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Brenner EE, Alexander AB, Londoño LA, Stacy NI, Crevasse SE, Hernandez JA, Wellehan JFX. USE OF VISCOELASTIC COAGULATION TESTING IN MEGACHIROPTERA ( PTEROPUS HYPOMELANUS AND PTEROPUS VAMPYRUS) REVEALS HIGH VARIABILITY IN CLOT KINETICS. J Zoo Wildl Med 2024; 55:393-403. [PMID: 38875195 DOI: 10.1638/2023-0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 06/16/2024] Open
Abstract
Megachiroptera is a mammalian suborder that includes old world fruit bats. Common clinical problems among captive Megachiroptera, such as liver disease (e.g., iron storage disease), kidney disease (e.g., protein-losing nephropathy), and heart disease (e.g., dilated cardiomyopathy), carry elevated risk for hemostatic derangements. The assessment of viscoelastic coagulation assays, however, has not yet been reported in bats. The main objective of the study was to describe viscoelastography data using the Viscoelastic Coagulation Monitor (VCM) Vet in captive large flying foxes (Pteropus vampyrus) (n = 20) and variable flying foxes (Pteropus hypomelanus) (n = 10). Additional objectives were to compare viscoelastic and clotting parameters (1) between healthy P. vampyrus and P. hypomelanus bats and (2) between untreated bats and those treated with meloxicam or aspirin, and (3) to examine relationships between activated partial thromboplastin time (aPTT) and potentially homologous viscoelastic parameters clotting time (CT) and clot formation time (CFT). The results showed marked variability among clinically normal bats. The intrinsic pathway, as measured by aPTT, had prolonged times compared with most terrestrial mammals, but similar times to birds, marine mammals, and sea turtles. A search of P. vampyrus genome found stop codons present in two exons of the factor XI gene; alterations in factor XI expression would be expected to alter intrinsic coagulation. Because of the high variability, no statistically significant findings were noted in the secondary objectives. Correlation between aPTT and CT or CFT was not strong (rs = 0.406 or 0.192, respectively). The results from this study suggest that clot kinetics vary widely among Megachiroptera when using the VCM Vet with untreated blood. A prolonged intrinsic coagulation pathway, as has been found in other megachiropteran species, and activation of the extrinsic coagulation pathway during venipuncture may be responsible for the inconsistent results.
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Affiliation(s)
- Emily E Brenner
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, College of Veterinary Medicine, Gainesville, FL 32610-0126, USA,
| | - Amy B Alexander
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, College of Veterinary Medicine, Gainesville, FL 32610-0126, USA
| | - Leonel A Londoño
- Department of Small Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, FL 32610-0126, USA
| | - Nicole I Stacy
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, College of Veterinary Medicine, Gainesville, FL 32610-0126, USA
| | - Sarah E Crevasse
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, College of Veterinary Medicine, Gainesville, FL 32610-0126, USA
| | - Jorge A Hernandez
- Department of Large Animal Clinical Sciences, University of Florida, College of Veterinary Medicine, Gainesville, FL 32610-0126, USA
| | - James F X Wellehan
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida, College of Veterinary Medicine, Gainesville, FL 32610-0126, USA
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Perrin KL. Coagulation Disorders, Testing, and Treatment in Exotic Animal Critical Care. Vet Clin North Am Exot Anim Pract 2023:S1094-9194(23)00024-5. [PMID: 37321935 DOI: 10.1016/j.cvex.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Despite poor recognition in the literature, exotic companion animals are affected by many diseases that can result in disordered coagulation and fibrinolysis. This article outlines current knowledge of hemostasis, common diagnostic tests and reviews reported diseases associated with coagulopathy in small mammals, bird and reptiles. A range of conditions affect platelets and thrombocytes, endothelium and blood vessels, and plasma clotting factors. Improved recognition and monitoring of hemostatic disorders will enable targeted therapy and improved case outcomes.
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Affiliation(s)
- Kathryn L Perrin
- San Diego Zoo Wildlife Alliance, Veterinary Services, 15500 San Pasqual Valley Road, Escondido, CA 92027, USA.
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3
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Vuong KS, Jones M, Craig LE. Postmortem Evaluation of Cardiac Valvular Disease in Bald Eagles ( Haliaeetus leucocephalus) and a Golden Eagle ( Aquila chrysaetos). J Avian Med Surg 2023; 37:22-31. [PMID: 37358206 DOI: 10.1647/1082-6742-37.1.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Limited data are available regarding cardiac diseases in birds of prey despite their prevalence in these avian species. Literature regarding valvular lesions in birds of prey is scarce and includes single reports of left atrioventricular valvular endocarditis in an adult, free-ranging, male bald eagle (Haliaeetus leucocephalus) and aortic valvular endocarditis in an adult, free-ranging, female red-tailed hawk (Buteo jamaicensis). The purpose of this study was to evaluate the prevalence, signalment, gross necropsy findings, and histologic lesions of valvular lesions in eagles. In this retrospective study, necropsy reports for 24 free-ranging and captive eagles were evaluated over a 15-year period (July 3, 2006-February 28, 2021). Six (25%; 95% confidence interval: 8.9-58.9) birds, 5 bald eagles and 1 golden eagle (Aquila chrysaetos), met the inclusion criteria. Five (83.3%) of the 6 birds had valvular degeneration, 2 (33.3%) had endocarditis, and Staphylococcus aureus was cultured from 1 (16.7%) of the endocarditis cases. The 6 eagles with valvular lesions were all captive adults. Four of the birds were female (66.7%), and the aortic and left atrioventricular valves were equally affected. Acute or chronic cerebral infarcts were present in all 6 birds. Valvular cardiac disease should be considered as a differential diagnosis in eagles exhibiting respiratory distress, neurologic signs, syncope, or in cases of sudden death.
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Affiliation(s)
- Kristina S Vuong
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, TN 37996, USA
| | - Michael Jones
- Department of Small Animal Clinical Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, TN 37996, USA
| | - Linden E Craig
- Department of Biomedical and Diagnostic Sciences, University of Tennessee, College of Veterinary Medicine, Knoxville, TN 37996, USA,
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Sugimoto K, Toume K. Amphibian thrombocyte-derived extracellular vesicles, including microRNAs, induce angiogenesis-related genes in endothelial cells. Genes Cells 2021; 26:757-771. [PMID: 34224189 DOI: 10.1111/gtc.12882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 06/22/2021] [Accepted: 06/30/2021] [Indexed: 11/29/2022]
Abstract
Thrombocytes circulate in the blood of nonmammalian vertebrates and are involved in hemostasis; however, many detailed characteristics of thrombocytes remain unclear. Recently, we established an amphibian thrombocyte cell line. Here, we report the finding that thrombocytes produce integrin alpha IIb (CD41)-positive extracellular vesicles (EVs), which include microRNAs (miRs). Flow cytometric analysis showed the expression of CD41+ and phosphatidylserine on the surface of EVs. Nanotracking analysis showed that these CD41+ EVs were approximately 100 nm in diameter. As CD41+ EVs were also observed from African clawed frogs, the production of CD41+ EVs might be common to amphibians. Microarray analysis showed that the CD41+ EVs contain many kinds of miRs. These CD41+ EVs were phagocytosed by endothelial cells and macrophages. qPCR analysis showed that many angiogenesis-related genes were up-regulated in CD41+ EV-treated endothelial cells. Over-expression of some miRs in the CD41+ EVs increased the proliferation of endothelial cells. These results indicated that thrombocytes produced CD41+ EVs, including miRs, that were received by endothelial cells to induce the expression of angiogenesis-related genes. These results indicated that the CD41+ EVs produced from thrombocytes act as signaling molecules to repair damaged blood vessels.
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Affiliation(s)
- Kenkichi Sugimoto
- Department of Cell Science, Faculty of the Graduate School of Science and Technology, Niigata University, Niigata, Japan
| | - Kayano Toume
- Department of Cell Science, Faculty of the Graduate School of Science and Technology, Niigata University, Niigata, Japan
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Marín Ò, Aguirre J, de la Cruz X. Compensated pathogenic variants in coagulation factors VIII and IX present complex mapping between molecular impact and hemophilia severity. Sci Rep 2019; 9:9538. [PMID: 31267011 PMCID: PMC6606640 DOI: 10.1038/s41598-019-45916-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 06/18/2019] [Indexed: 01/07/2023] Open
Abstract
Compensated pathogenic deviations (CPDs) are sequence variants that are pathogenic in humans but neutral in other species. In recent years, our molecular understanding of CPDs has advanced substantially. For example, it is known that their impact on human proteins is generally milder than that of average pathogenic mutations and that their impact is suppressed in non-human carriers by compensatory mutations. However, prior studies have ignored the evolutionarily relevant relationship between molecular impact and organismal phenotype. Here, we explore this topic using CPDs from FVIII and FIX and data concerning carriers' hemophilia severity. We find that, regardless of their molecular impact, these mutations can be associated with either mild or severe disease phenotypes. Only a weak relationship is found between protein stability changes and severity. We also characterize the population variability of hemostasis proteins, which constitute the genetic background of FVIII and FIX, using data from the 1000 Genome project. We observe that genetic background can vary substantially between individuals in terms of both the amount and nature of genetic variants. Finally, we discuss how these results highlight the need to include new terms in present models of protein evolution to explain the origin of CPDs.
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Affiliation(s)
- Òscar Marín
- Research Unit in Clinical and Translational Bioinformatics, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, P/Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Josu Aguirre
- Research Unit in Clinical and Translational Bioinformatics, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, P/Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Xavier de la Cruz
- Research Unit in Clinical and Translational Bioinformatics, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, P/Vall d'Hebron, 119-129, 08035, Barcelona, Spain. .,ICREA, Barcelona, Spain.
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Rodenbaugh CI, Lyon SD, Hanzlicek AS, Kanda I, Payton ME, Rizzi TE, Holland LA, Brandão J. Dynamic viscoelastic coagulometry of blood obtained from healthy chickens. Am J Vet Res 2019; 80:441-448. [PMID: 31034267 DOI: 10.2460/ajvr.80.5.441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess feasibility of the use of a dynamic viscoelastic coagulometer on chicken blood and compare coagulation variables for fresh whole blood and sodium citrate-preserved whole blood as well as effects of 3 coagulation activators on blood from chickens. SAMPLE Blood samples from 30 hens. PROCEDURES Chickens were allowed to rest undisturbed for 1 hour. A blood sample was collected from an ulnar vein; 1.4 mL was analyzed immediately, and 1.8 mL was mixed with sodium citrate and subsequently recalcified and analyzed. A separate coagulation activator (glass beads, kaolin clay, or tissue factor) was in each of the 2 channels of the analyzer. Chickens were allowed a 1-hour rest period, and another blood sample was collected from the contralateral ulnar vein; it was processed in the same manner as for the first sample, except both channels of the analyzer contained the same coagulation activator. RESULTS Compared with fresh samples, citrated samples had higher values for activated clotting time and platelet function and lower clotting rates. Intra-assay coefficients of variation of coagulation profiles for citrated samples were markedly greater than the limit of 10%, whereas values for fresh samples were close to or < 10%. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that use of a dynamic viscoelastic coagulometer on chicken blood was feasible and that analysis of fresh whole blood from healthy chickens provided results with less variability than did analysis of citrated blood. Samples preserved with sodium citrate were associated with significant relative hypocoagulability, compared with results for fresh blood.
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Chana-Muñoz A, Jendroszek A, Sønnichsen M, Wang T, Ploug M, Jensen JK, Andreasen PA, Bendixen C, Panitz F. Origin and diversification of the plasminogen activation system among chordates. BMC Evol Biol 2019; 19:27. [PMID: 30654737 PMCID: PMC6337849 DOI: 10.1186/s12862-019-1353-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 01/02/2019] [Indexed: 01/01/2023] Open
Abstract
Background The plasminogen (PLG) activation system is composed by a series of serine proteases, inhibitors and several binding proteins, which together control the temporal and spatial generation of the active serine protease plasmin. As this proteolytic system plays a central role in human physiology and pathophysiology it has been extensively studied in mammals. The serine proteases of this system are believed to originate from an ancestral gene by gene duplications followed by domain gains and deletions. However, the identification of ancestral forms in primitive chordates supporting these theories remains elusive. In addition, evolutionary studies of the non-proteolytic members of this system are scarce. Results Our phylogenetic analyses place lamprey PLG at the root of the vertebrate PLG-group, while lamprey PLG-related growth factors represent the ancestral forms of the jawed-vertebrate orthologues. Furthermore, we find that the earliest putative orthologue of the PLG activator group is the hyaluronan binding protein 2 (HABP2) gene found in lampreys. The prime plasminogen activators (tissue- and urokinase-type plasminogen activator, tPA and uPA) first occur in cartilaginous fish and phylogenetic analyses confirm that all orthologues identified compose monophyletic groups to their mammalian counterparts. Cartilaginous fishes exhibit the most ancient vitronectin of all vertebrates, while plasminogen activator inhibitor 1 (PAI-1) appears for the first time in cartilaginous fishes and is conserved in the rest of jawed vertebrate clades. PAI-2 appears for the first time in the common ancestor of reptiles and mammals, and represents the latest appearing plasminogen activator inhibitor. Finally, we noted that the urokinase-type plasminogen activator receptor (uPAR)—and three-LU domain containing genes in general—occurred later in evolution and was first detectable after coelacanths. Conclusions This study identifies several primitive orthologues of the mammalian plasminogen activation system. These ancestral forms provide clues to the origin and diversification of this enzyme system. Further, the discovery of several members—hitherto unknown in mammals—provide new perspectives on the evolution of this important enzyme system. Electronic supplementary material The online version of this article (10.1186/s12862-019-1353-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrés Chana-Muñoz
- Department of Molecular Biology and Genetics, Aarhus University, 8830, Tjele, Denmark
| | - Agnieszka Jendroszek
- Department of Molecular Biology and Genetics, Aarhus University, 8000, Aarhus, Denmark.,Present address: Interdisciplinary Nanoscience Center - INANO-MBG, Aarhus University, 8000, Aarhus, Denmark
| | - Malene Sønnichsen
- Department of Molecular Biology and Genetics, Aarhus University, 8000, Aarhus, Denmark.,Present address: Interdisciplinary Nanoscience Center - INANO-MBG, Aarhus University, 8000, Aarhus, Denmark
| | - Tobias Wang
- Institute for Bioscience Zoophysiology, Aarhus University, 8000, Aarhus, Denmark
| | - Michael Ploug
- Finsen Laboratory, Rigshospitalet, DK-2200 Copenhagen N, Denmark and Biotech Research and Innovation Centre (BRIC), University of Copenhagen, DK-2200, Copenhagen, Denmark
| | - Jan K Jensen
- Department of Molecular Biology and Genetics, Aarhus University, 8000, Aarhus, Denmark
| | - Peter A Andreasen
- Department of Molecular Biology and Genetics, Aarhus University, 8000, Aarhus, Denmark
| | - Christian Bendixen
- Department of Molecular Biology and Genetics, Aarhus University, 8830, Tjele, Denmark
| | - Frank Panitz
- Department of Molecular Biology and Genetics, Aarhus University, 8830, Tjele, Denmark.
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Coagulotoxicity of Bothrops (Lancehead Pit-Vipers) Venoms from Brazil: Differential Biochemistry and Antivenom Efficacy Resulting from Prey-Driven Venom Variation. Toxins (Basel) 2018; 10:toxins10100411. [PMID: 30314373 PMCID: PMC6215258 DOI: 10.3390/toxins10100411] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/03/2018] [Accepted: 10/08/2018] [Indexed: 01/10/2023] Open
Abstract
Lancehead pit-vipers (Bothrops genus) are an extremely diverse and medically important group responsible for the greatest number of snakebite envenomations and deaths in South America. Bothrops atrox (common lancehead), responsible for majority of snakebites and related deaths within the Brazilian Amazon, is a highly adaptable and widely distributed species, whose venom variability has been related to several factors, including geographical distribution and habitat type. This study examined venoms from four B. atrox populations (Belterra and Santarém, PA; Pres. Figueiredo, AM and São Bento, MA), and two additional Bothrops species (B. jararaca and B. neuwiedi) from Southeastern region for their coagulotoxic effects upon different plasmas (human, amphibian, and avian). The results revealed inter– and intraspecific variations in coagulotoxicity, including distinct activities between the three plasmas, with variations in the latter two linked to ecological niche occupied by the snakes. Also examined were the correlated biochemical mechanisms of venom action. Significant variation in the relative reliance upon the cofactors calcium and phospholipid were revealed, and the relative dependency did not significantly correlate with potency. Relative levels of Factor X or prothrombin activating toxins correlated with prey type and prey escape potential. The antivenom was shown to perform better in neutralising prothrombin activation activity than neutralising Factor X activation activity. Thus, the data reveal new information regarding the evolutionary selection pressures shaping snake venom evolution, while also having significant implications for the treatment of the envenomed patient. These results are, therefore, an intersection between evolutionary biology and clinical medicine.
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Guddorf V, Rohn K, Kummerfeld N, Mischke R. [Vergleichende Bestimmung von Gerinnungsparametern in Blutproben verschiedener Wild- und Ziervogelspezies]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2017; 45:246-252. [PMID: 28480942 DOI: 10.15654/tpk-160059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 01/24/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Information about the influence of species variety or diseases on coagulation values in avian blood is rare. The aim of this study was to assess the influence of species on measurements of coagulation parameters in avian plasma samples using commercially available reagents and to investigate potential influences of selected diseases on clotting times. MATERIAL AND METHODS Prothrombin time (PT), activated partial thromboplastin time (aPTT) and thrombin time (TT) were measured in citrated plasma of healthy individuals collected from eight different wild and captive avian species applying currently commercially available reagents prepared for use in humans, which were preselected in preliminary studies. The same parameters were tested in plasma samples from birds affected by aspergillosis, atherosclerosis, neoplasia and traumata. RESULTS PT and aPTT showed a high interspecies variety. Irrespective of species, aPTTs were extremely long and partially exceeded the measurement range limit. Minor variations between species were seen in TT measurements. Clotting times obtained from birds affected by aspergillosis, atherosclerosis and neoplasia were not significantly different when compared to healthy birds. Plasma obtained from traumatised individuals showed significantly shorter PT and aPTT than that in healthy birds. CONCLUSION AND CLINICAL RELEVANCE Differences between species must be considered in diagnostic coagulation measurements in avian blood. Regardless of the avian species, aPTT measurements on avian samples appear to be of limited value. Lower PT and aPTT values reflect coagulation activation in traumatised birds.
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Affiliation(s)
- Vanessa Guddorf
- Vanessa Guddorf, Klinik für Heimtiere, Reptilien, Zier- und Wildvögel, Stiftung Tierärztliche Hochschule Hannover, Bünteweg 9, 30559 Hannover, Germany,
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Jarvis ED. Perspectives from the Avian Phylogenomics Project: Questions that Can Be Answered with Sequencing All Genomes of a Vertebrate Class. Annu Rev Anim Biosci 2016; 4:45-59. [PMID: 26884102 DOI: 10.1146/annurev-animal-021815-111216] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The rapid pace of advances in genome technology, with concomitant reductions in cost, makes it feasible that one day in our lifetime we will have available extant genomes of entire classes of species, including vertebrates. I recently helped cocoordinate the large-scale Avian Phylogenomics Project, which collected and sequenced genomes of 48 bird species representing most currently classified orders to address a range of questions in phylogenomics and comparative genomics. The consortium was able to answer questions not previously possible with just a few genomes. This success spurred on the creation of a project to sequence the genomes of at least one individual of all extant ∼10,500 bird species. The initiation of this project has led us to consider what questions now impossible to answer could be answered with all genomes, and could drive new questions now unimaginable. These include the generation of a highly resolved family tree of extant species, genome-wide association studies across species to identify genetic substrates of many complex traits, redefinition of species and the species concept, reconstruction of the genomes of common ancestors, and generation of new computational tools to address these questions. Here I present visions for the future by posing and answering questions regarding what scientists could potentially do with available genomes of an entire vertebrate class.
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Affiliation(s)
- Erich D Jarvis
- Department of Neurobiology, Duke University Medical Center, Durham, North Carolina 27710
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Struble E, Harrouk W, DeFelice A, Tesfamariam B. Nonclinical aspects of venous thrombosis in pregnancy. ACTA ACUST UNITED AC 2015; 105:190-200. [PMID: 26404176 DOI: 10.1002/bdrc.21111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pregnancy is a hypercoagulable state which carries an excess risk of maternal venous thrombosis. Endothelial injury, alterations in blood flow and activation of the coagulation pathway are proposed to contribute to the hypercoagulability. The risk for thrombosis may be accentuated by certain drugs and device implants that directly or indirectly affect the coagulation pathway. To help ensure that these interventions do not result in adverse maternal or fetal outcomes during pregnancy, gravid experimental animals can be exposed to such treatments at various stages of gestation and over a dosage range that would identify hazards and inform risk assessment. Circulating soluble biomarkers can also be evaluated for enhancing the assessment of any increased risk of venous thrombosis during pregnancy. In addition to traditional in vivo animal testing, efforts are under way to incorporate reliable non-animal methods in the assessment of embryofetal toxicity and thrombogenic effects. This review summarizes hemostatic balance during pregnancy in animal species, embryofetal development, biomarkers of venous thrombosis, and alterations caused by drug-induced venous thrombosis.
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Affiliation(s)
- Evi Struble
- Division of Hematology Research and Review, Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Wafa Harrouk
- Division of Nonprescription Drug Products, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Albert DeFelice
- Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Belay Tesfamariam
- Division of Cardiovascular and Renal Products, Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
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