Tourn Julie, Crescence Lydie, Bruzzese Laurie, Panicot-Dubois Laurence, Dubois Christophe
Aix Marseille University, INSERM 1263, INRAE 1260, Center for CardioVascular and Nutrition Research (C2VN), Marseille, France (J.T., L.C., L.B., L.P.-D., C.D.).
Plateforme Aix Marseille, Plateforme d'Imagerie Vasculaire et de Microscopie Intravitale, C2VN, Marseille, France (L.C., L.B., L.P.-D., C.D.).
Circ Res. 2025 Jan 3;136(1):115-134. doi: 10.1161/CIRCRESAHA.124.325208. Epub 2025 Jan 2.
Venous thromboembolism, characterized by deep vein thrombosis and pulmonary embolism, is the third cardiovascular disease in the world. Deep vein thrombosis occurs when a blood clot forms in areas of impaired blood flow, and it is significantly affected by environmental factors. Local hypoxia, caused by venous stasis, plays a critical role in deep vein thrombosis under normal conditions, and this effect is intensified when the Po decreases, such as during air travel or high-altitude exposure. The lower oxygen levels and reduced pressure at high altitudes further contribute to deep vein thrombosis development. These conditions increase the pro-coagulant activity of neutrophils, platelets, and red blood cells, which interact on the surface of activated endothelial cells, promoting clot formation. Understanding the mechanisms involved in thrombus formation when Po is reduced, with or without pressure reduction, is crucial for preventing the development of venous thromboembolisms in such conditions and identifying innovative therapeutic targets. This literature review explores the mechanisms involved in thrombus formation related to high-altitude conditions and discusses the pro-coagulant consequences induced by environmental disturbances.
静脉血栓栓塞症以深静脉血栓形成和肺栓塞为特征,是全球第三大心血管疾病。当血流受损区域形成血凝块时,就会发生深静脉血栓形成,它受环境因素的显著影响。在正常情况下,由静脉淤滞引起的局部缺氧在深静脉血栓形成中起关键作用,当血氧分压(Po)降低时,如在航空旅行或高海拔暴露期间,这种影响会加剧。高海拔地区较低的氧水平和压力降低进一步促使深静脉血栓形成。这些情况会增加中性粒细胞、血小板和红细胞的促凝血活性,它们在活化内皮细胞表面相互作用,促进血栓形成。了解在Po降低时(无论是否伴有压力降低)血栓形成的机制,对于预防此类情况下静脉血栓栓塞症的发生以及确定创新的治疗靶点至关重要。这篇文献综述探讨了与高海拔条件相关的血栓形成机制,并讨论了环境干扰引起的促凝血后果。