Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.
Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland; Internal Medicine, Angiology and Atherosclerosis, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Thromb Res. 2024 Sep;241:109100. doi: 10.1016/j.thromres.2024.109100. Epub 2024 Jul 18.
Hutchinson-Gilford Progeria Syndrome (HGPS) is an ultra-rare premature aging genetic disorder caused by a point mutation in the lamin A gene, LMNA. Children with HGPS display short lifespans and typically die due to myocardial infarction or ischemic stroke, both acute cardiovascular events that are tightly linked to arterial thrombosis. Despite this fact, the effect of the classic HGPS LMNA gene mutation on arterial thrombosis remains unknown.
Heterozygous Lmna knock-in (Lmna) mice, yielding an equivalent classic mutation observed in HGPS patients (c.1824C>T; pG608G mutation in the human LMNA gene) and corresponding wild-type (WT) control littermates underwent photochemically laser-induced carotid injury to trigger thrombosis. Coagulation and fibrinolytic factors were measured. Furthermore, platelet activation and reactivity were investigated.
Lmna mice displayed accelerated arterial thrombus formation, as underlined by shortened time to occlusion compared to WT littermates. Levels of factors involved in the coagulation and fibrinolytic system were comparable between groups, while Lmna animals showed higher plasma levels of thrombin-antithrombin complex and lower levels of antithrombin. Bone marrow analysis showed larger megakaryocytes in progeric mice. Lastly, enhanced platelet activation upon adenosine diphosphate, collagen-related peptide, and thrombin stimulation was observed in Lmna animals compared to the WT group, indicating a higher platelet reactivity in progeric animals.
LMNA mutation in HGPS mice accelerates arterial thrombus formation, which is mediated, at least in part, by enhanced platelet reactivity, which consequently augments thrombin generation. Given the wide spectrum of antiplatelet agents available clinically, further investigation is warranted to consider the most suitable antiplatelet regimen for children with HGPS to mitigate disease mortality and morbidity.
亨廷顿舞蹈病-吉福德早衰综合征(HGPS)是一种罕见的早发性遗传疾病,由核纤层蛋白 A 基因(LMNA)中的点突变引起。HGPS 患儿的寿命较短,通常死于心肌梗死或缺血性中风,这两种都是与动脉血栓形成密切相关的急性心血管事件。尽管如此,经典的 HGPS LMNA 基因突变对动脉血栓形成的影响仍不清楚。
杂合 Lmna 敲入(Lmna)小鼠,产生与 HGPS 患者中观察到的等效经典突变(c.1824C>T;人 LMNA 基因中的 pG608G 突变)和相应的野生型(WT)对照同窝仔鼠接受光化学激光诱导的颈动脉损伤以触发血栓形成。测量凝血和纤维蛋白溶解因子。此外,还研究了血小板激活和反应性。
与 WT 同窝仔鼠相比,Lmna 小鼠表现出加速的动脉血栓形成,表现为闭塞时间缩短。各组间参与凝血和纤维蛋白溶解系统的因子水平相当,而 Lmna 动物的血浆凝血酶-抗凝血酶复合物水平较高,抗凝血酶水平较低。骨髓分析显示,progeric 小鼠的巨核细胞较大。最后,与 WT 组相比,Lmna 动物在二磷酸腺苷、胶原相关肽和凝血酶刺激下观察到增强的血小板激活,表明 progeric 动物的血小板反应性更高。
HGPS 小鼠中的 LMNA 突变加速了动脉血栓形成,这至少部分是通过增强的血小板反应性介导的,从而增加了凝血酶的生成。鉴于临床上有广泛的抗血小板药物,有必要进一步研究,以考虑最适合 HGPS 患儿的抗血小板治疗方案,以减轻疾病的死亡率和发病率。