University of Michigan Medical School, Ann Arbor, Michigan, USA.
Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
J Thromb Haemost. 2022 May;20(5):1056-1066. doi: 10.1111/jth.15689. Epub 2022 Mar 25.
Venous thromboembolism is a very common and costly health problem worldwide. Anticoagulant treatment for VTE is imperfect: all have the potential for significant bleeding, and none prevent the development of post thrombotic syndrome after deep vein thrombosis or chronic thromboembolic pulmonary hypertension after pulmonary embolism. For these reasons, alternate forms of therapy with improved efficacy and decreased bleeding are needed. Selectins are a family (P-selectin, E-selectin, L-selectin) of glycoproteins that facilitate and augment thrombosis, modulating neutrophil, monocyte, and platelet activity. P- and E-selectin have been investigated as potential biomarkers for thrombosis. Inhibition of P-selectin and E-selectin decrease thrombosis and vein wall fibrosis, with no increase in bleeding. Selectin inhibition is a promising avenue of future study as either a stand-alone treatment for VTE or as an adjunct to standard anticoagulation therapies.
静脉血栓栓塞症是全球范围内一种非常常见且代价高昂的健康问题。VTE 的抗凝治疗并不完善：所有抗凝药物都有发生严重出血的潜在风险，且没有一种药物能预防深静脉血栓形成后血栓后综合征或肺栓塞后慢性血栓栓塞性肺动脉高压的发生。由于这些原因，需要寻找具有改善疗效和减少出血风险的替代治疗方法。选择素是糖蛋白家族（P 选择素、E 选择素、L 选择素），可促进和加重血栓形成，调节中性粒细胞、单核细胞和血小板的活性。P 选择素和 E 选择素已被研究作为血栓形成的潜在生物标志物。抑制 P 选择素和 E 选择素可减少血栓形成和静脉壁纤维化，且不会增加出血风险。选择素抑制是未来研究的一个有前途的方向，无论是作为 VTE 的独立治疗方法，还是作为标准抗凝治疗的辅助方法。
