate the role of THBD polymorphism in VTE recurrence. THBD c.1418C>T polymorphism was genotyped by using Taqman polymerase chain reaction in a prospective population based study of 1465 consecutive objectively verified VTE patients. Uni- and multivariate Cox regression were performed for the risk assessment of VTE recurrence. Patients who had VTE before inclusion or had recurrence or died during anticoagulant treatment were excluded. Among the remaining (N = 1046) patients, 126 (12.05 %) had VTE recurrence during the follow up period (from 1998 to 2008). THBD polymorphism was not significantly associated with risk of VTE recurrence in the univariate [Hazard ratio (HR) 1.11, 95 % confidence interval (CI) 0.78-1.59, p = 0.55] as well as the multivariate analysis adjusted for age, sex and thrombophilia (HR 1.11, 95 % CI 0.78-1.59, p = 0.54). Similarly, in unprovoked first VTE (n = 614), no association was observed between THBD polymorphism and risk of VTE recurrence (HR 1.22 and 95 % CI 0.78-1.89, p = 0.38). In this prospective study, our results do not suggest a predictive role for THBD c.1418C>T polymorphism in VTE recurrence.
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Affiliation(s)
- Abrar Ahmad
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Skåne University Hospital, Malmö, Sweden. .,Wallenberg Laboratory, 6th floor, Inga Marie Nilsson's gata 53, S-205 02, Malmö, Sweden.
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Skåne University Hospital, Malmö, Sweden.,Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Bengt Zöller
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Skåne University Hospital, Malmö, Sweden
| | - Peter J Svensson
- Department of Coagulation Disorders, Skåne University Hospital, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Skåne University Hospital, Malmö, Sweden.,Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Ashfaque A Memon
- Center for Primary Health Care Research, Department of Clinical Sciences, Lund University/Skåne University Hospital, Malmö, Sweden
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15
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Sapru A, Liu KD, Wiemels J, Hansen H, Pawlikowska L, Poon A, Jorgenson E, Witte JS, Calfee CS, Ware LB, Matthay MA. Association of common genetic variation in the protein C pathway genes with clinical outcomes in acute respiratory distress syndrome. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2016; 20:151. [PMID: 27215212 PMCID: PMC4876559 DOI: 10.1186/s13054-016-1330-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 04/27/2016] [Indexed: 01/10/2023]
Abstract
Background Altered plasma levels of protein C, thrombomodulin, and the endothelial protein C receptor are associated with poor clinical outcomes in patients with acute respiratory distress syndrome (ARDS). We hypothesized that common variants in these genes would be associated with mortality as well as ventilator-free and organ failure-free days in patients with ARDS. Methods We genotyped linkage disequilibrium-based tag single-nucleotide polymorphisms in the ProteinC, Thrombomodulin and Endothelial Protein C Reptor Genes among 320 self-identified white patients of European ancestry from the ARDS Network Fluid and Catheter Treatment Trial. We then tested their association with mortality as well as ventilator-free and organ-failure free days. Results The GG genotype of rs1042580 (p = 0.02) and CC genotype of rs3716123 (p = 0.002), both in the thrombomodulin gene, and GC/CC genotypes of rs9574 (p = 0.04) in the endothelial protein C receptor gene were independently associated with increased mortality. An additive effect on mortality (p < 0.001), ventilator-free days (p = 0.01), and organ failure-free days was observed with combinations of these high-risk genotypes. This association was independent of age, severity of illness, presence or absence of sepsis, and treatment allocation. Conclusions Genetic variants in thrombomodulin and endothelial protein C receptor genes are additively associated with mortality in ARDS. These findings suggest that genetic differences may be at least partially responsible for the observed associations between dysregulated coagulation and poor outcomes in ARDS. Electronic supplementary material The online version of this article (doi:10.1186/s13054-016-1330-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anil Sapru
- Departments of Pediatrics, University of California, Box 0106, , 550, 16th Street, San Francisco, CA, 94143, USA. .,David Geffen School of Medicine, Department of Pediatrics, University of California, 10833 Le Conte Avenue, 12-488 MDCC, Los Angeles, 90095, CA, USA.
| | - Kathleen D Liu
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Joseph Wiemels
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Helen Hansen
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Ludmilla Pawlikowska
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA.,Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Annie Poon
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA
| | - Eric Jorgenson
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - John S Witte
- Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - Carolyn S Calfee
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Lorraine B Ware
- Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Michael A Matthay
- Department of Medicine, University of California, San Francisco, CA, USA.,Cardiovascular Research Institute, University of California, San Francisco, CA, USA
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16
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Jiang J, Jiao Y, Ding X, Zhang B. Association between genetic polymorphisms and deep vein thrombosis in a Chinese population. Thromb Res 2015; 136:687-9. [DOI: 10.1016/j.thromres.2015.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 06/01/2015] [Accepted: 07/08/2015] [Indexed: 10/23/2022]
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17
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Rachakonda SP, Penack O, Dietrich S, Blau O, Blau IW, Radujkovic A, Isermann B, Ho AD, Uharek L, Dreger P, Kumar R, Luft T. Single-Nucleotide Polymorphisms Within the Thrombomodulin Gene (THBD) Predict Mortality in Patients With Graft-Versus-Host Disease. J Clin Oncol 2014; 32:3421-7. [PMID: 25225421 DOI: 10.1200/jco.2013.54.4056] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Steroid-refractory graft-versus-host disease (GVHD) is a major and often fatal complication after allogeneic stem-cell transplantation (alloSCT). Although the pathophysiology of steroid refractoriness is not fully understood, evidence is accumulating that endothelial cell stress is involved, and endothelial thrombomodulin (THBD) plays a role in this process. Here we assess whether single-nucleotide polymorphisms (SNPs) within the THBD gene predict outcome after alloSCT. PATIENTS AND METHODS Seven SNPs within the THBD gene were studied (rs1962, rs1042579, rs1042580, rs3176123, rs3176124, rs3176126, and rs3176134) in a training cohort of 306 patients. The relevant genotypes were then validated in an independent cohort (n = 321). RESULTS In the training cohort, an increased risk of nonrelapse mortality (NRM) was associated with three of seven SNPs tested: rs1962, rs1042579 (in linkage disequilibrium with rs3176123), and rs1042580. When patients were divided into risk groups (one v no high-risk SNP), a strong correlation with NRM was observed (hazard ratio [HR], 2.31; 95% CI, 1.36 to 3.95; P = .002). More specifically, NRM was predicted by THBD SNPs in patients who later developed GVHD (HR, 3.03; 95% CI, 1.61 to 5.68; P < .001) but not in patients without GVHD. In contrast, THBD SNPs did not predict incidence of acute GVHD. Multivariable analyses adjusting for clinical variables confirmed the independent effect of THBD SNPs on NRM. All findings could be reproduced in the validation cohort. CONCLUSION THBD SNPs predict mortality of manifest GVHD but not the risk of acquiring GVHD, supporting the hypothesis that endothelial vulnerability contributes to GVHD refractoriness.
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Affiliation(s)
- Sivaramakrishna P Rachakonda
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Olaf Penack
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Sascha Dietrich
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Olga Blau
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Igor Wolfgang Blau
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Aleksandar Radujkovic
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Berend Isermann
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Anthony D Ho
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Lutz Uharek
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Peter Dreger
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Rajiv Kumar
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Thomas Luft
- Sivaramakrishna P. Rachakonda and Rajiv Kumar, German Cancer Research Centre; Sascha Dietrich, Aleksandar Radujkovic, Anthony D. Ho, Peter Dreger, and Thomas Luft, University of Heidelberg, Heidelberg; Olaf Penack, Olga Blau, Igor Wolfgang Blau, and Lutz Uharek, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin; and Berend Isermann, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
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18
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A hereditary bleeding disorder resulting from a premature stop codon in thrombomodulin (p.Cys537Stop). Blood 2014; 124:1951-6. [PMID: 25049278 DOI: 10.1182/blood-2014-02-557538] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
In this study, we describe a novel thrombomodulin (TM) mutation (c.1611C>A) that codes for a change from cysteine 537 to a premature stop codon (p.Cys537Stop). Three members of a family with a history of posttraumatic bleeding were identified to be heterozygous for this TM mutation. All coagulation screening tests, coagulation factor assays, and platelet function test results were within normal limits. However, the endogenous thrombin potential was markedly reduced at low-tissue factor concentration, and failure to correct with normal plasma indicated the presence of a coagulation inhibitor. Plasma TM levels were highly elevated (433-845 ng/ml, normal range 2-8 ng/ml, equating to 5 to 10 nM), and the addition of exogenous protein C further decreased thrombin generation. The mutation, p.Cys537Stop, results in a truncation within the carboxyl-terminal transmembrane helix. We predict that as a consequence of the truncation, the variant TM is shed from the endothelial surface into the blood plasma. This would promote systemic protein C activation and early cessation of thrombin generation within a developing hemostatic clot, thereby explaining the phenotype of posttraumatic bleeding observed within this family.
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19
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Cao Y, Zhang Z, Xu J, Yuan W, Wang J, Huang X, Shen Y, Du J. The association of idiopathic recurrent pregnancy loss with polymorphisms in hemostasis-related genes. Gene 2013; 530:248-52. [DOI: 10.1016/j.gene.2013.07.080] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/19/2013] [Accepted: 07/23/2013] [Indexed: 11/30/2022]
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20
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Tsai C, Lin Y, Shih C, Chen Y, Lin C, Tsai Y, Lee C, Shih C, Huang C, Chung H, Lin F. Thrombomodulin Gene Polymorphism (C1418T) is Associated with the Development of Coronary Allograft Vasculopathy. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Thrombomodulin (TM) is the endothelial cell membrane-bound anticoagulant protein cofactor in the thrombin-mediated activation of protein C. Previous evidence has been reported regarding the association between TM polymorphisms and coronary artery disease. Allograft rejection-mediated vasculopathy is the main cause of death at more than one year after heart transplantation. However, whether TM polymorphism is associated with allograft rejection is still unclear. We analyzed the TM gene polymorphism C1418T using allele-specific primers in a PCR assay in 60 patients who underwent heart transplantation. The retrospective clinical data were collected and tested for any correlations with the TM gene polymorphism. We separated the patients into 2 groups according to their TM genotype (group 1: CC genotype; group 2: CT or TT genotype). Additionally, we generated expression constructs (TM full length-C1418 and TM full length-T1418) and performed in vitro studies to explore the correlation between the TM C1418T polymorphism and the migration of smooth muscle progenitor cells and monocytes, which may be involved in the development of vasculopathy. The results showed that the levels of CD68, C4d, PAS, and Masson staining in the CT/TT genotype group increased at year 1 and continued to increase throughout the 3 years. These levels were higher than those observed in the CC genotype group. The ISHLT-WF2004 grade of the CT/TT genotype group was significantly different from that of the CC genotype group at the same time point post-transplantation. The coronary allograft vasculopathy (CAV) score was significantly different between the CC and CT/TT genotype groups at 1 and 3 years post-transplantation. Our in vitro studies demonstrate that both smooth muscle progenitor cells and monocytic THP-1 cells with either the CT-1418 or the TT-1418 TM genotype have higher migratory abilities than cells with the CC-1418 genotype. Our results support a significant association between the TM C1418T polymorphism and the development of CAV after heart transplantation in the short- to medium-term.
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Affiliation(s)
- C.S. Tsai
- Division of Cardiovascular Surgery, National Defense Medical Center, Taipei
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei
| | - Y.W. Lin
- Division of Cardiovascular Surgery, National Defense Medical Center, Taipei
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - C.C. Shih
- Division of Cardiovascular Surgery, Taipei Veterans General Hospital, Taipei
| | - Y.H. Chen
- Graduate Institute of Integrated Medicine, China Medical University, Taichung
| | - C.Y. Lin
- Division of Cardiovascular Surgery, National Defense Medical Center, Taipei
| | - Y.T. Tsai
- Division of Cardiovascular Surgery, National Defense Medical Center, Taipei
| | - C.Y. Lee
- Division of Cardiovascular Surgery, National Defense Medical Center, Taipei
| | - C.M. Shih
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei
- Division of Cardiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - C.Y. Huang
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei
- Division of Cardiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - H.H. Chung
- Division of Cardiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - F.Y. Lin
- Cardiovascular Research Center, Taipei Medical University Hospital, Taipei
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei
- Division of Cardiology, Taipei Medical University Hospital, Taipei, Taiwan
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21
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Navarro S, Medina P, Bonet E, Corral J, Martínez-Sales V, Martos L, Rivera M, Roselló-Lletí E, Alberca I, Roldán V, Mira Y, Ferrando F, Estellés A, Vicente V, Bertina RM, España F. Association of the Thrombomodulin Gene c.1418C>T Polymorphism With Thrombomodulin Levels and With Venous Thrombosis Risk. Arterioscler Thromb Vasc Biol 2013; 33:1435-40. [DOI: 10.1161/atvbaha.113.301360] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
To investigate the association of the
THBD
c.1418C>T polymorphism, which encodes for the replacement of Ala455 by Val in thrombomodulin (TM), with venous thromboembolism (VTE), plasma soluble TM, and activated protein C levels. In addition, human umbilical vein endothelial cells (HUVEC) isolated from 100 umbilical cords were used to analyze the relation between this polymorphism and
THBD
mRNA and TM protein expression.
Approach and Results—
The
THBD
c.1418C>T polymorphism was genotyped in 1173 patients with VTE and 1262 control subjects. Levels of soluble TM and activated protein C were measured in 414 patients with VTE (not on oral anticoagulants) and 451 controls. HUVECs were genotyped for the polymorphism and analyzed for
THBD
mRNA and TM protein expression and for the ability to enhance protein C activation by thrombin. The 1418T allele frequency was lower in patients than in controls (
P
<0.001), and its presence was associated with a reduced VTE risk, reduced soluble TM levels, and increased circulating activated protein C levels (
P
<0.001). In cultured HUVEC, the 1418T allele did not influence
THBD
expression but was associated with increased TM in cell lysates, increased rate of protein C activation, and reduced soluble TM levels in conditioned medium.
Conclusions—
The
THBD
1418T allele is associated with lower soluble TM, both in plasma and in HUVEC-conditioned medium, and with an increase in functional membrane–bound TM in HUVEC, which could explain the increased activated protein C levels and the reduced VTE risk observed in individuals carrying this allele.
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Affiliation(s)
- Silvia Navarro
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Pilar Medina
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Elena Bonet
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Javier Corral
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Vicenta Martínez-Sales
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Laura Martos
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Miguel Rivera
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Esther Roselló-Lletí
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Ignacio Alberca
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Vanessa Roldán
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Yolanda Mira
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Fernando Ferrando
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Amparo Estellés
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Vicente Vicente
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Rogier M. Bertina
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
| | - Francisco España
- From the Unidad de Bioquímica, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (S.N., P.M., E.B., V.M.-S., L.M., A.E., F.E.); Servicio de Análisis Clínicos, Hospital Universitario La Fe, Valencia, Spain (E.B.); Centro Regional de Hemodonación, Universidad de Murcia, Spain (J.C., V.R., V.V.); Unidad de Cardiocirculación, Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain (M.R., E.R.-L); Hematology Service, Hospital Clínico Universitario, Salamanca, Spain (I
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Tang L, Wang HF, Lu X, Jian XR, Jin B, Zheng H, Li YQ, Wang QY, Wu TC, Guo H, Liu H, Guo T, Yu JM, Yang R, Yang Y, Hu Y. Common genetic risk factors for venous thrombosis in the Chinese population. Am J Hum Genet 2013; 92:177-87. [PMID: 23332921 DOI: 10.1016/j.ajhg.2012.12.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 10/23/2012] [Accepted: 12/20/2012] [Indexed: 12/21/2022] Open
Abstract
Venous thrombosis is a major medical disorder caused by both genetic and environmental factors. Little is known about the genetic background of venous thrombosis in the Chinese population. A total of 1,304 individuals diagnosed with a first venous thrombosis and 1,334 age- and sex-matched healthy participants were enrolled in this study. Resequencing of THBD (encoding thrombomodulin) in 60 individuals with venous thrombosis and 60 controls and a functional assay showed that a common variant, c.-151G>T (rs16984852), in the 5' UTR significantly reduced the gene expression and could cause a predisposition to venous thrombosis. Therefore, this variant was genotyped in a case-control study, and results indicated that heterozygotes had a 2.80-fold (95% confidence interval = 1.88-4.29) increased risk of venous thrombosis. The THBD c.-151G>T variant was further investigated in a family analysis involving 176 first-degree relatives from 38 index families. First-degree relatives with this variant had a 3.42-fold increased risk of venous thrombosis, and their probability of remaining thrombosis-free was significantly lower than that of relatives without the variant. In addition, five rare mutations that might be deleterious were also identified in thrombophilic individuals by sequencing. This study is the largest genetic investigation of venous thrombosis in the Chinese population. Further study on genetics of thrombosis should focus on resequencing of THBD and other hemostasis genes in different populations.
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Pushkov AA, Blagodatskikh KA, Nikitin AG, Agapkina YV, Brovkin AN, Chudakova DA, Evdokimova MA, Aseycheva OY, Osmolovskaya VS, Minushkina LO, Baklanova TN, Talyzin PA, Donetskaya OP, Tereschenko SN, Dzhaiani NA, Akanova EV, Glezer MG, Galyavich AS, Zakirova VB, Koziolova NA, Yagoda AV, Boyeva OI, Horolets EV, Shlyk SV, Volkova EG, Margaryan MP, Guz IO, Konstantinov VO, Sidorenko BA, Zeteyshchikov DA, Nosikov VV. Polymorphic markers Ala455Val of the THBD gene and Arg353Gln of the F7 gene and genetic association with unfavorable outcomes of coronary atherosclerosis in patients with a history of acute ischemic heart disease. RUSS J GENET+ 2011. [DOI: 10.1134/s1022795411100140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Yin YD, Wang C, Zhai ZG, Pang BS, Yang YH, Huang XX. Decreased plasma soluble thrombomodulin levels as a risk factor for pulmonary thromboembolism. J Thromb Thrombolysis 2008; 27:274-9. [PMID: 18373234 DOI: 10.1007/s11239-008-0218-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Accepted: 03/20/2008] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To observe the changes of the plasma soluble thrombomodulin (sTM) concentrations in patients with pulmonary thromboembolism (PTE) and assess the association between plasma sTM concentration and the risk of PTE. PATIENTS AND METHODS We measured plasma concentrations of sTM, protein C (PC) and protein S (PS) and examined the association between those plasma markers and the risk of PTE in 72 selected PTE patients and 70 controls. RESULTS Significant difference was identified in plasma sTM level between overall PTE patients and controls. Female PTE patients had statistically lower sTM concentrations than male patients. A positive linear correlation was found between plasma sTM concentration and age in female patients. Decreased plasma sTM concentration was associated with a continuously and progressively increased risk for PTE in women. The concentrations of plasma PC and PS did not differ between groups and no significant quantitative association was identified between the risk of PTE and the levels of plasma PC or PS. CONCLUSION Decreased plasma sTM concentration is associated with an increased risk of PTE in women.
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Affiliation(s)
- Yu-Dong Yin
- Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China
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25
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Olivot JM, Labreuche J, De Broucker T, Poirier O, Cambien F, Aiach M, Amarenco P. Thrombomodulin gene polymorphisms in brain infarction and mortality after stroke. J Neurol 2008; 255:514-9. [DOI: 10.1007/s00415-008-0725-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 07/03/2007] [Accepted: 07/17/2007] [Indexed: 12/01/2022]
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Strandberg K, Svensson PJ, Ohlin AK. Venous thromboembolism in carriers of the Factor V Leiden mutation and in patients without known thrombophilic risk factor; prediction of recurrence and APC–PCI complex concentration and/or soluble thrombomodulin antigen and activity. Thromb Res 2007; 121:145-51. [PMID: 17499343 DOI: 10.1016/j.thromres.2007.03.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2006] [Revised: 02/19/2007] [Accepted: 03/27/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND The complex between activated protein C (APC) and the protein C inhibitor (PCI) is a sensitive indicator of the degree of activation of blood coagulation and higher concentrations have been measured in carriers of the FV Leiden mutation who were in the recovery phase after treatment for venous thromboembolism (VTE). OBJECTIVES The main purpose of this study was to correlate the APC-PCI complex concentration to thrombomodulin activity and antigen concentration in the same group of patients. We also add a prospective clinical follow-up of the VTE recurrence after 1 year to investigate if the markers can predict the risk for a new VTE. PATIENTS/METHODS Blood samples were collected from 50 patients with the FV Leiden mutation and 132 without any known risk factor for thrombophilia after finished treatment. RESULTS The APC-PCI complex, s-TM activity and the quotient (s-TM activity)/(s-TM antigen) were higher in VTE patients with FV Leiden. In total, there were 19 VTE recurrences (10%) after 1 year. The OR for recurrence was 1.9 (95% CI 0.68-5.0) in all VTE patients with elevated APC-PCI complex (above 75th percentile) and 3.6 (95% CI 1.1-12) in VTE patients without any known risk factor for thrombophilia and with elevated s-TM activity. CONCLUSION The APC-PCI complex concentration, s-TM activity and the quotient (s-TM activity)/(s-TM antigen) were higher in VTE patients with FV Leiden. The s-TM activity showed higher OR for recurrence of VTE in patients without known thrombophilic risk factor. Both methods could be sensitive markers of increased risk for venous thrombosis.
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Affiliation(s)
- Karin Strandberg
- Department of Clinical Chemistry, Lund University, Malmö University Hospital, SE-205 02 Malmö, Sweden.
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27
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Sugiyama S, Hirota H, Kimura R, Kokubo Y, Kawasaki T, Suehisa E, Okayama A, Tomoike H, Hayashi T, Nishigami K, Kawase I, Miyata T. Haplotype of thrombomodulin gene associated with plasma thrombomodulin level and deep vein thrombosis in the Japanese population. Thromb Res 2007; 119:35-43. [PMID: 16507317 DOI: 10.1016/j.thromres.2005.12.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Revised: 12/19/2005] [Accepted: 12/20/2005] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Thrombomodulin (TM) is an essential cofactor in protein C activation by thrombin. Here, we evaluated the contribution of genetic variations in the TM gene to soluble TM (sTM) level and deep vein thrombosis (DVT) in Japanese. PATIENTS AND METHODS We sequenced the TM putative promoter, exon, and 3'-untranslated region in DVT patients (n=118). Among 17 genetic variations we identified, two missense mutations (R385K, D468Y) and three common single nucleotide polymorphisms (-202G>A, 2487A>T, 2729A>C) were genotyped in a general population of 2247 subjects (1032 men and 1215 women) whose sTM levels were measured. We then compared the frequency of these mutations in DVT patients with that in the age, body mass index-adjusted population-based controls. RESULTS We identified one neutral mutation (H381) and three missense mutations (R385K; n=2, A455V; n=53 heterozygous, n=14 homozygous, D468Y; n=2) of TM in the DVT patients. Age-adjusted mean values of sTM were lower in C-allele carriers of 2729A>C than in noncarriers in the Japanese general population (women: 16.7+/-0.3 U/ml vs. 17.9+/-0.2 U/ml, p<0.01, men: 19.4+/-0.3 U/ml vs. 20.4+/-0.3 U/ml, p=0.03). Additionally, the CC genotype of this mutation was more common in the male DVT patients than in the male individuals of the general population (odds ratio=2.76, 95% confidence interval=1.14-6.67; p=0.02). This mutation was in linkage disequilibrium (r-square>0.9) with A455V mutation. CONCLUSIONS TM mutations, especially those with a haplotype consisting of 2729A>C and A455V missense mutation, affect sTM levels, and may be associated with DVT in Japanese.
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Affiliation(s)
- Shoko Sugiyama
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita City, Osaka 565-0871, Japan
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Ohlin AK, Larsson K, Hansson M. Soluble thrombomodulin activity and soluble thrombomodulin antigen in plasma. J Thromb Haemost 2005; 3:976-82. [PMID: 15869594 DOI: 10.1111/j.1538-7836.2005.01267.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Endothelial cell membrane-bound thrombomodulin (TM) plays a critical role as a cofactor in the protein C pathway, important in regulating coagulation as well as inflammation. Heterogeneous soluble TM fragments circulate in the plasma and are found at increased levels in various diseases such as cardiovascular disease and diabetes, and in ischemic and/or inflammatory endothelial injuries. The anticoagulant function of these soluble fragments has not been measured in healthy individuals or in patients. Using an immobilized monoclonal antibody against TM and a microtiter plate format, an assay was designed to capture the soluble TM fragments in plasma and measure their cofactor activity in the thrombin-mediated activation of protein C. In addition, soluble TM antigen levels were measured by enzyme-linked immunosorbent assay. Both assays were used to investigate a group of healthy blood donors. TM fragments released into plasma were shown to retain significant cofactor activity, and reference intervals for healthy men and women were established. Furthermore, a statistically significant correlation was observed between soluble TM antigen levels and soluble TM cofactor activity. This notwithstanding, soluble TM activity only accounted for a minor part of all variation in soluble TM antigen levels (R2 = 22% in men and R2 = 16% in women).
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Affiliation(s)
- A-K Ohlin
- Division of Laboratory Medicine, Department of Clinical Chemistry, University Hospital, Lund, Sweden.
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Heit JA, Petterson TM, Owen WG, Burke JP, DE Andrade M, Melton LJ. Thrombomodulin gene polymorphisms or haplotypes as potential risk factors for venous thromboembolism: a population-based case-control study. J Thromb Haemost 2005; 3:710-7. [PMID: 15842356 DOI: 10.1111/j.1538-7836.2005.01187.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Dysfunction of the protein C anticoagulant system is associated with venous thromboembolism (VTE) and thrombomodulin (TM) is a critical cofactor within the protein C system. The aim of this study was to test the hypotheses that polymorphisms or haplotypes within the TM gene are common risk factors for VTE. We screened the TM putative promoter, exon and 3'-untranslated region for sequence variations in a random sample (n = 266) of consecutive idiopathic, objectively confirmed non-Olmsted County VTE patients referred to the Mayo Clinic. We then genotyped a sample of Olmsted County, MN residents with a first lifetime, objectively confirmed VTE in the 25-year period, 1966-90 (n = 223), and a sample of Olmsted County residents without VTE (n = 237) for polymorphisms either discovered in the screening population or previously published, and tested for an association of VTE with TM genotype or haplotypes using unconditional logistic regression and generalized linear models, respectively. We also genotyped these Olmsted County cases and controls at 20 'null' genetic maker loci and tested for population admixture. Nine novel and three previously described mutations were identified in the screening population. Mutations within the TM promoter, EGF(1-5), serine/threonine-rich, transmembrane, and cytoplasm regions were absent or uncommon. TM845G-->A (Ala25Thr; lectin region), TM2136T-->C (Ala455Val; EGF(6) region), TM2470C deletion (3'-untranslated region), and 4363A-->G (3'-flanking region) were more common, but were not associated with VTE by genotype or haplotype. Null genetic marker allele frequencies did not differ significantly among cases and controls. We conclude that polymorphisms or haplotypes within the TM gene are not common risk factors for incident VTE.
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Affiliation(s)
- John A Heit
- Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, MI, USA.
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30
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Cole JW, Roberts SC, Gallagher M, Giles WH, Mitchell BD, Steinberg KK, Wozniak MA, Macko RF, Reinhart LJ, Kittner SJ. Thrombomodulin Ala455Val Polymorphism and the risk of cerebral infarction in a biracial population: the Stroke Prevention in Young Women Study. BMC Neurol 2004; 4:21. [PMID: 15574195 PMCID: PMC538749 DOI: 10.1186/1471-2377-4-21] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2004] [Accepted: 12/01/2004] [Indexed: 11/27/2022] Open
Abstract
Background The genes encoding proteins in the thrombomodulin-protein C pathway are promising candidate genes for stroke susceptibility because of their importance in thrombosis regulation and inflammatory response. Several published studies have shown that the Ala455Val thrombomodulin polymorphism is associated with ischemic heart disease, but none has examined the association with stroke. Using data from the Stroke Prevention in Young Women Study, we sought to determine the association between the Ala455Val thrombomodulin polymorphism and the occurrence of ischemic stroke in young women. Methods All 59 hospitals in the greater Baltimore-Washington area participated in a population-based case-control study of stroke in young women. We compared 141 cases of first ischemic stroke (44% black) among women 15 to 44 years of age with 210 control subjects (35% black) who were identified by random digit dialing and frequency matched to the cases by age and geographical region of residence. Data on historical risk factors were collected by standardized interview. Genotyping of the thrombomodulin Ala455Val polymorphism was performed by pyrosequencing. Results The A allele (frequency = 0.85) was associated with stroke under the recessive model. After adjustment for age, race, cigarette smoking, hypertension, and diabetes, the AA genotype, compared with the AV and VV genotypes combined, was significantly associated with stroke (odds ratio 1.9, 95% CI 1.1–3.3). The AA genotype was more common among black than white control subjects (81% versus 68%) but there was no significant interaction between the risk genotype and race (adjusted odds ratio 2.7 for blacks and 1.6 for whites). A secondary analysis removing all probable (n = 16) and possible (n = 15) cardioembolic strokes demonstrated an increased association (odds ratio 2.2, 95% CI 1.2–4.2). Conclusions Among women aged 15 to 44 years, the AA genotype is more prevalent among blacks than whites and is associated with increased risk of early onset ischemic stroke. Removing strokes potentially related to cardioembolic phenomena increased this association. Further studies are needed to determine whether this polymorphism is functionally related to thrombomodulin expression or whether the association is due to population stratification or linkage to a nearby functional polymorphism.
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Affiliation(s)
- John W Cole
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Geriatrics Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA
| | - Stacy C Roberts
- Molecular Biology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Margaret Gallagher
- Molecular Biology Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Wayne H Giles
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Braxton D Mitchell
- Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Karen K Steinberg
- Coordinating Center for Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marcella A Wozniak
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Richard F Macko
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Geriatrics Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA
| | - Laurie J Reinhart
- Department of Medicine University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Steven J Kittner
- Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Geriatrics Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Baltimore, Maryland, USA
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