凝血酶生成作为静脉血栓形成的中间表型。

Thrombin generation as an intermediate phenotype for venous thrombosis.

机构信息

Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, the Netherlands.

出版信息

Thromb Haemost. 2010 Jan;103(1):114-22. doi: 10.1160/TH09-06-0356. Epub 2009 Nov 13.

Abstract

In vitro thrombin generation, which reflects an individual's plasma coagulation potential and has been shown to correlate with the risk of venous thromboembolism (VTE), might represent a useful intermediate phenotype for the genetic dissection of VTE. As a proof of principle, we have investigated whether the thrombin generation assay can detect changes in the haemostatic balance associated with common genetic variation affecting the level or function of coagulation factors and inhibitors. The study population consisted of 140 healthy individuals. Plasma levels of coagulation factors and inhibitors and thrombin generation parameters determined at low tissue factor (TF) + or - thrombomodulin (TM) and at high TF + or - activated protein C (APC) were available from a previous study. All individuals were genotyped for F5 Leiden, F2 G20210A and 19 additional single nucleotide polymorphisms (SNPs) in haemostasis-related genes. The association of each SNP with plasma levels of the corresponding proteins and with thrombin generation parameters (lag time, peak height and endogenous thrombin potential [ETP]) was evaluated by statistical analysis. Not only F5 Leiden and F2 G20210A, but also several other common SNPs, significantly affected thrombin generation parameters. In particular, FGA A1069G (Thr312Ala) decreased the ETP(-APC), F2 A19911G increased the ETP(-APC), F10 IVS2 C+517G decreased the ETP(+APC), F12 C-46T decreased peak height at low TF, and TFPI T-287C and TFPI IVS7 T-33C decreased the ETP(+APC). These results indicate that the thrombin generation assay is sensitive to genetic variation in haemostasis-related genes, which makes it a promising tool to identify novel genetic risk factors of VTE.

摘要

体外凝血酶生成反映了个体的血浆凝血潜能,已被证明与静脉血栓栓塞症(VTE)的风险相关,可能代表了一种用于 VTE 遗传分析的有用的中间表型。作为一个原理验证,我们研究了凝血酶生成试验是否能够检测与影响凝血因子和抑制剂水平或功能的常见遗传变异相关的止血平衡变化。该研究人群由 140 名健康个体组成。先前的研究中已经获得了低组织因子(TF)+或-血栓调节蛋白(TM)和高 TF+或-激活蛋白 C(APC)时的凝血因子和抑制剂的血浆水平以及凝血酶生成参数。所有个体均针对 F5 Leiden、F2 G20210A 以及止血相关基因中的 19 个额外单核苷酸多态性(SNP)进行了基因分型。通过统计分析评估了每个 SNP 与相应蛋白的血浆水平以及与凝血酶生成参数(lag time、peak height 和内源性凝血酶潜能 [ETP])的关联。不仅 F5 Leiden 和 F2 G20210A,而且其他一些常见 SNP 也显著影响了凝血酶生成参数。特别是 FGA A1069G(Thr312Ala)降低了 ETP(-APC),F2 A19911G 增加了 ETP(-APC),F10 IVS2 C+517G 降低了 ETP(+APC),F12 C-46T 降低了低 TF 时的峰值高度,而 TFPI T-287C 和 TFPI IVS7 T-33C 降低了 ETP(+APC)。这些结果表明凝血酶生成试验对止血相关基因的遗传变异敏感,使其成为识别 VTE 新遗传风险因素的有前途的工具。

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