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Hoang VT, Le DS, Hoang DM, Phan TTK, Ngo LAT, Nguyen TK, Bui VA, Nguyen Thanh L. Impact of tissue factor expression and administration routes on thrombosis development induced by mesenchymal stem/stromal cell infusions: re-evaluating the dogma. Stem Cell Res Ther 2024; 15:56. [PMID: 38414067 PMCID: PMC10900728 DOI: 10.1186/s13287-023-03582-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/22/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Hyperactive coagulation might cause dangerous complications such as portal vein thrombosis and pulmonary embolism after mesenchymal stem/stromal cell (MSC) therapy. Tissue factor (TF), an initiator of the extrinsic coagulation pathway, has been suggested as a predictor of this process. METHODS The expression of TF and other pro- and anticoagulant genes was analyzed in xeno- and serum-free manufactured MSCs. Furthermore, culture factors affecting its expression in MSCs were investigated. Finally, coagulation tests of fibrinogen, D-dimer, aPPTs, PTs, and TTs were measured in patient serum after umbilical cord (UC)-MSC infusions to challenge a potential connection between TF expression and MSC-induced coagulant activity. RESULTS: Xeno- and serum-free cultured adipose tissue and UC-derived MSCs expressed the highest level of TF, followed by those from dental pulp, and the lowest expression was observed in MSCs of bone marrow origin. Environmental factors such as cell density, hypoxia, and inflammation impact TF expression, so in vitro analysis might fail to reflect their in vivo behaviors. MSCs also expressed heterogeneous levels of the coagulant factor COL1A1 and surface phosphatidylserine and anticoagulant factors TFPI and PTGIR. MSCs of diverse origins induced fibrin clots in healthy plasma that were partially suppressed by an anti-TF inhibitory monoclonal antibody. Furthermore, human umbilical vein endothelial cells exhibited coagulant activity in vitro despite their negative expression of TF and COL1A1. Patients receiving intravenous UC-MSC infusion exhibited a transient increase in D-dimer serum concentration, while this remained stable in the group with intrathecal infusion. There was no correlation between TF expression and D-dimer or other coagulation indicators. CONCLUSIONS The study suggests that TF cannot be used as a solid biomarker to predict MSC-induced hypercoagulation. Local administration, prophylactic intervention with anticoagulation drugs, and monitoring of coagulation indicators are useful to prevent thrombogenic events in patients receiving MSCs. Trial registration NCT05292625. Registered March 23, 2022, retrospectively registered, https://www. CLINICALTRIALS gov/ct2/show/NCT05292625?term=NCT05292625&draw=2&rank=1 . NCT04919135. Registered June 9, 2021, https://www. CLINICALTRIALS gov/ct2/show/NCT04919135?term=NCT04919135&draw=2&rank=1 .
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Affiliation(s)
- Van T Hoang
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, 458 Minh Khai, Hai Ba Trung District, Hanoi, 100000, Vietnam.
| | - Duc Son Le
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, 458 Minh Khai, Hai Ba Trung District, Hanoi, 100000, Vietnam
| | - Duc M Hoang
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, 458 Minh Khai, Hai Ba Trung District, Hanoi, 100000, Vietnam
| | - Trang Thi Kieu Phan
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, 458 Minh Khai, Hai Ba Trung District, Hanoi, 100000, Vietnam
| | - Lan Anh Thi Ngo
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, 458 Minh Khai, Hai Ba Trung District, Hanoi, 100000, Vietnam
- Center of Applied Science and Regenerative Medicine, Vinmec Health Care System, 458 Minh Khai, Hanoi, 10000, Vietnam
| | - Trung Kien Nguyen
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, 458 Minh Khai, Hai Ba Trung District, Hanoi, 100000, Vietnam
| | - Viet Anh Bui
- Center of Applied Science and Regenerative Medicine, Vinmec Health Care System, 458 Minh Khai, Hanoi, 10000, Vietnam
| | - Liem Nguyen Thanh
- Vinmec Research Institute of Stem Cell and Gene Technology, Vinmec Health Care System, 458 Minh Khai, Hai Ba Trung District, Hanoi, 100000, Vietnam.
- Vinmec International Hospital - Times City, Vinmec Health Care System, 458 Minh Khai, Hanoi, 11622, Vietnam.
- College of Health Science, VinUniversity, Vinhomes Ocean Park, Gia Lam District, Hanoi, 1310, Vietnam.
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2
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Raadsen M, Langerak T, Du Toit J, Kruip MJHA, Aynekulu Mersha D, De Maat MPM, Vermin B, Van den Akker JPC, Schmitz KS, Bakhtiari K, Meijers JCM, van Gorp ECM, Short KR, Haagmans B, de Vries RD, Gommers DAMPJ, Endeman H, Goeijenbier M. Presence of procoagulant peripheral blood mononuclear cells in severe COVID-19 patients relate to ventilation perfusion mismatch and precede pulmonary embolism. J Crit Care 2024; 79:154463. [PMID: 37976997 DOI: 10.1016/j.jcrc.2023.154463] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/07/2023] [Accepted: 10/31/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Pulmonary emboli (PE) contribute substantially to coronavirus disease 2019 (COVID-19) related mortality and morbidity. Immune cell-mediated hyperinflammation drives the procoagulant state in COVID-19 patients, resulting in immunothrombosis. To study the role of peripheral blood mononuclear cells (PBMC) in the procoagulant state of COVID-19 patients, we performed a functional bioassay and related outcomes to the occurrence of PE. Secondary aims were to relate this functional assay to plasma D-dimer levels, ventilation perfusion mismatch and TF expression on monocyte subsets. METHODS PBMC from an ICU biobank were obtained from 20 patients with a computed tomography angiograph (CTA) proven PE and compared to 15 COVID-19 controls without a proven PE. Functional procoagulant properties of PBMC were measured using a modified fibrin generation time (MC-FGT) assay. Tissue factor (TF) expression on monocyte subsets were measured by flow cytometry. Additional clinical data were obtained from patient records including end-tidal to arterial carbon dioxide gradient. RESULTS MC-FGT levels were highest in the samples taken closest to the PE detection, similar to the end-tidal to arterial carbon dioxide gradient (ETCO2 - PaCO2), a measurement to quantify ventilation-perfusion mismatch. In patients without proven PE, peak MC-FGT relates to an increase in end-tidal to arterial carbon dioxide gradient. We identified non-classical, CD16 positive monocytes as the subset with increased TF expression. CONCLUSION We show that the procoagulant state of PBMC could aid in early detection of PE in COVID-19 ICU patients. Combined with end-tidal to ETCO2 - PaCO2 gradient, these tests could improve early detection of PE on the ICU.
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Affiliation(s)
- M Raadsen
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - T Langerak
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - J Du Toit
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Hematology, Wits Donal Gordon Medical Center, Johannesburg, South Africa
| | - M J H A Kruip
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - D Aynekulu Mersha
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands
| | - M P M De Maat
- Department of Hematology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - B Vermin
- Department of Intensive care, Spaarne Gasthuis, Haarlem, Hoofddorp, the Netherlands
| | | | - K S Schmitz
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - K Bakhtiari
- Department of Molecular Hematology, Sanquin Research, Amsterdam, the Netherlands
| | - J C M Meijers
- Department of Molecular Hematology, Sanquin Research, Amsterdam, the Netherlands
| | - E C M van Gorp
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - K R Short
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Australia
| | - B Haagmans
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - R D de Vries
- Department of Viroscience, Erasmus Medical Center, Rotterdam, the Netherlands
| | - D A M P J Gommers
- Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands
| | - H Endeman
- Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands
| | - M Goeijenbier
- Department of Intensive care, Spaarne Gasthuis, Haarlem, Hoofddorp, the Netherlands; Department of Intensive Care, Erasmus MC, Rotterdam, the Netherlands.
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3
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Razanakolona M, Adam F, Bianchini E, Saller F, Carvalho AD, Diehl JL, Denis CV, Meziani F, Borgel D, Helms J, Vasse M. Anti-inflammatory Activity of the Protein Z-Dependent Protease Inhibitor. TH OPEN 2021; 5:e220-e229. [PMID: 34189397 PMCID: PMC8233056 DOI: 10.1055/s-0041-1730037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/08/2021] [Indexed: 12/19/2022] Open
Abstract
The protein Z (PZ)-dependent plasma protease inhibitor (ZPI) is a glycoprotein that inhibits factor XIa and, in the presence of PZ, FXa. Recently, ZPI has been shown to be an acute-phase protein (APP). As usually APPs downregulate the harmful effects of inflammation, we tested whether ZPI could modulate the increase of cytokines observed in inflammatory states. We observed that recombinant human ZPI (rhZPI) significantly decreases the levels of interleukin (IL)-1, IL-6, and tumor necrosis factor- α (TNF-α) induced by lipopolysaccharide (LPS) in a whole blood model. This inhibitory effect was unaffected by the presence of PZ or heparin. A ZPI mutant within the reactive loop center ZPI (Y387A), lacking anticoagulant activity, still had an anti-inflammatory activity. Surprisingly, rhZPI did not inhibit the synthesis of IL-6 or TNF-α when purified monocytes were stimulated by LPS, whereas the inhibitory effect was evidenced when lymphocytes were added to monocytes. The requirement of lymphocytes could be due to the synthesis of CCL5 (RANTES), a chemokine mainly produced by activated lymphocytes which is induced by rhZPI, and which can reduce the production of proinflammatory cytokines in whole blood. Lastly, we observed that the intraperitoneal injection of rhZPI significantly decreased LPS-induced IL-6 and TNF-α production in mouse plasma.
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Affiliation(s)
- Mahita Razanakolona
- HITh, INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre cedex, France
| | - Frédéric Adam
- HITh, INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre cedex, France
| | - Elsa Bianchini
- HITh, INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre cedex, France
| | - François Saller
- HITh, INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre cedex, France
| | - Allan de Carvalho
- HITh, INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre cedex, France
| | - Jean-Luc Diehl
- Département de réanimation médicale, Hôpital Européen Georges Pompidou, Paris, France
| | - Cécile V Denis
- HITh, INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre cedex, France
| | - Ferhat Meziani
- Faculté de Médecine, Service de Médecine Intensive-Réanimation, Université de Strasbourg (UNISTRA), Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France.,INSERM (French National Institute of Health and Medical Research), Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France
| | - Delphine Borgel
- HITh, INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre cedex, France.,APHP, Laboratoire d'Hématologie, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Julie Helms
- Faculté de Médecine, Service de Médecine Intensive-Réanimation, Université de Strasbourg (UNISTRA), Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France.,ImmunoRhumatologie Moléculaire, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Marc Vasse
- HITh, INSERM, UMR_S1176, Université Paris-Saclay, Le Kremlin-Bicêtre cedex, France.,Service de Biologie Clinique, Hôpital Foch, Suresnes, France
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4
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Tournois C, Pignon B, Sevestre MA, Djerada Z, Capiod JC, Poitevin G, Delloup AM, Nguyen P. Critical limb ischemia: thrombogenic evaluation of two autologous cell therapy products and biologic profile in treated patients. Transfusion 2015. [DOI: 10.1111/trf.13203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Claire Tournois
- Laboratoire d'Hématologie; CHU Robert Debré; Reims
- EA-3801; SFR CAP-Santé; Université de Reims Champagne-Ardenne; Reims
| | | | | | - Zoubir Djerada
- EA-3801; SFR CAP-Santé; Université de Reims Champagne-Ardenne; Reims
| | | | - Gaël Poitevin
- EA-3801; SFR CAP-Santé; Université de Reims Champagne-Ardenne; Reims
| | | | - Philippe Nguyen
- Laboratoire d'Hématologie; CHU Robert Debré; Reims
- EA-3801; SFR CAP-Santé; Université de Reims Champagne-Ardenne; Reims
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5
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Laurent M, Joimel U, Varin R, Cazin L, Gest C, Le-Cam-Duchez V, Jin J, Liu J, Vannier JP, Lu H, Soria J, Li H, Soria C. Comparative study of the effect of rivaroxaban and fondaparinux on monocyte's coagulant activity and cytokine release. Exp Hematol Oncol 2014; 3:30. [PMID: 25601900 PMCID: PMC4298120 DOI: 10.1186/2162-3619-3-30] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/07/2014] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Tissue factor (TF) exposed on activated monocytes and macrophages is involved in thrombosis through activation of factor X and cytokine release, responsible for inflammation and thrombosis. We investigated the effect of two anti-factor Xa drugs: rivaroxaban, a direct anti-Xa inhibitor, and fondaparinux, an antithrombin dependent anti-Xa inhibitor, on monocyte/macrophage procoagulant activity and cytokine release. METHODS Rivaroxaban and fondaparinux were tested at pharmacological concentrations on LPS-activated monocytes and on THP-1 cells, a human monocytic cell line, to assess 1) TF expression by flow cytometry 2) prothrombinase activity by its coagulant activity and 3) cytokine release in cell supernatants by antibody based cytokine array and ELISA for IL-8 and TNFα. RESULTS AND CONCLUSION Rivaroxaban and fondaparinux did not modify TF expression level on activated cells. In contrast procoagulant activity associated to monocytes and macrophages was dose dependently inhibited by rivaroxaban, but not significantly by fondaparinux. These results could explain why patients undergoing major orthopedic surgery with rivaroxaban prophylaxis were able to achieve significant reductions in venous thromboembolism, compared with drugs commonly used, i.e. fondaparinux and low molecular weight heparin. In addition, rivaroxaban and fondaparinux suppressed some chemokine secretion produced by activated macrophages. This may also contribute to their antithrombotic effect in clinic.
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Affiliation(s)
- Marc Laurent
- Laboratory MERCI (EA 3829), Faculty of Medicine and Pharmacy, CHU Rouen, Rouen, France
| | - Ulrich Joimel
- Laboratory MERCI (EA 3829), Faculty of Medicine and Pharmacy, CHU Rouen, Rouen, France
| | - Rémi Varin
- Laboratory MERCI (EA 3829), Faculty of Medicine and Pharmacy, CHU Rouen, Rouen, France.,INSERM UMR 965, Lariboisiere Hospital, University of Paris Diderot, Paris, France
| | - Lionel Cazin
- Laboratory MERCI (EA 3829), Faculty of Medicine and Pharmacy, CHU Rouen, Rouen, France
| | - Caroline Gest
- Laboratory MERCI (EA 3829), Faculty of Medicine and Pharmacy, CHU Rouen, Rouen, France
| | | | - Jian Jin
- INSERM UMR_S1165, IUH, University of Paris Diderot, Saint Louis Hospital, Paris, France.,School of Pharmaceutical Sciences, Jiangnan University, Wuxi, Jiangsu 214122 China
| | - Jielin Liu
- INSERM UMR_S1165, IUH, University of Paris Diderot, Saint Louis Hospital, Paris, France.,Research center of Tissue engineering and stem cells, Guiyang Medical University, 550004 Guiyang, China
| | - Jean-Pierre Vannier
- Laboratory MERCI (EA 3829), Faculty of Medicine and Pharmacy, CHU Rouen, Rouen, France
| | - He Lu
- INSERM UMR_S1165, IUH, University of Paris Diderot, Saint Louis Hospital, Paris, France
| | - Jeannette Soria
- INSERM UMR 965, Lariboisiere Hospital, University of Paris Diderot, Paris, France
| | - Hong Li
- Laboratory MERCI (EA 3829), Faculty of Medicine and Pharmacy, CHU Rouen, Rouen, France
| | - Claudine Soria
- Laboratory MERCI (EA 3829), Faculty of Medicine and Pharmacy, CHU Rouen, Rouen, France
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Ogasawara S, Stokol T. Interleukin-10 inhibits lipopolysaccharide-induced upregulation of tissue factor in canine peripheral blood monocytes. Vet Immunol Immunopathol 2012; 148:331-6. [DOI: 10.1016/j.vetimm.2012.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 04/18/2012] [Accepted: 04/26/2012] [Indexed: 11/29/2022]
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7
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Heying R, Wolf C, Beekhuizen H, Moelleken ML, Jockenhoevel S, Hoylaerts MF, Schmidt KG, Schroten H. Fibrin- and Collagen-Based Matrices Attenuate Inflammatory and Procoagulant Responses in Human Endothelial Cell Cultures Exposed toStaphylococcus aureus. Tissue Eng Part A 2012; 18:147-56. [DOI: 10.1089/ten.tea.2011.0029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Ruth Heying
- Department of Pediatric Cardiology and Pneumology, University Children's Hospital, Duesseldorf, Germany
- Department of Pediatric Cardiology, UZ Leuven, Leuven, Belgium
| | - Carolin Wolf
- Pediatric Infectious Diseases, Department of Pediatrics, University Children's Hospital, Duesseldorf, Germany
| | - Henry Beekhuizen
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Marie-Luise Moelleken
- Pediatric Infectious Diseases, Department of Pediatrics, University Children's Hospital, Duesseldorf, Germany
| | | | - Marc F. Hoylaerts
- Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium
| | - Klaus G. Schmidt
- Department of Pediatric Cardiology and Pneumology, University Children's Hospital, Duesseldorf, Germany
| | - Horst Schroten
- Department of Pediatric Cardiology, UZ Leuven, Leuven, Belgium
- Pediatric Infectious Diseases, Department of Pediatrics, University Hospital Mannheim, Heidelberg University, Germany
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Paffen E, Medina P, de Visser MCH, van Wijngaarden A, Zorio E, Estellés A, Rosendaal FR, España F, Bertina RM, Doggen CJM. The -589C>T polymorphism in the interleukin-4 gene (IL-4) is associated with a reduced risk of myocardial infarction in young individuals. J Thromb Haemost 2008; 6:1633-8. [PMID: 18662263 DOI: 10.1111/j.1538-7836.2008.03096.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Inflammatory reactions contribute to the development of arterial disease. We investigated the role of interleukin-4 (IL-4) in the development of myocardial infarction (MI) by genotyping patients with MI and control subjects for the -589C>T (rs2243250) single nucleotide polymorphism (SNP), which tags a functional haplotype of IL-4. METHODS AND RESULTS Study of Myocardial Infarctions Leiden (SMILE) included 560 men with a first MI and 646 control subjects. The Valencia study included 305 patients with MI at T genotype was found [odds ratio (OR) 0.84; 95% CI 0.37-1.95 for -589TT and 0.82; 95% CI 0.62-1.07 for -589CT compared with -589CC]. In patients younger than 50 years, carriership of one or two -589T alleles was associated with a reduced risk of MI (OR 0.57: 95% CI 0.34-0.95). This result was replicated in the Valencia study, where carriers of one or two -589T alleles had a reduced risk of MI (OR 0.67: 95% CI 0.47-0.95), with a strong protective effect of the -598T allele in homozygous -589T (OR 0.33: 95% CI 0.10-1.05). In the control subjects of the Valencia study, the -589T allele was associated with reduced levels of F1+2. CONCLUSION Our data indicate that the IL-4 haplotype tagged by the -589T allele reduces the risk of MI in young individuals.
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Affiliation(s)
- E Paffen
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, the Netherlands
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