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Fei J, Wang H, Han J, Zhang X, Ma H, Qin X, Yu C, Jiang J. TXNIP activates NLRP3/IL-1β and participate in inflammatory response and oxidative stress to promote deep venous thrombosis. Exp Biol Med (Maywood) 2023; 248:1588-1597. [PMID: 37749991 PMCID: PMC10676131 DOI: 10.1177/15353702231191124] [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: 09/11/2022] [Accepted: 04/12/2023] [Indexed: 09/27/2023] Open
Abstract
Increasing evidence indicates that deep venous thrombosis (DVT) is a common peripheral vascular disease. This study aims to investigate the mechanisms of thioredoxin-interacting protein (TXNIP) and nod-like receptor protein 3 (NLRP3) inflammasome in deep venous thrombosis (DVT). A total of 66 Sprague-Dawley (SD) rats were employed to conduct DVT model. DVT rat was treated with silenced TXNIP (si-TXNIP) lentivirus and MCC950 (a NLRP3 inhibitor). The thrombosis weight and weight/length ratio, tissue factor, inflammatory factors, superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione peroxidase (GSH-Px) were measured. Hematoxylin-eosin (H&E) staining was used to investigate the pathological change. Western blotting was used to determine the protein expression level. The expression level of thioredoxin (TRx) was suppressed, whereas TXNIP and NLRP3 were elevated in DVT rat. Si-TXNIP or MCC950 could reduce the thrombosis weight and weight/length ratio, ameliorate the pathological change, and decrease inflammatory reaction. Mechanistically, si-TXNIP or MCC950 inhibited the expression levels of TXNIP, NLRP3, and interleukin (IL)-1β while elevating the TRx level, thereby suppressing the DVT. Our study indicated that si-TXNIP or MCC950 injection rescued the injury of vein induced by DVT. The possible mechanisms connected with the inhibition of TXNIP and NLRP3. TXNIP is a possible therapeutic target for DVT.
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Affiliation(s)
- Jianwen Fei
- Department of Pulmonary and Critical Care Medicine, Yantaishan Hospital, Yantai 264000, China
| | - Haixia Wang
- Department of Pulmonary and Critical Care Medicine, Yantaishan Hospital, Yantai 264000, China
| | - Jin Han
- Department of Pulmonary and Critical Care Medicine, Yantaishan Hospital, Yantai 264000, China
| | - Xuefeng Zhang
- Department of Pulmonary and Critical Care Medicine, Yantaishan Hospital, Yantai 264000, China
| | - Hongfu Ma
- Department of Pulmonary and Critical Care Medicine, Yantaishan Hospital, Yantai 264000, China
| | - Xiao Qin
- Department of Pulmonary and Critical Care Medicine, Yantaishan Hospital, Yantai 264000, China
| | - Chaoxiao Yu
- Department of Pulmonary and Critical Care Medicine, Yantaishan Hospital, Yantai 264000, China
| | - Junjie Jiang
- Department of Orthopedics, Yantaishan Hospital, Yantai 264000, China
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Ghasemi M, Oh J, Jeong S, Lee M, Bohlooli Darian S, Oh K, Kim JK. Fabry-Perot Interferometric Fiber-Optic Sensor for Rapid and Accurate Thrombus Detection. BIOSENSORS 2023; 13:817. [PMID: 37622903 PMCID: PMC10452065 DOI: 10.3390/bios13080817] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/28/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
We present a fiber-optic sensor based on the principles of a Fabry-Perot interferometer (FPI), which promptly, sensitively, and precisely detects blood clot formation. This sensor has two types of sensor tips; the first was crafted by splicing a tapered fiber into a single-mode fiber (SMF), where fine-tuning was achieved by adjusting the tapered diameter and length. The second type is an ultra-compact blood FPI situated on the core of a single-mode fiber. The sensor performance was evaluated via clot-formation-indicating spectrum shifts induced by the varied quantities of a thrombin reagent introduced into the blood. The most remarkable spectral sensitivity of the micro-tip fiber type was approximately 7 nm/μL, with a power sensitivity of 4.1 dB/μL, obtained with a taper fiber diameter and length of 55 and 300 μm, respectively. For the SMF type, spectral sensitivity was observed to be 8.7 nm/μL, with an optical power sensitivity of 0.4 dB/μL. This pioneering fiber-optic thrombosis sensor has the potential for in situ applications, healthcare, medical monitoring, harsh environments, and chemical and biological sensing. The study underscores the scope of optical technology in thrombus detection, establishing a platform for future medical research and application.
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Affiliation(s)
- Marjan Ghasemi
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea; (M.G.); (S.J.); (M.L.)
| | - Jeongmin Oh
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (J.O.); (S.B.D.)
| | - Sunghoon Jeong
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea; (M.G.); (S.J.); (M.L.)
| | - Mingyu Lee
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea; (M.G.); (S.J.); (M.L.)
| | - Saeed Bohlooli Darian
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (J.O.); (S.B.D.)
| | - Kyunghwan Oh
- Department of Physics, Yonsei University, Seoul 03722, Republic of Korea; (M.G.); (S.J.); (M.L.)
| | - Jun Ki Kim
- Department of Biomedical Engineering, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; (J.O.); (S.B.D.)
- Biomedical Engineering Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul 05505, Republic of Korea
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Martin-Fernandez L, Garcia-Martínez I, Lopez S, Martinez-Perez A, Vilalta N, Plaza M, Moret C, Viñuela A, Brown AA, Panousis NI, Buil A, Dermitzakis ET, Corrales I, Souto JC, Vidal F, Soria JM. Multiallelic Copy Number Variation in ORM1 is Associated with Plasma Cell-Free DNA Levels as an Intermediate Phenotype for Venous Thromboembolism. Thromb Haemost 2023; 123:438-452. [PMID: 36696913 DOI: 10.1055/s-0043-1760844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Venous thromboembolism (VTE) is a common disease with high heritability. However, only a small portion of the genetic variance of VTE can be explained by known genetic risk factors. Neutrophil extracellular traps (NETs) have been associated with prothrombotic activity. Therefore, the genetic basis of NETs could reveal novel risk factors for VTE. A recent genome-wide association study of plasma cell-free DNA (cfDNA) levels in the Genetic Analysis of Idiopathic Thrombophilia 2 (GAIT-2) Project showed a significant associated locus near ORM1. We aimed to further explore this candidate region by next-generation sequencing, copy number variation (CNV) quantification, and expression analysis using an extreme phenotype sampling design involving 80 individuals from the GAIT-2 Project. The RETROVE study with 400 VTE cases and 400 controls was used to replicate the results. A total of 105 genetic variants and a multiallelic CNV (mCNV) spanning ORM1 were identified in GAIT-2. Of these, 17 independent common variants, a region of 22 rare variants, and the mCNV were significantly associated with cfDNA levels. In addition, eight of these common variants and the mCNV influenced ORM1 expression. The association of the mCNV and cfDNA levels was replicated in RETROVE (p-value = 1.19 × 10-6). Additional associations between the mCNV and thrombin generation parameters were identified. Our results reveal that increased mCNV dosages in ORM1 decreased gene expression and upregulated cfDNA levels. Therefore, the mCNV in ORM1 appears to be a novel marker for cfDNA levels, which could contribute to VTE risk.
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Affiliation(s)
- Laura Martin-Fernandez
- Genomics of Complex Diseases Unit, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
- Congenital Coagulopathies Laboratory, Blood and Tissue Bank, Barcelona, Spain
- Fundación Española de Trombosis y Hemostasia (FETH), Madrid, Spain
- Transfusional Medicine, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain
| | - Iris Garcia-Martínez
- Congenital Coagulopathies Laboratory, Blood and Tissue Bank, Barcelona, Spain
- Transfusional Medicine, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain
| | - Sonia Lopez
- Genomics of Complex Diseases Unit, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Angel Martinez-Perez
- Genomics of Complex Diseases Unit, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Noelia Vilalta
- Hemostasis and Thrombosis Unit, Department of Hematology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Melania Plaza
- Hemostasis and Thrombosis Unit, Department of Hematology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Carla Moret
- Hemostasis and Thrombosis Unit, Department of Hematology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Ana Viñuela
- Biosciences Institute, Faculty of Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Andrew A Brown
- Population Health and Genomics, University of Dundee, Dundee, Scotland, United Kingdom
| | - Nikolaos I Panousis
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, South Cambridgeshire, United Kingdom
- Department of Genetic Medicine and Development, University of Geneva, Geneva, Switzerland
| | - Alfonso Buil
- Institute of Biological Psychiatry, Mental Health Sct. Hans Hospital, Roskilde, Denmark
| | | | - Irene Corrales
- Congenital Coagulopathies Laboratory, Blood and Tissue Bank, Barcelona, Spain
- Transfusional Medicine, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto Carlos III (ISCIII), Madrid, Spain
| | - Juan Carlos Souto
- Hemostasis and Thrombosis Unit, Department of Hematology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
| | - Francisco Vidal
- Congenital Coagulopathies Laboratory, Blood and Tissue Bank, Barcelona, Spain
- Transfusional Medicine, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona (VHIR-UAB), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto Carlos III (ISCIII), Madrid, Spain
| | - Jose Manuel Soria
- Genomics of Complex Diseases Unit, Research Institute Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain
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Iarossi M, Hermans C. Direct Oral Anticoagulants for Inferior Vena Cava Agenesis. Clin Appl Thromb Hemost 2023; 29:10760296231200224. [PMID: 37671416 PMCID: PMC10483963 DOI: 10.1177/10760296231200224] [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] [Received: 06/16/2023] [Revised: 08/12/2023] [Accepted: 08/23/2023] [Indexed: 09/07/2023] Open
Abstract
Deep vein thrombosis (DVT) is common in the general population, with an annual incidence of 1 to 2 per 1000 people. Inferior vena cava agenesis (IVCA) increased the risk of developing DVT and is found in approximately 5% of young adults (20-40-year-olds) diagnosed with unprovoked proximal DVT. IVCA can be caused by a defective embryological process, or be a result of intrauterine or perinatal thrombosis. Its estimated incidence in the general population ranges from 0.0005% to 1%, usually involving a partial absence of one of the four segments of the inferior vena cava (IVC). The management during the extended phase of patients with DVT associated with IVCA is not yet harmonized, as it is poorly described in the literature. Patients with IVCA are considered to be at high risk of DVT occurrence, prompting physicians to continue extended anticoagulation, often using vitamin K antagonists. In this retrospective study, we present a cohort of 11 patients diagnosed with IVCA following a DVT, who subsequently received extended treatment with a direct oral anticoagulants. These findings offer reassuring insights into the extended utilization of direct oral anticoagulants, demonstrating both antithrombotic efficacy and a favorable safety profile.
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Affiliation(s)
- Michael Iarossi
- Division of Haematology, Haemostasis and Thrombosis Unit, Saint-Luc University Hospital, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Cedric Hermans
- Division of Haematology, Haemostasis and Thrombosis Unit, Saint-Luc University Hospital, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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Thrombophilia and outcomes of venous thromboembolism in older patients. Res Pract Thromb Haemost 2022; 7:100015. [PMID: 36970742 PMCID: PMC10031374 DOI: 10.1016/j.rpth.2022.100015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 10/12/2022] [Accepted: 10/30/2022] [Indexed: 01/26/2023] Open
Abstract
Background Limited data exist on thrombophilic risk factors and clinical outcomes in the elderly with venous thromboembolism (VTE). Objectives To describe the prevalence of laboratory thrombophilic risk factors and their association with VTE recurrence or death in a cohort of elderly people with VTE. Methods In 240 patients aged ≥65 years with acute VTE without active cancer or an indication for extended anticoagulation, we performed laboratory thrombophilia testing 1 year after the index VTE. Recurrence or death was assessed during the 2-year follow-up. Results A total of 78% of patients had ≥1 laboratory thrombophilic risk factor(s). Elevated levels of von Willebrand factor, homocysteine, coagulant activity of factor VIII (FVIII:C), fibrinogen, FIX:C, and low antithrombin activity were the most prevalent risk factors (43%, 30%, 15%, 14%, 13%, and 11%, respectively). Additionally, 16.2% of patients experienced VTE recurrence and 5.8% of patients died. Patients with a von Willebrand factor of >182%, FVIII:C level >200%, homocysteine level >15μmol/L, or lupus anticoagulant had a significantly higher rate of recurrence than those without these risk factors (15.0 vs. 6.1 [P = .006], 23.5 vs. 8.2 [P = .01], 17.0 vs. 6.8 [P = .006], and 89.5 vs. 9.2 [P = .02] events per 100 patient-years, respectively). Furthermore, patients with a high fibrinogen level or hyperhomocysteinemia with a homocysteine level ≥30 μmol/L had significantly higher mortality than patients with normal levels (18.5 vs. 2.8 [P = .049] and 13.6 vs. 2 [P = .002] deaths per 100 patient-years, respectively). After adjustments for relevant confounders, these associations remained unchanged. Conclusion Laboratory thrombophilic risk factors are common in elderly people with VTE and allow for the identification of a population at the risk of worse clinical outcomes.
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Speck NE, Hellstern P, Farhadi J. Microsurgical Breast Reconstruction in Patients with Disorders of Hemostasis: Perioperative Risks and Management. Plast Reconstr Surg 2022; 150:95S-104S. [PMID: 35943960 PMCID: PMC10262037 DOI: 10.1097/prs.0000000000009499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 11/23/2021] [Indexed: 10/15/2022]
Abstract
BACKGROUND Surgical and technological advances have resulted in the widespread adoption of microsurgical breast reconstruction. Many comorbidities that potentially might impair vasculature and wound healing are no longer considered contraindications for these procedures. However, some uncertainty still prevails regarding the perioperative management of patients with disorders of hemostasis. METHODS The authors combined a literature review with a retrospective chart review of patients with disorders of hemostasis who had undergone microsurgical breast reconstruction at the senior author's (J.F.) center between 2015 to 2020. Several disorders associated with thrombotic and/or hemorrhagic complications were identified, and a standardized risk assessment and management strategy was developed in cooperation with a hematologist. RESULTS Overall, 10 studies were identified comprising 29 patients who had a defined disorder of hemostasis and underwent microsurgical breast reconstruction. Seventeen microsurgical breast reconstructions were performed on 11 patients at the senior author's (J.F.) center. High factor VIII levels, heterozygous factor V Leiden, and heterozygous prothrombin mutation G20210A were the most common genetic or mixed genetic/acquired thrombophilic conditions. As expected, hereditary antithrombin, protein C, or protein S deficiencies were rare. Among hemorrhagic disorders, thrombocytopenia, platelet dysfunction, and von Willebrand disease or low von Willebrand factor levels were those factors most frequently associated with increased perioperative bleeding. CONCLUSIONS Patients should be screened for elevated risk of thrombosis or bleeding before undergoing microsurgical breast reconstruction, and positive screening should prompt a complete hematologic evaluation. Interdisciplinary management of these disorders with a hematologist is essential to minimize risks and to obtain optimal reconstructive results. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, IV.
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Affiliation(s)
- Nicole E. Speck
- From the Plastic Surgery Group; Center of Hemostasis and Thrombosis Zurich; and University of Basel
| | - Peter Hellstern
- From the Plastic Surgery Group; Center of Hemostasis and Thrombosis Zurich; and University of Basel
| | - Jian Farhadi
- From the Plastic Surgery Group; Center of Hemostasis and Thrombosis Zurich; and University of Basel
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Sanchez ZAC, Vijayananda V, Virassammy DM, Rosenfeld L, Ramasubramanian AK. The interaction of vortical flows with red cells in venous valve mimics. BIOMICROFLUIDICS 2022; 16:024103. [PMID: 35282036 PMCID: PMC8896891 DOI: 10.1063/5.0078337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
The motion of cells orthogonal to the direction of main flow is of importance in natural and engineered systems. The lateral movement of red blood cells (RBCs) distal to sudden expansion is considered to influence the formation and progression of thrombosis in venous valves, aortic aneurysms, and blood-circulating devices and is also a determining parameter for cell separation applications in flow-focusing microfluidic devices. Although it is known that the unique geometry of venous valves alters the blood flow patterns and cell distribution in venous valve sinuses, the interactions between fluid flow and RBCs have not been elucidated. Here, using a dilute cell suspension in an in vitro microfluidic model of a venous valve, we quantified the spatial distribution of RBCs by microscopy and image analysis, and using micro-particle image velocimetry and 3D computational fluid dynamics simulations, we analyzed the complex flow patterns. The results show that the local hematocrit in the valve pockets is spatially heterogeneous and is significantly different from the feed hematocrit. Above a threshold shear rate, the inertial separation of streamlines and lift forces contribute to an uneven distribution of RBCs in the vortices, the entrapment of RBCs in the vortices, and non-monotonic wall shear stresses in the valve pockets. Our experimental and computational characterization provides insights into the complex interactions between fluid flow, RBC distribution, and wall shear rates in venous valve mimics, which is of relevance to understanding the pathophysiology of thrombosis and improving cell separation efficiency.
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Liao F, Zeng JL, Pan JG, Ma J, Zhang ZJ, Lin ZJ, Lin LF, Chen YS, Ma XT. Patients with SERPINC1 rs2227589 polymorphism found to have multiple cerebral venous sinus thromboses despite a normal antithrombin level: A case report. World J Clin Cases 2022; 10:618-624. [PMID: 35097087 PMCID: PMC8771368 DOI: 10.12998/wjcc.v10.i2.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 10/10/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The hereditary antithrombin (AT) deficiency caused by SERPINC1 gene mutation is an autosomal dominant thrombotic disorder. An increasing number of studies have shown that mutations in the SERPINC1 rs2227589 polymorphic site are correlated with a risk of venous thromboembolism (VTE) at common sites, such as lower extremity deep venous thrombosis and pulmonary thromboembolism. Currently, there are no reports of cerebral venous sinus thrombosis (CVST), a VTE site with a low incidence rate and rs2227589 polymorphism.
CASE SUMMARY Here, we report a Chinese CVST case with a mutation of the SERPINC1 rs2227589 polymorphic site, which did not cause significant AT deficiency. In a 50-year-old male patient presenting with multiple cerebral venous sinus thromboses no predisposing factors were detected, although a relative had a history of lower extremity deep venous thrombosis. We performed sequencing of the SERPINC1 gene for the patient and his daughter, which revealed the same heterozygous mutation at the rs2227589 polymorphic site: c.41+141G>A.
CONCLUSION The results showed that more studies should be conducted to assess the correlation between rs2227589 polymorphism and CVST.
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Affiliation(s)
- Feng Liao
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Jun-Ling Zeng
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Jian-Gang Pan
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Jing Ma
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Zhi-Jian Zhang
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Zhi-Jun Lin
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Li-Feng Lin
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Yu-Sen Chen
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Xiao-Tang Ma
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
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Ramberg C, Wilsgård L, Latysheva N, Brækkan SK, Hindberg K, Sovershaev T, Snir O, Hansen J. Plasma procoagulant phospholipid clotting time and venous thromboembolism risk. Res Pract Thromb Haemost 2021; 5:e12640. [PMID: 34977449 PMCID: PMC8686193 DOI: 10.1002/rth2.12640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/03/2021] [Accepted: 11/01/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Negatively charged procoagulant phospholipids, phosphatidylserine (PS) in particular, are vital to coagulation and expressed on the surface membrane of extracellular vesicles. No previous study has investigated the association between plasma procoagulant phospholipid clotting time (PPLCT) and future risk of venous thromboembolism (VTE). OBJECTIVES To investigate the association between plasma PPLCT and the risk of incident VTE in a nested case-control study. METHODS We conducted a nested case-control study in 296 VTE patients and 674 age- and sex-matched controls derived from a general population cohort (The Tromsø Study 1994-2007). PPLCT was measured in platelet-free plasma using a modified factor Xa-dependent clotting assay. Logistic regression was used to estimate odds ratio (OR) with 95% confidence intervals (CI) for VTE with PPLCT modelled as a continuous variable across quartiles and in dichotomized analyses. RESULTS There was a weak inverse association between plasma PPLCT and risk of VTE per 1 standard deviation increase of PPLCT (OR 0.93, 95% CI 0.80-1.07) and when comparing those with PPLCT in the highest quartile (OR 0.89, 95% CI 0.60-1.30) with those in the lowest quartile. Subjects with PPLCT >95th percentile had substantially lowered OR for VTE (OR 0.35, 95% CI 0.13-0.81). The inverse association was stronger when the analyses were restricted to samples taken shortly before the event. The risk estimates by categories of plasma PPLCT were similar for deep vein thrombosis and pulmonary embolism. CONCLUSION Our findings suggest that high plasma PPLCT is associated with reduced risk of VTE.
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Affiliation(s)
- Cathrine Ramberg
- Thrombosis Research Centre (TREC)Department of Clinical MedicineUiT ‐ The Arctic University of NorwayTromsøNorway
| | - Line Wilsgård
- Thrombosis Research Centre (TREC)Department of Clinical MedicineUiT ‐ The Arctic University of NorwayTromsøNorway
| | - Nadezhda Latysheva
- Thrombosis Research Centre (TREC)Department of Clinical MedicineUiT ‐ The Arctic University of NorwayTromsøNorway
| | - Sigrid K. Brækkan
- Thrombosis Research Centre (TREC)Department of Clinical MedicineUiT ‐ The Arctic University of NorwayTromsøNorway
- Division of Internal MedicineUniversity Hospital of North NorwayTromsøNorway
| | - Kristian Hindberg
- Thrombosis Research Centre (TREC)Department of Clinical MedicineUiT ‐ The Arctic University of NorwayTromsøNorway
| | - Timofey Sovershaev
- Thrombosis Research Centre (TREC)Department of Clinical MedicineUiT ‐ The Arctic University of NorwayTromsøNorway
| | - Omri Snir
- Thrombosis Research Centre (TREC)Department of Clinical MedicineUiT ‐ The Arctic University of NorwayTromsøNorway
| | - John‐Bjarne Hansen
- Thrombosis Research Centre (TREC)Department of Clinical MedicineUiT ‐ The Arctic University of NorwayTromsøNorway
- Division of Internal MedicineUniversity Hospital of North NorwayTromsøNorway
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Wang Q, Yuan L, Ding X, Zhou Z. Prediction and Diagnosis of Venous Thromboembolism Using Artificial Intelligence Approaches: A Systematic Review and Meta-Analysis. Clin Appl Thromb Hemost 2021; 27:10760296211021162. [PMID: 34184560 PMCID: PMC8246532 DOI: 10.1177/10760296211021162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Venous thromboembolism (VTE) is a fatal disease and has become a burden on the global health system. Recent studies have suggested that artificial intelligence (AI) could be used to make a diagnosis and predict venous thrombosis more accurately. Thus, we performed a meta-analysis to better evaluate the performance of AI in the prediction and diagnosis of venous thrombosis. PubMed, Web of Science, and EMBASE were used to identify relevant studies. Of the 741 studies, 12 met the inclusion criteria and were included in the meta-analysis. Among them, 5 studies included a training set and test set, and 7 studies included only a training set. In the training set, the pooled sensitivity was 0.87 (95% CI 0.79-0.92), the pooled specificity was 0.95 (95% CI 0.89-0.97), and the area under the summary receiver operating characteristic (SROC) curve was 0.97 (95% CI 0.95-0.98). In the test set, the pooled sensitivity was 0.87 (95% CI 0.74-0.93), the pooled specificity was 0.96 (95% CI 0.79-0.99), and the area under the SROC curve was 0.98 (95% CI 0.97-0.99). The combined results remained significant in the subgroup analyzes, which included venous thrombosis type, AI type, model type (diagnosis/prediction), and whether the period was perioperative. In conclusion, AI may aid in the diagnosis and prediction of venous thrombosis, demonstrating high sensitivity, specificity and area under the SROC curve values. Thus, AI has important clinical value.
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Affiliation(s)
- Qi Wang
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Wuhu, China
| | - Lili Yuan
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Wuhu, China
| | - Xianhui Ding
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Wuhu, China
| | - Zhiming Zhou
- Department of Neurology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, Wuhu, China
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Crippen MM, Ganti RS, Xu V, Swendseid B, Tzeng DL, Curry J. Outcomes in Head and Neck Free Flap Reconstruction Among Patients With a History of Venous Thromboembolism. Otolaryngol Head Neck Surg 2021; 166:267-273. [PMID: 34060945 DOI: 10.1177/01945998211011999] [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: 11/15/2022]
Abstract
OBJECTIVE To investigate if a history of venous thromboembolism (VTE) is a risk factor for complications in head and neck free flap surgery by assessing outcomes among patients with a history of deep vein thrombosis (DVT) and/or pulmonary embolism (PE). STUDY DESIGN Retrospective cohort study. SETTING Single tertiary care center. METHODS All patients undergoing head and neck free flap reconstruction at our institution between September 1, 2006, and April 2, 2020, were assessed for inclusion. Patients with and without a history of DVT or PE preoperatively were identified and grouped for comparison. Groups were compared for demographics, comorbidities, and 30-day complications. Significance was assessed with chi-square and binary logistic regression analyses. RESULTS Of the 1061 patients meeting inclusion criteria, 40 (3.8%) had a history of VTE. These patients were significantly older (mean [SD], years: 67.8 [11.7] vs 63.0 [14.1], P = .038) and significantly more likely to have history of chemotherapy (35.0% vs 18.7%, P = .010) and stroke (27.5% vs 4.5%, P < .001). After accounting for patient characteristics via binary logistic regression, VTE was independently associated with an increased risk for postoperative thrombosis of the free flap pedicle (odds ratio [95% CI] = 3.65 [1.12-11.90], P = .032) and reoperation (2.45 [1.25-4.80], P = .009). Patients with history of PE had a significantly increased risk for flap failure (7.70 [1.77-33.52], P = .007). Prior VTE was not independently associated with an increased risk for medical complications or readmission. CONCLUSION Patients with a history of VTE may be at an increased risk for free flap compromise secondary to postoperative pedicle thrombosis. This risk should be considered in preoperative workup and postoperative monitoring.
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Affiliation(s)
- Meghan M Crippen
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Rohan S Ganti
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Vivian Xu
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Brian Swendseid
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Diana L Tzeng
- Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Joseph Curry
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Katić J, Katić A, Katić K, Duplančić D, Lozo M. CONCURRENT DEEP VEIN THROMBOSIS AND PULMONARY EMBOLISM ASSOCIATED WITH HYPERTHYROIDISM: A CASE REPORT. Acta Clin Croat 2021; 60:314-316. [PMID: 34744284 PMCID: PMC8564842 DOI: 10.20471/acc.2021.60.02.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022] Open
Abstract
Numerous disorders of coagulation and fibrinolysis have been reported in patients with thyroid diseases, especially with hyperthyroidism. Most articles are focused on deep vein thrombosis risk, however, few of them describe association between hyperthyroidism and pulmonary embolism. We report a case of a 43-year-old woman with long-term uncontrolled hyperthyroidism complicated by venous thromboembolism. The potential mechanisms could be endothelial dysfunction, decreased fibrinolytic activity, and increased levels of coagulation factors. Thyroid evaluation should be recommended in patients with unprovoked venous thromboembolic events.
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Affiliation(s)
| | - Ana Katić
- 1Department of Cardiology, Split University Hospital Centre, Split, Croatia; 2University of Split School of Medicine, Split, Croatia; 3Department of Ophthalmology, Split University Hospital Centre, Split, Croatia
| | - Karla Katić
- 1Department of Cardiology, Split University Hospital Centre, Split, Croatia; 2University of Split School of Medicine, Split, Croatia; 3Department of Ophthalmology, Split University Hospital Centre, Split, Croatia
| | - Darko Duplančić
- 1Department of Cardiology, Split University Hospital Centre, Split, Croatia; 2University of Split School of Medicine, Split, Croatia; 3Department of Ophthalmology, Split University Hospital Centre, Split, Croatia
| | - Mislav Lozo
- 1Department of Cardiology, Split University Hospital Centre, Split, Croatia; 2University of Split School of Medicine, Split, Croatia; 3Department of Ophthalmology, Split University Hospital Centre, Split, Croatia
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13
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Satturwar S, Fowkes M, Farver C, Wilson AM, Eccher A, Girolami I, Pujadas E, Bryce C, Salem F, El Jamal SM, Paniz-Mondolfi A, Petersen B, Gordon RE, Reidy J, Fraggetta F, Marshall DA, Pantanowitz L. Postmortem Findings Associated With SARS-CoV-2: Systematic Review and Meta-analysis. Am J Surg Pathol 2021; 45:587-603. [PMID: 33481385 PMCID: PMC8132567 DOI: 10.1097/pas.0000000000001650] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Coronavirus Disease 2019 (COVID-19), caused by the novel Severe Acute Respiratory Syndrome-associated Coronavirus 2 (SARS-CoV-2), has become a global threat to public health. COVID-19 is more pathogenic and infectious than the prior 2002 pandemic caused by SARS-CoV-1. The pathogenesis of certain disease manifestations in COVID-19 such as diffuse alveolar damage (DAD) are thought to be similar to SARS-CoV-1. However, the exact pathogenesis of COVID-19 related deaths remains poorly understood. The aim of this article was to systematically summarize the rapidly emerging literature regarding COVID-19 autopsies. A meta-analysis was also conducted based on data accrued from preprint and published articles on COVID-19 (n=241 patients) and the results compared with postmortem findings associated with SARS-CoV-1 deaths (n=91 patients). Both autopsy groups included mostly adults of median age 70 years with COVID-19 and 50 years with SARS-CoV-1. Overall, prevalence of DAD was more common in SARS-CoV-1 (100.0%) than COVID-19 (80.9%) autopsies (P=0.001). Extrapulmonary findings among both groups were not statistically significant except for hepatic necrosis (P <0.001), splenic necrosis (P<0.006) and white pulp depletion (P <0.001) that were more common with SARS-CoV-1. Remarkable postmortem findings in association with COVID-19 apart from DAD include pulmonary hemorrhage, viral cytopathic effect within pneumocytes, thromboembolism, brain infarction, endotheliitis, acute renal tubular damage, white pulp depletion of the spleen, cardiac myocyte necrosis, megakaryocyte recruitment, and hemophagocytosis.
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Affiliation(s)
- Swati Satturwar
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Mary Fowkes
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Carol Farver
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | | | - Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona
| | - Ilaria Girolami
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona
| | - Elisabet Pujadas
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Clare Bryce
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Fadi Salem
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Siraj M. El Jamal
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Bruce Petersen
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ronald E. Gordon
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jason Reidy
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Desiree A. Marshall
- Department of Pathology, University of Washington Medical Center, Seattle, WA
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14
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Hugon-Rodin J, Perol S, Plu-Bureau G. [Menopause and risk of thromboembolic events. Postmenopausal women management: CNGOF and GEMVi clinical practice guidelines]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2021; 49:455-461. [PMID: 33757918 DOI: 10.1016/j.gofs.2021.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The incidence of venous thromboembolism (VTE) increases with age with an annual incidence of 1.25/1000 women in the 40-59 age group. Menopausal hormone therapy (MHT) may also increase the risk of VTE. This risk must be assessed during the first consultation before initiating MHT and assess each renewal of the MHT. MHT with oral estrogen combined (or not) with progestin increases the risk of VTE by about 70%. Using transdermal estrogen does not appear to increase the risk of VTE in women. VTE risk appears to be modulated by the type of progestin combined in MHT. The risk of VTE associated with MHT with transdermal estradiol appears to be safe in women using micronised progesterone and pregnane derivatives and higher in women using norpregnane derivatives . To limit the risk of VTE associated with MHT, transdermal estradiol use is recommended. In women at risk of VTE, MHT with oral estrogen is contraindicated. MHT with transdermal estradiol associated (or not) with micronised progesterone or dydrogesterone may be used in women with low or moderate risk of VTE.
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Affiliation(s)
- J Hugon-Rodin
- Service de gynécologie, groupe hospitalier Paris Saint-Joseph, Paris, France; Inserm U 1153, Épidémiologie obstétricale, périnatale et pédiatrique, Centre de recherche en épidémiologie et statistiques, Paris, France
| | - S Perol
- Service de gynécologie obstétrique, unité de gynécologie médicale, hôpital Port-Royal-Cochin, Paris, France; Université de Paris, Paris, France
| | - G Plu-Bureau
- Service de gynécologie obstétrique, unité de gynécologie médicale, hôpital Port-Royal-Cochin, Paris, France; Université de Paris, Paris, France; Inserm U 1153, Épidémiologie obstétricale, périnatale et pédiatrique, Centre de recherche en épidémiologie et statistiques, Paris, France.
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15
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Gromadziński L, Skowrońska A, Holak P, Smoliński M, Lepiarczyk E, Żurada A, Majewski MK, Skowroński MT, Majewska M. A New Experimental Porcine Model of Venous Thromboembolism. J Clin Med 2021; 10:1862. [PMID: 33923100 PMCID: PMC8123404 DOI: 10.3390/jcm10091862] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/19/2021] [Accepted: 04/24/2021] [Indexed: 12/22/2022] Open
Abstract
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a severe disease affecting the human venous system, accompanied by high morbidity and mortality rates. The aim of the study was to establish a new porcine VTE model based on the formation of the thrombus in vivo. The study was performed on 10 castrated male pigs: thrombus was formed in each closed femoral vein and then successfully released from the right femoral vein into the circulation of animals. In six pigs PE was confirmed via both computed tomography pulmonary angiography and an autopsy. Our research presents a novel experimental porcine model of VTE that involves inducing DVT and PE in the same animal in vivo, making it suitable for advanced clinical research and testing of future therapies.
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Affiliation(s)
- Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Warszawska Str. 30, 10-082 Olsztyn, Poland;
| | - Agnieszka Skowrońska
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Warszawska Str. 30, 10-082 Olsztyn, Poland; (A.S.); (E.L.); (M.K.M.)
| | - Piotr Holak
- Department of Surgery and Radiology with Clinic, Faculty of Veterinary Medicine, University of Warmia and Mazury in Olsztyn, Oczapowskiego Str. 14, 10-719 Olsztyn, Poland;
| | - Michał Smoliński
- University Clinical Hospital in Olsztyn, Clinic of Cardiology and Internal Diseases, Warszawska Str. 30, 10-082 Olsztyn, Poland;
| | - Ewa Lepiarczyk
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Warszawska Str. 30, 10-082 Olsztyn, Poland; (A.S.); (E.L.); (M.K.M.)
| | - Anna Żurada
- Department of Radiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Warszawska Str. 30, 10-082 Olsztyn, Poland;
| | - Mariusz Krzysztof Majewski
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Warszawska Str. 30, 10-082 Olsztyn, Poland; (A.S.); (E.L.); (M.K.M.)
| | - Mariusz Tomasz Skowroński
- Department of Basic and Preclinical Sciences, Institute for Veterinary Medicine, Nicolaus Copernicus University, Gagarina Str. 7, 87-100 Torun, Poland;
| | - Marta Majewska
- Department of Human Physiology and Pathophysiology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Warszawska Str. 30, 10-082 Olsztyn, Poland; (A.S.); (E.L.); (M.K.M.)
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16
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Doshi G, Nailwal N. A Review on Molecular Mechanisms and Patents of Marine-derived Anti-thrombotic Agents. Curr Drug Targets 2021; 22:318-335. [PMID: 33081673 DOI: 10.2174/1389450121666201020151927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 11/22/2022]
Abstract
Thrombosis is a condition of major concern worldwide as it is associated with life-threatening diseases related to the cardiovascular system. The condition affects 1 in 1000 adults annually, whereas 1 in 4 dies due to thrombosis, and this increases as the age group increases. The major outcomes are considered to be a recurrence, bleeding due to commercially available anti-coagulants, and deaths. The side effects associated with available anti-thrombotic drugs are a point of concern. Therefore, it is necessary to discover and develop an improvised benefit-risk profile drug, therefore, in search of alternative therapy for the treatment of thrombosis, marine sources have been used as promising treatment agents. They have shown the presence of sulfated fucans/galactans, fibrinolytic proteases, diterpenes, glycosaminoglycan, glycoside, peptides, amino acids, sterols, polysaccharides, polyphenols, vitamins, and minerals. Out of these marine sources, many chemicals were found to have anti-thrombotic activities. This review focuses on the recent discovery of anti-thrombotic agents obtained from marine algae, sponges, mussels, and sea cucumber, along with their mechanism of action and patents on its extraction process, preparation methods, and their applications. Further, the article concludes with the author's insight related to marine drugs, which have a promising future.
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Affiliation(s)
- Gaurav Doshi
- Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, V.M. Road, Vile Parle (W), Mumbai, Maharashtra, India
| | - Namrata Nailwal
- M. Pharm Research Scholar, Department of Pharmacology, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, V.M. Road, Vile Parle (W), Mumbai, Maharashtra, India
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17
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Role of Inferior Vena Cava Filter Retrieval in Patients on Chronic Anticoagulation Therapy. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2021. [DOI: 10.1007/s11936-020-00891-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractPurpose of reviewDescribe the role of inferior vena cava filter (IVCF) retrieval in patients on chronic anticoagulation given the overlap of these treatment options in the management of patients with venous thromboembolic disease.Recent findingsDespite the increase in IVCF retrievals since the Food and Drug Administration safety communications in 2010 and 2014, retrieval rates remain low. Previous studies have shown that longer filter dwell times are associated with greater risk for filter complications and more difficulty with filter retrievals. Recent findings suggest that complications are more frequent in the first 30 days after placement.SummaryThe decision to retrieve an optional IVCF is individualized and requires diligent follow-up with consistent re-evaluation of the need for the indwelling IVCF, particularly in those on long-term anticoagulation therapy.
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18
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MicroRNA Signatures in Plasma of Patients With Venous Thrombosis: A Preliminary Report. Am J Med Sci 2021; 361:509-516. [PMID: 33781391 DOI: 10.1016/j.amjms.2020.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/11/2020] [Accepted: 12/04/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a frequent and potentially fatal disease, but its pathophysiology is incompletely understood. microRNAs (miR) dysregulate hemostatic proteins and influence thrombotic pathology by posttranscriptional regulation of gene expression. Consensus in defining VTE-related miR clusters and functionally relevant miR has not been reached. We aimed to generate a miR database in patients at high thrombotic risk of VTE and explored their biological functions by seeking information on their messenger RNA targets. METHODS By high-throughput screening (Affymetrix miRNA Microarray), we identified 159 miR in venous blood of male patients who had two unprovoked VTE and in age-matched male controls. RESULTS Of the 159 miR, 41 were significantly higher expressed in patients compared to controls. Six miR (hsa-miR-6798-3p, hsa-miR-6789-5p hsa-miR-4651, hsa-miR-6765-5p, hsa-miR-6816-5p, hsa-miR-4734) were modulated ≥ 5.0-fold higher. Higher expression levels of 4 of these miR (hsa-miR-6789-5p, hsa-miR-4651, hsa-miR-6765-5p, and hsa-miR-6816-5p; primers were unavailable for hsa-miR-6798-3p and hsa-miR-4734) were confirmed by quantitative real-time polymerase chain reaction in 10 independent patients and 10 control samples. Ingenuity Pathway Analysis identified 23 altered miR including hsa-miR-6789-5p, hsa-miR-4651, hsa-miR-6765-5p and hsa-miR-4734 as the main regulators of messenger RNAs involved in the pathology of VTE. Seven messenger RNA targets including thrombomodulin and four targets related to platelet function had a direct relationship to 4 identified miR. CONCLUSIONS We provide evidence of distinct, independently validated miR signatures in patients with VTE and identified a subset of miR as main regulators of messenger RNA involved in disorders related to pathophysiologic processes in venous thrombosis development.
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19
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Yousef B, Abdalla M, Hassan A. Evaluation of Use and Outcomes of Heparins in Acute Deep Venous Thrombosis Treatment at Khartoum State Hospitals: A Descriptive Retrospective Study. MATRIX SCIENCE MEDICA 2021. [DOI: 10.4103/mtsm.mtsm_36_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
Venous thromboembolism (VTE) is an important vascular disease and public health problem. Prevention of VTE has focused mainly on using thromboprophylaxis to avoid provoked VTE or recurrent VTE, with little attention paid to the possibility of preventing the one third to one half of VTEs that are unprovoked. We review growing research suggesting that unhealthy lifestyle risk factors may cause a considerable proportion of unprovoked VTE. Using epidemiologic data to calculate population attributable risks, we estimate that in the United States obesity may contribute to 30% of VTEs, physical inactivity to 4%, current smoking to 3%, and Western dietary pattern to 11%. We also review possibilities for VTE primary prevention either through a high-risk individual approach or a population-wide approach. Interventions for outpatients at high VTE risk but without VTE provoking factors have not been fully tested; yet, improving patient awareness of risk and symptoms, lifestyle counseling, and possibly statins or direct oral anticoagulants may prove useful in primary prevention of unprovoked VTE. A population approach to prevention would bolster awareness of VTE and aim to shift lifestyle risk factors downward in the whole population using education, environmental changes, and policy. Assuming the epidemiological associations are accurate, causal, and independent of each other, a reduction of obesity, physical inactivity, current smoking, and Western diet by 25% in the general population might reduce the incidence of unprovoked VTE by 12%. We urge further research and consideration that primary prevention of unprovoked VTE may be a worthwhile public health aim.
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Affiliation(s)
- Aaron R. Folsom
- Division of Epidemiology & Community HealthSchool of Public HealthUniversity of MinnesotaMinneapolisMN
| | - Mary Cushman
- Departments of Medicine and Pathology & Laboratory MedicineLarner College of Medicine at the University of VermontBurlingtonVT
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21
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Swanepoel AC, Bester J, de Lange-Loots Z. Mechanical and Physical Behavior of Fibrin Clot Formation and Lysis in Combined Oral Contraceptive Users. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2020; 26:1007-1013. [PMID: 32778190 DOI: 10.1017/s1431927620024289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Combined oral contraceptives (COCs) are commonly prescribed and increase the risk of venous thromboembolism (VTE). We have previously found that two COCs, both containing drospirenone (DRSP) and ethinyl estradiol (EE), cause spontaneous fibrin formation in whole blood. The aim of this study was, therefore, to use platelet-poor plasma (PPP) from the same cohort of DRSP/EE users to determine the impact of these COCs on the fibrin component, specifically the fibrin clot viscoelasticity, turbidimetry, and biophysical traits. PPP from 25 females per test group and a control group (n = 25) were analyzed using thromboelastography (TEG), turbidimetry, and scanning electron microscopy. The results highlight abnormal fibrin clot formation, lysis, and architecture; DRSP/20EE showed the greatest effect. DRSP/EE use increased the fibrin fiber diameter and showed dense matted clots. Only when the influence of COCs on the structural properties and behavior of fibrin fibers during thrombus formation and lysis is better understood are we able to predict and prevent coagulopathies associated with these synthetic hormones. Clinical practitioners should take this into consideration for female patients that either have comorbidities, which could burden the coagulation system, or may be exposed to external factors that could increase their risk for VTE.
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Affiliation(s)
- Albe Carina Swanepoel
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia0007, South Africa
- Centre of Excellence for Nutrition, North-West University, Potchefstroom Campus, Private Bag X6001, Potchefstroom2520, South Africa
| | - Janette Bester
- Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Private Bag X323, Arcadia0007, South Africa
| | - Zelda de Lange-Loots
- Centre of Excellence for Nutrition, North-West University, Potchefstroom Campus, Private Bag X6001, Potchefstroom2520, South Africa
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22
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Ker J. Pelvic kidney as a cause of May-Thurner syndrome. Trop Doct 2020; 51:269-271. [PMID: 32981474 DOI: 10.1177/0049475520959917] [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: 11/17/2022]
Abstract
Deep venous thrombosis is a common clinical problem with significant morbidity and mortality. Since the iconic publication by Virchow in 1856, which placed all known causes of deep venous thrombosis into three groups, namely venous stasis, vascular injury and hypercoagulability, numerous causes have been added to each category. This case report highlights the importance of an anatomical imaging study of the pelvis in cases of recurring, proximal deep venous thrombosis of the lower limb.
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Affiliation(s)
- James Ker
- Department of Internal Medicine, University of Pretoria, Pretoria, South Africa
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Krüger-Genge A, Jung F, Hufert F, Jung EM, Küpper JH, Storsberg J. Effects of gut microbial metabolite trimethylamine N-oxide (TMAO) on platelets and endothelial cells. Clin Hemorheol Microcirc 2020; 76:309-316. [PMID: 32925010 DOI: 10.3233/ch-209206] [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: 11/15/2022]
Abstract
Thrombotic events result from different pathologies and are the underlying causes of severe diseases like stroke or myocardial infarction. Recent basic research now revealed a link between food uptake, food conversion and gut metabolism. Gut microbial production of trimethylamine N-oxide (TMAO) from dietary nutrients like choline, lecithin and L-carnitine was associated with the development of cardiovascular diseases. Within this review we give a systematic overview about the influence of TMAO on blood components like platelets and endothelial cells which both are involved as key players in thrombotic processes. In summary, a mechanistic correlation between the gut microbiome, TMAO and cardiovascular diseases becomes obvious and emphasizes to the significance of the intestinal microbiome.
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Affiliation(s)
- A Krüger-Genge
- Fraunhofer-Institute for Applied Polymer Research (IAP), Potsdam-Golm, Germany
| | - F Jung
- Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology, Senftenberg, Germany
| | - F Hufert
- Institute for Microbiology and Virology, Medizinische Hochschule Brandenburg Theodor Fontane, Senftenberg, Germany
| | - E-M Jung
- Department of Radiology and Interdisciplinary Ultrasound Department, University Hospital Regensburg, Regensburg, Germany
| | - J-H Küpper
- Institute of Biotechnology, Molecular Cell Biology, Brandenburg University of Technology, Senftenberg, Germany
| | - J Storsberg
- Fraunhofer-Institute for Applied Polymer Research (IAP), Potsdam-Golm, Germany
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Bai J, Zhong JY, Liao W, Hu R, Chen L, Wu XJ, Liu SP. iTRAQ‑based proteomic analysis reveals potential regulatory networks in dust mite‑related asthma treated with subcutaneous allergen immunotherapy. Mol Med Rep 2020; 22:3607-3620. [PMID: 32901873 PMCID: PMC7533450 DOI: 10.3892/mmr.2020.11472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 02/24/2020] [Indexed: 12/29/2022] Open
Abstract
Asthma is one of the most common childhood chronic diseases worldwide. Subcutaneous immunotherapy (SCIT) is commonly used in the treatment of house dust mite (HDM)‑related asthma in children. However, the therapeutic mechanism of SCIT in asthma remains unclear. The present study aimed to investigate the molecular biomarkers associated with HDM‑related asthma in asthmatic children prior and subsequent to SCIT treatment compared with those in healthy children via proteomic analysis. The study included a control group (30 healthy children), ‑Treatment group (30 children with HDM‑related allergic asthma) and +Treatment group (30 children with HDM‑related allergic asthma treated with SCIT). An isobaric labeling with relative and absolute quantification‑based method was used to analyze serum proteome changes to detect differentially expressed proteins, while functional enrichment and protein‑protein interaction network analysis were used to select candidate biomarkers. A total of 72 differentially expressed proteins were detected in the ‑Treatment, +Treatment and control groups. A total of 33 and 57 differentially expressed proteins were observed in the ‑Treatment vs. control and +Treatment vs. control groups, respectively. Through bioinformatics analysis, 5 candidate proteins [keratin 1 (KRT1), apolipoprotein B (APOB), fibronectin 1, antithrombin III (SERPINC1) and α‑1‑antitrypsin (SERPINA1)] were selected for validation by western blotting; among them, 4 proteins (KRT1, APOB, SERPINC1 and SERPINA1) showed robust reproducibility in asthma and control samples. This study illustrated the changes in proteome regulation following SCIT treatment for asthma. The 4 identified proteins may serve as potential biomarkers prior and subsequent to SCIT treatment, and help elucidate the molecular regulation mechanisms of SCIT to treat HDM‑related asthma.
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Affiliation(s)
- Jun Bai
- Department of Pediatrics, Foshan Maternal and Children's Hospital Affiliated to Southern Medical University, Foshan, Guangdong 528000, P.R. China
| | - Jia-Yong Zhong
- Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong 510623, P.R. China
| | - Wang Liao
- Department of Pediatrics, Foshan Maternal and Children's Hospital Affiliated to Southern Medical University, Foshan, Guangdong 528000, P.R. China
| | - Ruo Hu
- School of Computer Science, Guangdong Polytechnic Normal University, Guangzhou, Guangdong 510000, P.R. China
| | - Liang Chen
- Department of Pediatrics, Foshan Maternal and Children's Hospital Affiliated to Southern Medical University, Foshan, Guangdong 528000, P.R. China
| | - Xian-Jin Wu
- Key Laboratory of Research and Utilization of Ethnomedicinal Plant Resources of Hunan Province, Key Laboratory of Hunan Higher Education for Western Hunan Medicinal Plant and Ethnobotany, College of Biological and Food Engineering, Huaihua University, Huaihua, Hunan 418008, P.R. China
| | - Shuang-Ping Liu
- Chronic Disease Research Center, Medical College, Dalian University, Dalian, Liaoning 116622, P.R. China
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25
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Desch KC, Ozel AB, Halvorsen M, Jacobi PM, Golden K, Underwood M, Germain M, Tregouet DA, Reitsma PH, Kearon C, Mokry L, Richards JB, Williams F, Li JZ, Goldstein D, Ginsburg D. Whole-exome sequencing identifies rare variants in STAB2 associated with venous thromboembolic disease. Blood 2020; 136:533-541. [PMID: 32457982 PMCID: PMC7393257 DOI: 10.1182/blood.2019004161] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 04/12/2020] [Indexed: 12/13/2022] Open
Abstract
Deep vein thrombosis and pulmonary embolism, collectively defined as venous thromboembolism (VTE), are the third leading cause of cardiovascular death in the United States. Common genetic variants conferring increased varying degrees of VTE risk have been identified by genome-wide association studies (GWAS). Rare mutations in the anticoagulant genes PROC, PROS1 and SERPINC1 result in perinatal lethal thrombosis in homozygotes and markedly increased VTE risk in heterozygotes. However, currently described VTE variants account for an insufficient portion of risk to be routinely used for clinical decision making. To identify new rare VTE risk variants, we performed a whole-exome study of 393 individuals with unprovoked VTE and 6114 controls. This study identified 4 genes harboring an excess number of rare damaging variants in patients with VTE: PROS1, STAB2, PROC, and SERPINC1. At STAB2, 7.8% of VTE cases and 2.4% of controls had a qualifying rare variant. In cell culture, VTE-associated variants of STAB2 had a reduced surface expression compared with reference STAB2. Common variants in STAB2 have been previously associated with plasma von Willebrand factor and coagulation factor VIII levels in GWAS, suggesting that haploinsufficiency of stabilin-2 may increase VTE risk through elevated levels of these procoagulants. In an independent cohort, we found higher von Willebrand factor levels and equivalent propeptide levels in individuals with rare STAB2 variants compared with controls. Taken together, this study demonstrates the utility of gene-based collapsing analyses to identify loci harboring an excess of rare variants with functional connections to a complex thrombotic disease.
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Affiliation(s)
| | - Ayse B Ozel
- Department of Human Genetics, University of Michigan, Ann Arbor, MI
| | - Matt Halvorsen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | | | - Marine Germain
- INSERM UMR_S 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - David-Alexandre Tregouet
- INSERM UMR_S 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Pieter H Reitsma
- Einthoven Laboratory for Experimental Vascular and Regenerative Medicine, Leiden, The Netherlands
| | - Clive Kearon
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Lauren Mokry
- Department of Medicine, Human Genetics, Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - J Brent Richards
- Department of Medicine, Human Genetics, Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada
| | - Frances Williams
- Department of Twin Research and Genetic Epidemiology, Kings College London, London, United Kingdom
| | - Jun Z Li
- Department of Human Genetics, University of Michigan, Ann Arbor, MI
| | - David Goldstein
- Columbia University, Institute for Genomic Medicine, New York, NY; and
| | - David Ginsburg
- Department of Pediatrics and
- Department of Human Genetics, University of Michigan, Ann Arbor, MI
- Department of Internal Medicine, Howard Hughes Medical Institute, University of Michigan, Ann Arbor, MI
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26
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Constantinescu-Bercu A, Salles-Crawley II, Crawley JTB. SLC44A2 - A novel therapeutic target for venous thrombosis? J Thromb Haemost 2020; 18:1556-1558. [PMID: 32619343 DOI: 10.1111/jth.14834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/06/2020] [Indexed: 12/17/2022]
Affiliation(s)
| | | | - James T B Crawley
- Department of Immunology & Inflammation, Imperial College London, London, UK
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27
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Khialani D, le Cessie S, Lijfering WM, Cannegieter SC, Rosendaal FR, van Hylckama Vlieg A. The joint effect of genetic risk factors and different types of combined oral contraceptives on venous thrombosis risk. Br J Haematol 2020; 191:90-97. [PMID: 32342502 PMCID: PMC7586802 DOI: 10.1111/bjh.16666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/23/2020] [Indexed: 02/06/2023]
Abstract
It is not known whether the synergistic effect of genetic markers, increasing the risk of venous thrombosis (VT), and combined oral contraceptives (COC) use varies between different types of progestogens in these preparations. We investigated the joint effect of genetic risk factor, that is, F5 rs6025, F2 rs1799963, and FGG rs2066865 mutations, and different progestogens on the risk of VT. The constrained maximum likelihood estimation (CMLE) method was used to calculate joint effects, expressed as odds ratio (OR) with 95% confidence intervals [CI]. As the dose of estrogen is known to be a risk factor for VT, analyses were restricted to COC with 30 µg estrogen and each progestogen. Overall, the joint effect of COC and genetic variants was lowest for COC containing the progestogen levonorgestrel, albeit CIs were wide. The OR (95% CI) of the four different analyses (i.e. joint effect with F5 rs6025, F2 rs1799963, F5 rs6025 or F2 rs1799963 and FGG rs2066865) ranged between 7·4 (5·4–10·2) and 24·8 (12·3–50·0) for levonorgestrel. For gestodene the joint effect ranged between 11·7 (7·2–19·1) and 30·9 (10·6–89·9). Desogestrel and cyproterone acetate had the highest risk estimates: 14·6 (9·7–21·9) and 32·6 (13·2–80·6) and 15·5 (9·7–24·9) and 44·4 (16·9–116·3) respectively. In women with inherited thrombophilia, COC containing levonorgestrel were associated with the lowest risk of VT, albeit the CIs were wide.
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Affiliation(s)
- Deeksha Khialani
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Saskia le Cessie
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Willem M Lijfering
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Suzanne C Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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28
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Deep vein thrombosis cured by homeopathy: A case report. J Ayurveda Integr Med 2020; 11:181-184. [PMID: 32057625 PMCID: PMC7329721 DOI: 10.1016/j.jaim.2019.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 07/31/2019] [Accepted: 10/03/2019] [Indexed: 02/08/2023] Open
Abstract
Venous thrombosis (VT) of deep vein is a life-threatening condition which may lead to sudden death as an immediate complication due to formation of thrombo-embolism. VT is associated with various risk factors such as prolonged immobilization, inflammation, and/or coagulation disorders including muscular or venous injury. Deep venous thrombosis (DVT) frequently occurs in the lower limb. Successful treatment of DVT exclusively with homeopathic remedies has rarely been recorded in peer-reviewed journals. The present case report intends to record yet another case of DVT in an old patient totally cured exclusively by the non-invasive method of treatment with micro doses of potentized homeopathic drugs selected on the basis of the totality of symptoms and individualization of the case. Since this report is based on a single case of recovery, results of more such cases are warranted to strengthen the outcome of the present study.
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29
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Groot HE, Villegas Sierra LE, Said MA, Lipsic E, Karper JC, van der Harst P. Genetically Determined ABO Blood Group and its Associations With Health and Disease. Arterioscler Thromb Vasc Biol 2020; 40:830-838. [PMID: 31969017 DOI: 10.1161/atvbaha.119.313658] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To determine the spectrum of phenotypes linked to the ABO blood group system, using genetic determinants of the ABO blood group system. Approach and Results: We assessed the risk of 41 health and disease outcomes, and 36 linear traits associated with the ABO blood group system in the UK Biobank cohort. A total of 406 755 unrelated individuals were included in this study. Blood groups A, B, and O were determined based on allele combinations of previously established single-nucleotide polymorphisms rs8176746, rs8176719 in the ABO gene. Group AB was excluded because of its relative small sample size. Overall, 187 387 (46%) were male with a mean (SD) age of 57±8.1 years and a median total exposure of 64 person-years (interquartile range, 57-70). Of 406 755 individuals, 182 621 (44.9%) participants had blood group O, 182 786 (44.9%) had blood group A, and 41 348 (10.2%) had blood group B. ABO blood groups were associated with 11 health and disease outcomes (P<2.19×10-4). ABO blood groups were primarily associated with cardiovascular outcomes. Compared with individuals with blood group O, blood groups A and B were associated with increased odds of up to 1.56 (95% CI, 1.43-1.69) for thromboembolic events and decreased odds for hypertension (0.94 [95% CI, 0.92-0.97]). CONCLUSIONS The ABO blood group system is associated with several parameters of healthy aging and disease development. Knowledge of ABO blood groups might be of interest for more personalized approaches towards health maintenance and the prevention of diseases.
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Affiliation(s)
- Hilde E Groot
- From the Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (H.E.G., L.E.V.S., M.A.S., E.L., J.C.K., P.v.d.H.)
| | - Laura E Villegas Sierra
- From the Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (H.E.G., L.E.V.S., M.A.S., E.L., J.C.K., P.v.d.H.).,University of Antioquia, School of Medicine, Medellín, Colombia (L.E.V.S.)
| | - M Abdullah Said
- From the Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (H.E.G., L.E.V.S., M.A.S., E.L., J.C.K., P.v.d.H.)
| | - Erik Lipsic
- From the Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (H.E.G., L.E.V.S., M.A.S., E.L., J.C.K., P.v.d.H.)
| | - Jacco C Karper
- From the Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (H.E.G., L.E.V.S., M.A.S., E.L., J.C.K., P.v.d.H.)
| | - Pim van der Harst
- From the Department of Cardiology, University of Groningen, University Medical Center Groningen, the Netherlands (H.E.G., L.E.V.S., M.A.S., E.L., J.C.K., P.v.d.H.)
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30
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Sutherland CS, Ademi Z, Michaud J, Schur N, Lingg M, Bhadhuri A, Pache TD, Bitzer J, Suchon P, Albert V, Hersberger KE, Tanackovic G, Schwenkglenks M. Economic evaluation of a novel genetic screening test for risk of venous thromboembolism compared with standard of care in women considering combined hormonal contraception in Switzerland. BMJ Open 2019; 9:e031325. [PMID: 31699733 PMCID: PMC6858234 DOI: 10.1136/bmjopen-2019-031325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM The aim of this study was to assess the cost effectiveness of the Pill Protect (PP) genetic screening test for venous thromboembolism (VTE) risk compared with standard of care (SoC), for women considering combined hormonal contraceptives (CHCs) in Switzerland. METHODS A two-part microsimulation model was developed to estimate VTE events, costs and quality-adjusted life years (QALYs) associated with the PP and SoC strategies. In the first portion of the model, a cohort of 1 million Swiss first-time seekers of a CHC were simulated. It was determined whether each women would receive a CHC or non-CHC by using prescribing patterns elicited from a modified Delphi study. These results formed the basis of the SoC strategy. For the PP strategy, a PP test was included and the results considered in addition to SoC practice. Each woman then entered a Markov model that captured morbidity and mortality over a lifetime. The risk of having a VTE was derived from the risk algorithm that underpins the PP test. The remaining model inputs relating to population characteristics, costs, health resource use, mortality and utilities were derived from published studies or national sources. The model was validated and calibrated to align with population-based studies. Extensive uncertainty analyses were conducted. RESULTS From a Swiss health system perspective, the PP strategy in comparison with the SoC strategy generated an additional CHF 231, and gained 0.003 QALYs per woman, leading to an incremental cost-effectiveness ratio of CHF 76 610 per QALY gained. Assuming a threshold of CHF 100 000 per QALY gained, the PP strategy is likely to be cost effective. Our results were generally robust to variations in the parameter values. CONCLUSIONS The PP test may be cost effective in Switzerland for screening women seeking CHCs for their risk of VTE based on the current evidence.
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Affiliation(s)
- C Simone Sutherland
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
| | - Zanfina Ademi
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Nadine Schur
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
| | - Myriam Lingg
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
| | - Arjun Bhadhuri
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Basel, Switzerland
| | | | - Johannes Bitzer
- Department of Obstetrics and Gynecology, University Hospital Basel, Basel, Switzerland
| | - Pierre Suchon
- Laboratory of Haematology, La Timone Hospital, Marseille, France
- C2VN, Aix Marseille Universite, INSERM, INRA, Marseille, France
| | - Valerie Albert
- Pharmaceutical Care Research Group (PCRG), University of Basel, Basel, Switzerland
| | - Kurt E Hersberger
- Pharmaceutical Care Research Group (PCRG), University of Basel, Basel, Switzerland
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31
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Heenkenda MK, Malmström A, Lysiak M, Mudaisi M, Bratthäll C, Milos P, Strandeus M, Åkesson L, Söderkvist P, Uppugunduri S, Osman A. Assessment of genetic and non-genetic risk factors for venous thromboembolism in glioblastoma - The predictive significance of B blood group. Thromb Res 2019; 183:136-142. [PMID: 31677594 DOI: 10.1016/j.thromres.2019.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/23/2019] [Accepted: 10/14/2019] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Venous thromboembolism (VTE) is a common problem among patients with glioblastoma multiforme (GBM) and with some other cancers. Here, we evaluated genetic and non-genetic potential risk factors for VTE among GBM patients. MATERIALS AND METHODS A cohort of 139 patients treated with concomitant radiotherapy and temozolomide were included in the study. Next generation sequencing and genotyping approaches were applied to assess genetic risk factors in the haemostatic system. Clinical data including surgery, reoperation as well as blood group and patient information such as age and gender were available from patient records. Logistic regression analysis was performed to asses VTE risk. RESULTS In the study 47 patients (34%) were diagnosed for VTE during the course of their disease. When genetic and non-genetic potential risk factors were evaluated, only B blood group was found to be significantly associated with VTE incidence (odds ratio [OR] = 6.91; confidence interval [CI] = 2.19-24.14; P = 0.001). In contrast, A and O blood groups did not correlate with VTE risk. Frontal lobe tumor location also seemed to slightly increase VTE risk compared to other brain sites (OR = 3.14; CI = 1.1-10.7) although the significance level was at borderline (P = 0.05). Current study identified B blood group as the component in non-O blood groups that is responsible for increased VTE risk. CONCLUSION In conclusion, these results suggest for the first time that B blood group is predictive for VTE incidence among patients with glioblastoma, information that may be potentially valuable when selecting GBM patients who are at risk for VTE for anticoagulant prophylaxis.
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Affiliation(s)
- Menikae K Heenkenda
- Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Annika Malmström
- Department of Advanced Home Care and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Malgorzata Lysiak
- Cell Biology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Munila Mudaisi
- Department of Oncology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - Peter Milos
- Department of Neurosurgery and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | | | - Lisa Åkesson
- Regional Cancer Centre South East Sweden and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Peter Söderkvist
- Cell Biology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Srinivas Uppugunduri
- Regional Cancer Centre South East Sweden and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Abdimajid Osman
- Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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32
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Confirmed validation of an innovative PCR-assay without DNA extraction for multiplex diagnosis of factor V Leiden and prothrombin gene variants. Thromb Res 2019; 183:143-145. [PMID: 31677595 DOI: 10.1016/j.thromres.2019.09.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/17/2019] [Accepted: 09/27/2019] [Indexed: 12/16/2022]
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Kamolratanapiboon K, Tantanate C. Inappropriate use of D-dimer and impact on the test characteristics for deep vein thrombosis exclusion. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 79:431-436. [PMID: 31443614 DOI: 10.1080/00365513.2019.1658214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This study aimed to investigate the prevalence of the inappropriate use of D-dimer testing for deep vein thrombosis (DVT) exclusion, and to evaluate the diagnostic value of D-dimer testing compared between testing in appropriate and inappropriate conditions. A retrospective chart review of patients with D-dimer requests at Siriraj Hospital, Bangkok, Thailand during January-September 2017 was performed. Data relating to D-dimer requests, Wells score, imaging investigations, and coexisting conditions that cause elevated D-dimer without correlation to DVT were analyzed. From 2196 cases, there were 300 D-dimer requests for DVT diagnosis. Of those, 5 (1.7%) and 158 (53.6%) requests were considered to be absolutely inappropriate D-dimer test requests due to the absence of pre-test Wells score evaluation and testing in DVT-likely patients, respectively. One-hundred and forty-eight (49.3%) requests were considered to be the relatively inappropriate D-dimer test requests due to testing in patients with coexisting conditions that included malignancies, sepsis, surgery, trauma, arterial thrombosis, and pregnancy. Three patients had more than one of these conditions. Comparatively higher negative predictive values (NPVs) of D-dimer assay for DVT exclusion were observed when used in DVT-unlikely (100% versus 80%), and in patients without coexisting conditions (100% versus 66.7%). The present study revealed the rate of inappropriate D-dimer testing for DVT exclusion to be high and this may lead to missed DVT diagnosis, overuse of imaging study, and unnecessary cost of D-dimer testing. Appropriate patient selection before test request can improve the NPV of D-dimer for DVT exclusion.
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Affiliation(s)
- Karnrawee Kamolratanapiboon
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand
| | - Chaicharoen Tantanate
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand
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Chung WS, Chen Y, Chen W, Lin CL. Incidence and risk of venous thromboembolism in patients following appendectomy: a nationwide cohort study. J Thromb Thrombolysis 2019; 48:483-490. [PMID: 31177485 DOI: 10.1007/s11239-019-01890-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Surgery may lead to poor blood flow and hypercoagulation. Few studies have investigated the incidence of venous thromboembolism (VTE) in Asian patients following appendectomy. We conducted a nationwide cohort study to investigate the risk of VTE in patients who underwent appendectomy compared with those who did not in Taiwan. We studied the entire hospitalized population in Taiwan from 2000 to 2012, with a follow-up period extending to the end of 2013. We identified patients who underwent appendectomy in Taiwan's National Health Insurance Research Database as the appendectomy cohort, and selected a nonappendectomy cohort from the general population that was 4:1 frequency-matched by age (5-year interval), sex, and index year for each appendectomy case. We used Cox models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for symptomatic VTE in the appendectomy cohort for comparison with the nonappendectomy cohort. The appendectomy cohort exhibited a higher incidence of symptomatic VTE than the nonappendectomy cohort (5.90 vs. 3.29 per 10,000 person-years). After adjustment for covariates, a 1.68-fold HR for symptomatic VTE was observed in the appendectomy cohort (95% CI 1.56-1.81). Compared with the nonappendectomy cohort, the patients who underwent open appendectomy had a 1.73-fold increased adjusted HR for symptomatic VTE (95% CI 1.61-1.87). Laparoscopic appendectomy was not significantly associated with symptomatic VTE. An 8.15-fold higher adjusted HR for VTE was observed in patients who underwent appendectomy within the first month after surgery compared with the nonappendectomy cohort. Open appendectomy carried an increased risk of symptomatic VTE. Laparoscopic appendectomy was not significantly associated with symptomatic VTE.
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Affiliation(s)
- Wei-Sheng Chung
- Department of Internal Medicine, Ministry of Health and Welfare, No. 199, Section 1, San-Min Road, Taichung City, 40343, Taiwan. .,Department of Health Services Administration, China Medical University, Taichung, Taiwan. .,Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan.
| | - YuPei Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
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Abstract
OBJECTIVES Identify and characterize pediatric pulmonary emboli present at autopsy. DESIGN Retrospective single institution observational study with clinicopathologic correlation. SETTING Tertiary medical center. PATIENTS All autopsy cases performed at Washington University from 1997 to 2017 in pediatric patients (≤ 18 yr old). MAIN RESULTS Of 1,763 pediatric autopsies, 13 cases of pulmonary emboli were identified, including thromboemboli (6/13, 46.1%), septic emboli (3/13, 23.1%), fat emboli, and foreign body emboli. CONCLUSIONS Pulmonary embolus is a relatively rare but potentially fatal cause of death in pediatric age patients and is often associated with congenital abnormalities, malignancy, or recent surgical procedures. Half of the fatal pulmonary emboli found in our series (3/6) show microscopic and diffuse, rather than large central or saddle emboli, potentially make a clinicoradiographic diagnosis more difficult. This series is also the first to report a case of hemostatic matrix pulmonary embolism in a pediatric age patient.
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Wang F, Shi T, Su C. Ultrasound with Microbubble Contrast Agent and Urokinase for Thrombosis. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:859-866. [PMID: 30594424 DOI: 10.1016/j.ultrasmedbio.2018.10.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/13/2018] [Accepted: 10/19/2018] [Indexed: 06/09/2023]
Abstract
This study was aimed at assessing the effects of urokinase (UK) in combination with ultrasound and microbubbles in in vitro and in vivo thrombolytic therapy for the treatment of deep vein thrombosis (DVT). Thrombi with formation times of 1, 3, 7, 14 and 21 d were used for thrombolysis. Forty-five adult mongrel dogs were used to evaluate thrombosis in vivo. Both in vitro and in vivo analyses revealed that UK + microbubbles had the best effect among the combinations. Thrombolysis <7 d was more effective at a thrombolysis rate of about 50%, but the thrombolytic effect of thrombi >7 d was poor at thrombolysis rates <30%. Ultrasound + UK significantly increased the thrombolysis rate of thrombi <7 d. These results suggest that the combination of ultrasound with microbubble contrast agents and UK may have a synergistic effect on thrombolysis.
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Affiliation(s)
- Fangfang Wang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Tiemei Shi
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Chang Su
- Department of Ultrasound, People's Hospital of Liaoning Province, Shenyang, Liaoning, China
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Abstract
Venous thromboembolism (VTE) including pulmonary embolism (PE) and deep vein thrombosis (DVT) is one of the leading causes of preventable cardiovascular disease in the United States (US) and is the number one preventable cause of death following a surgical procedure. Post-operative VTE is associated with multiple short and long-term complications. We will focus on reviewing the many faces of VTE in detail as they represent common challenging scenarios in clinical practice.
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Abdi AA, Osman A. Prevalence of common hereditary risk factors for thrombophilia in Somalia and identification of a novel Gln544Arg mutation in coagulation factor V. J Thromb Thrombolysis 2018; 44:536-543. [PMID: 28889200 PMCID: PMC5658450 DOI: 10.1007/s11239-017-1543-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Thrombophilia, commonly manifested as venous thromboembolism (VTE), is a worldwide concern but little is known on its genetic epidemiology in many parts of the globe particularly in the developing countries. Here we employed TaqMan genotyping and pyrosequencing to evaluate the prevalence of known common nucleotide polymorphisms associated with thrombophilia in a Somali population in the Puntland region of Somalia. We also employed next generation sequencing (NGS) to investigate other genetic variants in a Somali patient with deep venous thrombosis (DVT). As expected, we found no existence of factor V Leiden (rs6025) and prothrombin G20210A (rs1799963) in the Somali population. The G allele of ABO [261G/delG] polymorphism (rs8176719) was found at a frequency of 29%, similar to that observed in other African populations. We found the lowest so far reported frequency of MTHFR C677T (rs1801133) polymorphism in the Somali population (T allele frequency 1.5%). A novel and deleterious single nucleotide variation in exon 11 of coagulation factor V (c.1631A>G) causing Gln544Arg exchange in factor V was identified in a 29 years old Somali female with DVT. The same patient was heterozygous to VKORC1 Asp36Tyr polymorphism (rs61742245) that predisposes to warfarin resistance. In conclusion, this study shows that common hereditary factors for thromboembolism found in Caucasians are either less frequent or absent in the Somali population-similar to the situation in other Africans. NGS is possibly a better choice to detect genetic risk variants for thrombosis in this ethnic group.
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Affiliation(s)
- Abshir Ali Abdi
- Faculty of Medicine, East Africa University, Bosaso, Puntland, Somalia
| | - Abdimajid Osman
- Division of Clinical Chemistry, Region Östergötland, Ingång 64, 581 85, Linköping, Sweden. .,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
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Basol N, Karakus N, Savas AY, Karakus K, Kaya İ, Karaman S, Yigit S. The evaluation of two genetic polymorphisms of paraoxonase 1 in patients with pulmonary embolism. J Clin Lab Anal 2018; 32:e22455. [PMID: 29682786 DOI: 10.1002/jcla.22455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/26/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Pulmonary embolism (PE) is caused by some genetic factors for more than half patients. Paraoxonase 1 (PON1) has significant anti-oxidative and anti-inflammatory effects. According to our knowledge, there is no study researching the relation between PON 1 gene polymorphisms and PE in the literature. Therefore, it is aimed to research possible impacts of PON 1 Q192R and L55M polymorphisms on PE, considering anti-inflammatory and anti-oxidative effects of PON 1 in Turkish population. METHODS One hundred and five PE patients and one hundred and seventeen controls were enrolled in this study. Genomic DNA was isolated and genotyped using polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analyses for the PON1 gene Q192R and L55M polymorphisms. RESULTS Any associations were not found between clinical and demographical characteristics of PE patients and the PON1 gene Q192R polymorphism; however, there were associations between surgery, chronic renal failure, and cerebrovascular disease on the history of patients and L55M polymorphism (P = .013, P = .037, and P = .031, respectively). Genotype and allele frequencies did not show any significant differences between patients and controls according to PON1 gene Q192R and L55M polymorphisms (P > .05). CONCLUSION The results of this study suggest that there is no correlation between PE and PON 1 gene Q192R and L55M polymorphisms in the Turkish population from the Central Black Sea region. Besides, whole genotypes and alleles of Q192R and L55M are not risk factors for patients with PE in this population.
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Affiliation(s)
- Nursah Basol
- Department of Emergency Medicine, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Nevin Karakus
- Department of Medical Biology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | | | - Kayhan Karakus
- Department of Radiology, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - İlker Kaya
- Department of Cardiovascular Surgery, Tokat State Hospital, Tokat, Turkey
| | - Serhat Karaman
- Department of Emergency Medicine, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Serbulent Yigit
- Department of Medical Biology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
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Erben Y, Bjarnason H, Oladottir GL, McBane RD, Gloviczki P. Endovascular recanalization for nonmalignant obstruction of the inferior vena cava. J Vasc Surg Venous Lymphat Disord 2018; 6:173-182. [DOI: 10.1016/j.jvsv.2017.10.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/03/2017] [Indexed: 10/18/2022]
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Jiang Z, Ma J, Wang Q, Wu F, Ping J, Ming L. Circulating microRNA expression and their target genes in deep vein thrombosis: A systematic review and bioinformatics analysis. Medicine (Baltimore) 2017; 96:e9330. [PMID: 29390402 PMCID: PMC5815814 DOI: 10.1097/md.0000000000009330] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Clinically, D-dimer is the only established biomarker for the diagnosis of deep vein thrombosis (DVT). However, low specificity discounts its diagnostic value. Several publications have illustrated the differentially expressed circulating microRNAs (miRNAs) and their potential diagnostic values for DVT patients. Therefore, we systematically evaluated present researches and further performed bioinformatics analysis, to provide new insights into the diagnosis and underlying mechanisms of miRNAs in DVT. METHODS Databases PubMed, Web of Science, and Embase were searched from January 2000 to April 2017. Articles on circulating miRNAs expression in DVT were retrieved and reference lists were handpicked. Bioinformatics analysis was conducted for further evaluation. RESULTS Eventually, the eligibility criteria for inclusion in this study were met by 3 articles, which consisted of 13 specially expressed miRNAs and 149 putative target genes. Two representative KEGG pathways, vascular endothelial growth factor and phosphatidylinositol 3'-kinase (PI3K)-Akt signaling pathway, seemed to participate in the regulatory network of thrombosis. CONCLUSIONS Despite the potential diagnostic value and regulation effect, the results of circulating miRNAs used as biomarkers for DVT are not so encouraging. More in-depth and larger sample investigations are needed to explore the diagnostic and therapeutic values of miRNAs for DVT.
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Abstract
Streptokinase is an efficient thrombolytic agent used to treat thromboembolic disorders. Conventional streptokinase formulations have limited thrombolytic activity and several shortcomings because of their immunogenicity and dose-related side effects including short half-life, lack of tissue targeting and peripheral bleeding. Different liposomal formulations have been explored by researchers in order to improve thrombolytic activity of streptokinase. Liposomal formulations could improve plasma stability, retain drug for longer periods of time in the circulation and promote selective delivery to the thrombus. Side effects of conventional streptokinase formulations, such as immunogenicity and hemorrhage, can also be reduced by using liposomal carriers. In vivo therapeutic efficacy of the liposomal streptokinase has been demonstrated well in animal models. In the present review, we will discuss the potential of different liposomal carriers to improve thrombolytic efficacy of streptokinase.
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Smeets MWJ, Mourik MJ, Niessen HWM, Hordijk PL. Stasis Promotes Erythrocyte Adhesion to von Willebrand Factor. Arterioscler Thromb Vasc Biol 2017; 37:1618-1627. [PMID: 28775074 DOI: 10.1161/atvbaha.117.309885] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/18/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Venous thromboembolism is a major contributor to global disease burden. Leukocytes and platelets initiate thrombogenesis on blood stasis and initiate the formation of a fibrin, VWF (von Willebrand factor), and neutrophil extracellular trap scaffold for erythrocytes. However, there is little knowledge on how erythrocytes become stably incorporated into this scaffold. Recently, we described the adhesion of calcium-loaded erythrocytes to endothelial-derived VWF strings. Because VWF is part of the scaffold of venous thrombi, we questioned whether reduced flow or stasis promotes the adhesion of normal erythrocytes to VWF and whether venous thrombi show evidence of erythrocyte-VWF interactions. APPROACH AND RESULTS In the present work, we perfused, under controlled shear conditions, washed, normal erythrocytes over surface-immobilized plasma and extracellular matrix proteins and showed that normal erythrocytes specifically bind to VWF. The interaction between erythrocytes and VWF significantly increased when the wall shear stress was reduced. Next, we investigated whether erythrocyte-VWF interactions support the structure of venous thrombi. High-resolution immunofluorescence imaging of human venous thrombi showed a striking pattern between erythrocytes, VWF, and fibrin, which suggests that VWF plays a supporting role, linking erythrocytes to fibrin in the thrombus. CONCLUSIONS Our data suggest that erythrocyte retention in venous thrombi is mediated by erythrocyte-VWF or erythrocyte-VWF-fibrin interactions. Targeting erythrocyte retention could be a new strategy in the treatment or prevention of venous thrombosis.
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Affiliation(s)
- Michel W J Smeets
- From the Departments of Molecular Cell Biology (M.W.J.S., P.L.H.) and Plasma Proteins (M.J.M.), Sanquin-Academic Medical Center Landsteiner Laboratory, Amsterdam, The Netherlands; and Department of Pathology and Cardiac Surgery, ICaR-VU (H.W.M.N.) and Department of Physiology (P.L.H.), VU University Medical Center, Amsterdam, The Netherlands.
| | - Marjon J Mourik
- From the Departments of Molecular Cell Biology (M.W.J.S., P.L.H.) and Plasma Proteins (M.J.M.), Sanquin-Academic Medical Center Landsteiner Laboratory, Amsterdam, The Netherlands; and Department of Pathology and Cardiac Surgery, ICaR-VU (H.W.M.N.) and Department of Physiology (P.L.H.), VU University Medical Center, Amsterdam, The Netherlands
| | - Hans W M Niessen
- From the Departments of Molecular Cell Biology (M.W.J.S., P.L.H.) and Plasma Proteins (M.J.M.), Sanquin-Academic Medical Center Landsteiner Laboratory, Amsterdam, The Netherlands; and Department of Pathology and Cardiac Surgery, ICaR-VU (H.W.M.N.) and Department of Physiology (P.L.H.), VU University Medical Center, Amsterdam, The Netherlands
| | - Peter L Hordijk
- From the Departments of Molecular Cell Biology (M.W.J.S., P.L.H.) and Plasma Proteins (M.J.M.), Sanquin-Academic Medical Center Landsteiner Laboratory, Amsterdam, The Netherlands; and Department of Pathology and Cardiac Surgery, ICaR-VU (H.W.M.N.) and Department of Physiology (P.L.H.), VU University Medical Center, Amsterdam, The Netherlands
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McDaid A, Logette E, Buchillier V, Muriset M, Suchon P, Pache TD, Tanackovic G, Kutalik Z, Michaud J. Risk prediction of developing venous thrombosis in combined oral contraceptive users. PLoS One 2017; 12:e0182041. [PMID: 28750087 PMCID: PMC5531518 DOI: 10.1371/journal.pone.0182041] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 07/11/2017] [Indexed: 12/19/2022] Open
Abstract
Background Venous thromboembolism (VTE) is a complex multifactorial disease influenced by genetic and environmental risk factors. An example for the latter is the regular use of combined oral contraceptives (CC), which increases the risk to develop VTE by 3 to 7 fold, depending on estrogen dosage and the type of progestin present in the pill. One out of 1'000 women using CC develops thrombosis, often with life-long consequences; a risk assessment is therefore necessary prior to such treatment. Currently known clinical risk factors associated with VTE development in general are routinely checked by medical doctors, however they are far from being sufficient for risk prediction, even when combined with genetic tests for Factor V Leiden and Factor II G20210A variants. Thus, clinical and notably genetic risk factors specific to the development of thrombosis associated with the use of CC in particular should be identified. Methods and findings Step-wise (logistic) model selection was applied to a population of 1622 women using CC, half of whom (794) had developed a thromboembolic event while using contraceptives. 46 polymorphisms and clinical parameters were tested in the model selection and a specific combination of 4 clinical risk factors and 9 polymorphisms were identified. Among the 9 polymorphisms, there are two novel genetic polymorphisms (rs1799853 and rs4379368) that had not been previously associated with the development of thromboembolic event. This new prediction model outperforms (AUC 0.71, 95% CI 0.69–0.74) previously published models for general thromboembolic events in a cross-validation setting. Further validation in independent populations should be envisaged. Conclusion We identified two new genetic variants associated to VTE development, as well as a robust prediction model to assess the risk of thrombosis for women using combined oral contraceptives. This model outperforms current medical practice as well as previously published models and is the first model specific to CC use.
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Affiliation(s)
- Aaron McDaid
- Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
- Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | | | | | - Maude Muriset
- Gene Predictis SA, EPFL Innovation Park, 1015 Lausanne, Switzerland
| | - Pierre Suchon
- AIx Marseille Univ, INSERM, INRA, NORT, Marseille, France
- APHM, Hôpital de la Timone, Service d'hématologie biologique, Marseille, France
| | | | | | - Zoltán Kutalik
- Institute of Social and Preventive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
- Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland
| | - Joëlle Michaud
- Gene Predictis SA, EPFL Innovation Park, 1015 Lausanne, Switzerland
- * E-mail:
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Guo Y, Zou Z, Jia L, Huang Z, Yun X, Xing G. Safety and effectiveness of argatroban versus heparin for preventing venous thromboembolism after lumbar decompressive surgery. Int J Surg 2017; 44:324-328. [PMID: 28694001 DOI: 10.1016/j.ijsu.2017.07.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND To evaluate the safety and effectiveness of argatroban for the prevention of venous thromboembolism (VTE) after posterior lumbar decompressive surgery. METHODS Included in this retrospective study were 556 patients who underwent posterior lumbar decompressive surgery for trauma and degenerative diseases. They were divided into two groups: argatroban group (n = 274), and low molecular weight heparin (LMWH) group (n = 282). The occurrence of postoperative venous thrombosis and complications including hemorrhage and allergic reaction was compared between the two groups. Neurological and clinical outcomes in terms of Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) were assessed before operation and at 6 and 12 months after operation. RESULTS Postoperative venous thromboembolism (VTE) occurred in seven patient. No pulmonary embolism (PE) occurred in any patient. Thrombosis occurred in 3 cases (1.0%) and bleeding in 1 case (0.04%) in argatroban group vs. 4 (1.4%) and 4 (1.4%) in LMWH group, showing no significant between the two groups (P > 0.05). There was significant reduction in the severity of back and leg pain (VAS P < 0.05) and significant improvement in the patient quality of life (ODI, P < 0.05) 6 months and 1 year after operation, showing no significant difference between the two groups (P > 0.05). CONCLUSIONS Argatroban proved to be equally effective as LWMH for anticoagulation therapy. Both drugs exhibited a similar preventive effect against postoperative VTE after posterior lumbar spine surgery, without increasing the risk of postoperative bleeding. The neurological and clinical outcomes are satisfactory and similar between the two pharmacological methods.
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Affiliation(s)
- Ying Guo
- Department of Spine Surgery, Changzheng Hospital of Second Military Medical University, Shanghai, PR China; Department of Orthopedic Surgery, NO.187 Hospital of CPLA, Haikou, Hainan, PR China
| | - Zhongwen Zou
- Department of Orthopedic Surgery, NO.187 Hospital of CPLA, Haikou, Hainan, PR China
| | - Lianshun Jia
- Department of Spine Surgery, Changzheng Hospital of Second Military Medical University, Shanghai, PR China.
| | - Zhi Huang
- Department of Orthopedic Surgery, NO.187 Hospital of CPLA, Haikou, Hainan, PR China
| | - Xiong Yun
- Department of Orthopedic Surgery, NO.187 Hospital of CPLA, Haikou, Hainan, PR China
| | - Guo Xing
- Department of Orthopedic Surgery, NO.187 Hospital of CPLA, Haikou, Hainan, PR China
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Plasminogen activator inhibitor-1 4G/5G genotype and residual venous occlusion following acute unprovoked deep vein thrombosis of the lower limb: A prospective cohort study. Thromb Res 2017; 153:71-75. [DOI: 10.1016/j.thromres.2017.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/10/2017] [Accepted: 03/13/2017] [Indexed: 12/27/2022]
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