Journal of Thrombosis and Haemostasis最新文献

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Critical role for platelet Ral GTPases in regulating venous thrombosis in mice. 血小板 Ral GTP 酶在调节小鼠静脉血栓形成中的关键作用。
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-24 DOI: 10.1016/j.jtha.2024.10.010
Yong Li, Jonathan A Furniss, Jordan Vautrinot, Christopher M Williams, Tony G Walsh, Alexander Brill, Borko Amulic, Alastair W Poole
{"title":"Critical role for platelet Ral GTPases in regulating venous thrombosis in mice.","authors":"Yong Li, Jonathan A Furniss, Jordan Vautrinot, Christopher M Williams, Tony G Walsh, Alexander Brill, Borko Amulic, Alastair W Poole","doi":"10.1016/j.jtha.2024.10.010","DOIUrl":"10.1016/j.jtha.2024.10.010","url":null,"abstract":"<p><strong>Background: </strong>Deep vein thrombosis is a major cause of morbidity and mortality globally. While its pathophysiology is complex, increasing evidence suggests a more prominent role for platelets than previously suspected. Genetic deletion of Ral GTPases, RalA and RalB, conditionally in mouse platelets (RalAB double knockout [DKO]), results in a near complete defect in P-selectin externalization upon activation, while other platelet activation responses and arterial thrombosis are preserved.</p><p><strong>Objectives: </strong>Given the critical role of P-selectin in mediating platelet-neutrophil interaction and thromboinflammation, we sought to investigate whether platelet Rals would also play critical roles in venous thrombosis, a thromboinflammatory disease, using RalAB DKO mice.</p><p><strong>Methods: </strong>Deep vein thrombosis was induced by surgical partial ligation of the caudal (inferior) vena cava for 24 hours or 48 hours before venous thrombi were assessed by histology and immunofluorescence microscopy.</p><p><strong>Results: </strong>RalAB DKO mice showed a reduction in venous thrombus formation after 24 hours and near complete ablation of venous thrombosis by 48 hours post inferior vena cava ligation. Immunofluorescence microscopy revealed that cross-sections of thrombi from wild-type mice consisted of an organized scaffolded structure of platelets surrounding leukocytes/neutrophils producing neutrophil extracellular traps (NETs) to stabilize and propagate the thrombus. This organized structure was absent in platelet-specific conditional RalAB DKO thrombi. In vitro analysis of platelet-mediated NET formation was also significantly reduced when platelets lacked RalAB or when platelets were treated with the Ral inhibitor RBC8.</p><p><strong>Conclusion: </strong>We identify platelet Rals as novel, potentially critical regulators of venous thrombus stability through their ability to regulate neutrophil NET formation via platelet P-selectin.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pregnancy loss in individuals with von Willebrand disease and unspecified mucocutaneous bleeding disorders: a multicenter cohort study. 冯-威廉氏病和不明皮肤黏膜出血性疾病患者的妊娠损失:一项多中心队列研究。
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-23 DOI: 10.1016/j.jtha.2024.09.037
Leslie Skeith, Paula James, Peter Kouides, Kelsey Uminski, Lisa Duffett, Shannon Jackson, Michelle Sholzberg, Margaret V Ragni, Adam Cuker, Maeve O'Beirne, Julia Hews-Girard, Natalia Rydz, Dawn M Goodyear, Jill Baxter, Andra James, David Garcia, Sara K Vesely, Man-Chiu Poon
{"title":"Pregnancy loss in individuals with von Willebrand disease and unspecified mucocutaneous bleeding disorders: a multicenter cohort study.","authors":"Leslie Skeith, Paula James, Peter Kouides, Kelsey Uminski, Lisa Duffett, Shannon Jackson, Michelle Sholzberg, Margaret V Ragni, Adam Cuker, Maeve O'Beirne, Julia Hews-Girard, Natalia Rydz, Dawn M Goodyear, Jill Baxter, Andra James, David Garcia, Sara K Vesely, Man-Chiu Poon","doi":"10.1016/j.jtha.2024.09.037","DOIUrl":"10.1016/j.jtha.2024.09.037","url":null,"abstract":"<p><strong>Background: </strong>While bleeding around pregnancy is well described in von Willebrand disease (VWD), the risk of pregnancy loss is less certain.</p><p><strong>Objectives: </strong>We aimed to describe the frequency of pregnancy loss in females with VWD compared with those with a similar mucocutaneous bleeding phenotype and no VWD or compared with nonbleeding disorder controls.</p><p><strong>Methods: </strong>Female patients were consecutively approached in 8 specialty bleeding disorder clinics between 2014 and 2023. The VWD group was defined as having von Willebrand factor (VWF) antigen and VWF activity levels, each <0.50 IU/mL on ≥2 occasions, and a condensed MCMDM-1 score of ≥4. The non-VWD mucocutaneous bleeding disorder group had VWF levels ≥ 0.50 IU/mL on ≥2 occasions and an MCMDM-1 score ≥ 4. A nonbleeding disorder control group was recruited in pregnancy from a low-risk maternity clinic.</p><p><strong>Results: </strong>There were 150 females in the VWD group, 145 in the non-VWD mucocutaneous bleeding disorder group, and 137 in the control group. There was a similar frequency of individuals with ≥1 loss in the VWD group (45.3%, 68/150), the non-VWD group (56.6%; 82/145; -11.2%; 97.5% CI, -24.2%, 1.8%), and the nonbleeding disorder control group (37.2%; 51/137; 8.1%; 97.5% CI, -4.9%, 21.1%). Using a logistic regression, the odds ratio of pregnancy losses in the VWD group vs the non-VWD group was 0.94 (95% CI 0.65, 1.36). All groups experienced more recurrent losses compared with the literature.</p><p><strong>Conclusion: </strong>There was no statistically significant difference in risk of pregnancy loss between females with VWD, females with a similar mucocutaneous bleeding phenotype, and nonbleeding disorder controls.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mechanistic basis of activation and inhibition of protein disulfide isomerase by allosteric antithrombotic compounds. 异位抗血栓化合物激活和抑制蛋白二硫异构酶的机制基础
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-23 DOI: 10.1016/j.jtha.2024.09.036
Nathan Ponzar, Mathivanan Chinnaraj, Anna Pagotto, Vincenzo De Filippis, Robert Flaumenhaft, Nicola Pozzi
{"title":"Mechanistic basis of activation and inhibition of protein disulfide isomerase by allosteric antithrombotic compounds.","authors":"Nathan Ponzar, Mathivanan Chinnaraj, Anna Pagotto, Vincenzo De Filippis, Robert Flaumenhaft, Nicola Pozzi","doi":"10.1016/j.jtha.2024.09.036","DOIUrl":"10.1016/j.jtha.2024.09.036","url":null,"abstract":"<p><strong>Background: </strong>Protein disulfide isomerase (PDI) is a promising target for combating thrombosis. Extensive research over the past decade has identified numerous PDI-targeting compounds. However, limited information exists regarding how these compounds control PDI activity, which complicates further development.</p><p><strong>Objectives: </strong>To define the mechanism of action of 2 allosteric antithrombotic compounds of therapeutic interest, quercetin-3-O-rutinoside and bepristat-2a.</p><p><strong>Methods: </strong>A multipronged approach that integrates single-molecule spectroscopy, steady-state kinetics, single-turnover kinetics, and site-specific mutagenesis.</p><p><strong>Results: </strong>PDI is a thiol isomerase consisting of 2 catalytic a domains and 2 inactive b domains arranged in the order a-b-b'-a'. The active sites CGHC are located in the a and a' domains. The binding site of quercetin-3-O-rutinoside and bepristat-2a is in the b' domain. Using a library of 9 Förster resonance energy transfer sensors, we showed that quercetin-3-O-rutinoside and bepristat-2a globally alter PDI structure and dynamics, leading to ligand-specific modifications of its shape and reorientation of the active sites. Combined with enzyme kinetics and mutagenesis of the active sites, Förster resonance energy transfer data reveal that binding of quercetin-3-O-rutinoside results in a twisted enzyme with reduced affinity for the substrate. In contrast, bepristat-2a promotes a more compact conformation of PDI, in which a greater enzymatic activity is achieved by accelerating the nucleophilic step of the a domain, leading to faster formation of the covalent enzyme-substrate complex.</p><p><strong>Conclusion: </strong>This work reveals the mechanistic basis underlying PDI regulation by antithrombotic compounds quercetin-3-O-rutinoside and bepristat-2a and points to novel strategies for furthering the development of PDI-targeting compounds into drugs.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pazopanib in treatment of hereditary hemorrhagic telangiectasia-related epistaxis and gastrointestinal bleeding. 帕唑帕尼(Pazopanib)用于治疗遗传性出血性远端血管扩张症相关的鼻衄和消化道出血。
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-23 DOI: 10.1016/j.jtha.2024.10.014
Magdalena D Lewandowska, Shelby Gordon, Anthony Betbadal, Amy D Shapiro
{"title":"Pazopanib in treatment of hereditary hemorrhagic telangiectasia-related epistaxis and gastrointestinal bleeding.","authors":"Magdalena D Lewandowska, Shelby Gordon, Anthony Betbadal, Amy D Shapiro","doi":"10.1016/j.jtha.2024.10.014","DOIUrl":"10.1016/j.jtha.2024.10.014","url":null,"abstract":"<p><strong>Background: </strong>Hereditary hemorrhagic telangiectasia (HHT) is a bleeding disorder characterized by arteriovenous malformations, commonly presenting with epistaxis and gastrointestinal (GI) bleeding. Bleeding symptoms may be difficult to manage and may become life-threatening, with many patients developing dependence on parenteral iron and/or blood transfusion. There is a growing body of evidence that antiangiogenic therapies may be effective in management of bleeding symptoms, presumably targeting pathogenic HHT pathways such as vascular endothelial growth factor receptor.</p><p><strong>Objectives: </strong>To report single-center, retrospective real-world use of pazopanib, an orally administered tyrosine kinase inhibitor that blocks vascular endothelial growth factor receptors, in 6 patients with HHT-associated epistaxis and/or GI bleeding.</p><p><strong>Methods: </strong>A retrospective observational analysis was performed to assess the safety/efficacy of pazopanib use in patients with confirmed HHT-associated epistaxis and/or GI bleeding between January 1, 2019, and June 14, 2023. The Indiana Hemophilia and Thrombosis institutional electronic medical record was queried for HHT patients who were treated with pazopanib for ≥3 months. Patient data were obtained from patient documentation, physician/nursing notes, and on-call documentation. Institutional review board approval was obtained for data pull as an exempt study.</p><p><strong>Results: </strong>Our observations on the real-world use of pazopanib in 6 HHT patients with moderate-to-severe bleeding showed improvement in hemoglobin levels, with reduction in iron infusions and red blood cell transfusion requirement.</p><p><strong>Conclusion: </strong>Pazopanib may be a reasonable option for patients with HHT with epistaxis or gastrointestinal bleeding that are refractory to standard treatment.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A gain of function variant in RGS18 candidate for a familial mild bleeding syndrome. 候选家族性轻度出血综合征的 RGS18 功能增益变异。
IF 8.3 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-23 DOI: 10.1016/j.jtha.2024.10.016
Caroline Vayne, Maguelonne Roux, Yves Gruel, Marjorie Poggi, Claire Pouplard, Franck Peiretti, David-Alexandre Trégouët, Paquita Nurden, Marie-Christine Alessi
{"title":"A gain of function variant in RGS18 candidate for a familial mild bleeding syndrome.","authors":"Caroline Vayne, Maguelonne Roux, Yves Gruel, Marjorie Poggi, Claire Pouplard, Franck Peiretti, David-Alexandre Trégouët, Paquita Nurden, Marie-Christine Alessi","doi":"10.1016/j.jtha.2024.10.016","DOIUrl":"10.1016/j.jtha.2024.10.016","url":null,"abstract":"<p><strong>Background: </strong>Inherited platelet diseases are bleeding disorders characterized by either defects in platelet count or platelet function, the latter being less common and very heterogeneous. Numerous gene variants associated with abnormal receptors, granules, and signaling pathways have been reported. Despite significant advancements in our understanding, many patients still lack a precise diagnosis.</p><p><strong>Objectives: </strong>To identify the genetic basis of a novel mild bleeding syndrome in a family exhibiting a selective defect of platelet aggregation.</p><p><strong>Methods: </strong>Our study included 6 family members across 3 generations who displayed reduced platelet aggregation in response to adenosine diphosphate, protease-activated receptor 1-activating peptide, arachidonic acid, and epinephrine but not collagen. Platelet morphology, granule content, and expression of major surface glycoproteins were all found to be normal. Whole exome sequencing was performed for affected and nonaffected family members.</p><p><strong>Results: </strong>We identified RGS18, which encodes the regulator of G protein signaling (RGS) 18, as a candidate gene for the platelet function defect observed in this family. The RGS18 protein serves as a crucial negative regulator of G protein-coupled receptor signaling and coordinates the signaling pathways of natural platelet inhibitors. The heterozygous RGS18 c.643C>T, p.Arg215∗ variant was found to cosegregate among all 6 affected subjects.</p><p><strong>Conclusion: </strong>Truncation at Arg215 removes the S216 and S218 phosphorylation sites, which are crucial regulatory domains for RGS18 activation. The impaired platelet function is thought to arise from excessive platelet downregulation due to constitutive activation of RGS18, resulting from a loss of association of the truncated form with the 14-3-3 protein.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":8.3,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Risk assessment and management strategies in older patients with acute pulmonary embolism. 老年急性肺栓塞患者的风险评估和管理策略。
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-23 DOI: 10.1016/j.jtha.2024.10.015
Dieuwke Luijten, Denise Abbel, Suzanne C Cannegieter, Jeroen Eikenboom, Paul L den Exter, Jacobijn Gussekloo, Menno V Huisman, Thijs E van Mens, Lara Tahir, Stella Trompet, Simon P Mooijaart, Frederikus A Klok
{"title":"Risk assessment and management strategies in older patients with acute pulmonary embolism.","authors":"Dieuwke Luijten, Denise Abbel, Suzanne C Cannegieter, Jeroen Eikenboom, Paul L den Exter, Jacobijn Gussekloo, Menno V Huisman, Thijs E van Mens, Lara Tahir, Stella Trompet, Simon P Mooijaart, Frederikus A Klok","doi":"10.1016/j.jtha.2024.10.015","DOIUrl":"10.1016/j.jtha.2024.10.015","url":null,"abstract":"<p><strong>Background: </strong>Managing older patients with acute pulmonary embolism (PE) is challenging due to their underrepresentation in clinical trials, comorbidities, and increased complication risk.</p><p><strong>Objectives: </strong>To evaluate risk assessment and management outcomes in older patients with PE focusing on home and reperfusion treatment.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients aged 70 years or older diagnosed with acute PE at an academic medical center (2015-2022).</p><p><strong>Results: </strong>In total, 242 patients with a mean age of 77 years were included. All 59 patients with negative Hestia criteria were discharged ≤24 hours, and in total, 81 patients (35%) received home treatment. Among these 14-day mortality and recurrent venous thromboembolism were 0% and major bleeding occurred in 1.3% (1 patient, 95% CI: 0.11-6.1). European Society of Cardiology risk classification showed 9 low-risk (3.9%), 199 intermediate-risk (87%), and 20 high-risk (8.8) patients with PE. In 5 of the 20 high-risk patients, hypotension was mainly caused by another condition, that is, sepsis. Eight high-risk patients received reperfusion therapy. The 14-day mortality rate was 51% in high-risk patients (95% CI: 27-71); 5 of 8 patients receiving reperfusion treatment died within 5 days. Patients with an Acute Presenting Older Patient score of ≥45% had higher 14-day mortality (28%; 95% CI: 12-46) compared with <45% (3.2%; 95% CI: 0.85-8.3; hazard ratios: 10.2; 95% CI: 2.6-39).</p><p><strong>Conclusion: </strong>Selecting for home treatment using Hestia criteria was safe for older patients with PE in our cohort. Mortality in the high-risk group was high also when receiving reperfusion treatment. The European Society of Cardiology risk classification and Acute Presenting Older Patient score identified patients at higher mortality risk, suggesting their potential utility in clinical decision-making.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Insoluble proteomics analysis of acute intracranial large vessel occlusive thrombus. 急性颅内大血管闭塞性血栓的不溶性蛋白质组学分析
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-23 DOI: 10.1016/j.jtha.2024.09.033
Liuchang He, Yunchao Wang, Hanghang Zhu, Kaihao Han, Sen Wei, Tao Quan, Panxing Li, Bo Yang, Ke Sun, Yazhou Jin, Anran Wang, Xinli Xue, Lei Zhang, Conghui Liu, Yuan Gao, Yuming Xu
{"title":"Insoluble proteomics analysis of acute intracranial large vessel occlusive thrombus.","authors":"Liuchang He, Yunchao Wang, Hanghang Zhu, Kaihao Han, Sen Wei, Tao Quan, Panxing Li, Bo Yang, Ke Sun, Yazhou Jin, Anran Wang, Xinli Xue, Lei Zhang, Conghui Liu, Yuan Gao, Yuming Xu","doi":"10.1016/j.jtha.2024.09.033","DOIUrl":"10.1016/j.jtha.2024.09.033","url":null,"abstract":"<p><strong>Background: </strong>Acute large vessel occlusion (LVO) stroke is highly prevalent and severe. Despite thrombolytic therapy, many patients experience substantial complications. Understanding the origins, constituents, and pathologic processes involved in thrombus formation in acute intracranial large artery occlusion is crucial.</p><p><strong>Objectives: </strong>To identify the characteristics of insoluble proteins from different sources of cerebral thrombus.</p><p><strong>Methods: </strong>This study included 13 patients with cardiogenic embolic (CE) thrombus and 15 with large artery atherosclerotic (LAA) thrombus. High-performance liquid chromatography and liquid chromatography-tandem mass spectrometry were used to analyze insoluble proteins in thrombi. Bioinformatics analyses explored differential proteins and associated functional pathways. Least absolute shrinkage and selection operator and random forest identified biomarkers for diagnosing thrombus sources, validated by parallel reaction monitoring.</p><p><strong>Results: </strong>We constructed an insoluble protein atlas of cerebral thrombi, identifying 6975 insoluble proteins, including 143 extracellular matrix (ECM)-related proteins. The enrichment pathways considerably varied between thrombi from different sources. Inflammation-related pathways, such as acute inflammatory response, along with ECM-related pathways such as laminin interactions, were notably upregulated in LAA compared with CE. Additionally, 2 biomarkers (IDH2 and HSPG2) exhibited strong diagnostic performance (area under the curve = 1) and robustness.</p><p><strong>Conclusion: </strong>In the insoluble proteomics of thrombus, we highlighted the crucial roles of immune responses and ECM proteins in thrombus formation, providing new insights into its mechanisms and potential drug development. Additionally, we identified 2 biomarkers that offer new methods for determining thrombus sources in patients with LVO.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Non-immunogenic recombinant staphylokinase versus alteplase for patients with massive pulmonary embolism: a randomized open-label, multicenter, parallel-group, non-inferiority trial, FORPE. 治疗大面积肺栓塞患者的非免疫原性重组葡萄球菌激酶与阿替普酶:随机开放标签、多中心、平行分组、非劣效试验 FORPE。
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-23 DOI: 10.1016/j.jtha.2024.09.035
Alexander I Kirienko, Stanislav G Leontyev, Sergey N Tereschenko, Igor S Yavelov, Roman M Shakhnovich, Alexey D Erlikh, Oleg B Talibov, Elena B Yarovaya, Andrey M Semenov, Michail P Semenov, Sergey V Ivanov, Valery V Beregovykh, Alexander I Archakov, Sergey S Markin
{"title":"Non-immunogenic recombinant staphylokinase versus alteplase for patients with massive pulmonary embolism: a randomized open-label, multicenter, parallel-group, non-inferiority trial, FORPE.","authors":"Alexander I Kirienko, Stanislav G Leontyev, Sergey N Tereschenko, Igor S Yavelov, Roman M Shakhnovich, Alexey D Erlikh, Oleg B Talibov, Elena B Yarovaya, Andrey M Semenov, Michail P Semenov, Sergey V Ivanov, Valery V Beregovykh, Alexander I Archakov, Sergey S Markin","doi":"10.1016/j.jtha.2024.09.035","DOIUrl":"10.1016/j.jtha.2024.09.035","url":null,"abstract":"<p><strong>Background: </strong>Non-immunogenic staphylokinase is a modified recombinant staphylokinase with low immunogenicity, high thrombolytic activity, and fibrin selectivity.</p><p><strong>Objectives: </strong>To assess the safety and efficacy of a single intravenous bolus of non-immunogenic staphylokinase compared with those of alteplase in patients with massive pulmonary embolism and hemodynamic instability.</p><p><strong>Methods: </strong>A randomized, open-label, multicenter, parallel-group, non-inferiority trial, the FORPE (FORtelyzin Pulmionary Embolism), was conducted in Russia. A total of 310 patients aged 18 years and older with computed tomography pulmonary angiography confirmed diagnosis of massive pulmonary embolism and right ventricular dysfunction were included. The patients were randomly assigned to receive either non-immunogenic staphylokinase (15 mg) or alteplase (100 mg), both administered intravenously. The primary efficacy endpoint was death from all causes within 7 days of randomization.</p><p><strong>Results: </strong>A total of 155 patients were randomly assigned to receive non-immunogenic staphylokinase, and 155 received alteplase. In the non-immunogenic staphylokinase group, the primary efficacy endpoint was 2% in the intention-to-treat population, while in the alteplase group, it was 3% (odds ratio, 0.75; 95% CI, 0.11-4.49; P = 1.00). The difference in the primary efficacy endpoint was 0.6% (95% CI, -2.8% to 4.0%). Thus, the lower limit of the 95% CI did not cross the margin of non-inferiority. No cases of major bleeding were recorded in the non-immunogenic staphylokinase group, whereas there were 5 cases of major bleeding (3%; P = .09) in the alteplase group.</p><p><strong>Conclusion: </strong>Non-immunogenic staphylokinase was non-inferior to alteplase in patients with massive pulmonary embolism. Future observational studies are needed to assess its safety and efficacy.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aptamer BT200 is protective against myocardial ischemia-reperfusion injury in mice. Aptamer BT200 对小鼠心肌缺血再灌注损伤具有保护作用。
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-21 DOI: 10.1016/j.jtha.2024.09.032
Xinyuan Chen, Xianying Liao, Guiping Lu, Yue Ma, Ruowen Wang, Ancai Yuan, Yuquan Xie, Jun Pu
{"title":"Aptamer BT200 is protective against myocardial ischemia-reperfusion injury in mice.","authors":"Xinyuan Chen, Xianying Liao, Guiping Lu, Yue Ma, Ruowen Wang, Ancai Yuan, Yuquan Xie, Jun Pu","doi":"10.1016/j.jtha.2024.09.032","DOIUrl":"10.1016/j.jtha.2024.09.032","url":null,"abstract":"<p><strong>Background: </strong>Myocardial ischemia-reperfusion (MI/R) injury tends to affect cardiac function and leads to poor patient prognosis, and there is still no effectively targeted drug to develop anti-von Willebrand factor (VWF) aptamer in acute coronary heart disease. However, the newly anti-VWF aptamer BT200 is applied not only for stroke and hemophilia but also for antithrombolism function in clinical development. The role of BT200 in acute myocardial injury during MI/R is still unknown.</p><p><strong>Objectives: </strong>To investigate the cardioprotective effect of aptamer BT200 in a mouse model of MI/R.</p><p><strong>Methods: </strong>C57BL/6 mice were subjected to 30-minute ischemia and 24-hour reperfusion to establish MI/R model. Mice were treated with intravenous injection of cy3-labeled BT200 and were observed by an in vivo imaging system at different time points. Then, mice were sampled and evaluated by echocardiography, Evans triphenyltetrazolium chloride staining, histopathologic, western blotting, and real-time quantitative polymerase chain reaction assays to detect cardiac injury and inflammation response after 24-hour reperfusion.</p><p><strong>Results: </strong>BT200 aptamer can enter and infiltrate into the ischemic myocardium after 24-hour reperfusion. BT200 was shown to inhibit VWF A1 activity and prolong bleeding time in MI/R mice. Moreover, BT200-treated mice had a significant reduction in infarct size and an improvement in cardiac function post-MI/R. BT200 treatment can also alleviate MI/R-induced microvascular obstruction, inflammation response, and cardiomyocyte apoptosis.</p><p><strong>Conclusion: </strong>Pharmacologic targeting of VWF with BT200 alleviates acute MI/R injury in a murine model and may be a novel therapy strategy for acute myocardial infarction.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Integrative phosphoproteomic analyses reveal hemostatic-endothelial signaling interplay. 综合磷酸蛋白组分析揭示了止血-内皮信号的相互作用。
IF 5.5 2区 医学
Journal of Thrombosis and Haemostasis Pub Date : 2024-10-21 DOI: 10.1016/j.jtha.2024.10.011
Stijn A Groten, Bart L van den Eshof, Floris P J van Alphen, Alexander B Meijer, Maartje van den Biggelaar, Arie J Hoogendijk
{"title":"Integrative phosphoproteomic analyses reveal hemostatic-endothelial signaling interplay.","authors":"Stijn A Groten, Bart L van den Eshof, Floris P J van Alphen, Alexander B Meijer, Maartje van den Biggelaar, Arie J Hoogendijk","doi":"10.1016/j.jtha.2024.10.011","DOIUrl":"10.1016/j.jtha.2024.10.011","url":null,"abstract":"<p><strong>Background: </strong>The vascular endothelial cell (EC) monolayer plays a crucial part in maintaining hemostasis. An extensive array of G protein-coupled receptors allows ECs to dynamically act on key hemostatic stimuli such as thrombin and histamine. The impact of these individual stimuli on EC signal transduction has been the subject of various studies, but insight into discordant and concordant EC signaling between different G protein-coupled receptors remains limited.</p><p><strong>Objectives: </strong>To elucidate histamine and protease-activated receptor (PAR1-4) signaling cascades in ECs, discern overlapping and diverging regulation between these stimuli and their effect on the EC monolayer.</p><p><strong>Methods: </strong>We employed stable isotope labeling by amino acids in cell culture mass spectrometry-based phosphoproteomics on in vitro cultured blood outgrowth ECs stimulated with histamine and different PAR1 to 4 peptides. We investigated key phosphosites through immuno(fluorescence) staining and determined effects on barrier function through transendothelial resistance assays.</p><p><strong>Results: </strong>EC histamine activation initiated an extensive (kinase) signaling network (including MAPK3, STAT3, and CTNND1). PAR1 and PAR2 receptors induced highly similar signaling cascades, whereas PAR3 and PAR4 induced minimal phospho-regulation. Integration of all applied stimuli indicated uniquely activated proteins between both stimuli, as well as a general overlapping activation of cell junction and actin cytoskeletal proteins.</p><p><strong>Conclusion: </strong>We provide an integrative phosphoproteomic analysis of histamine and PAR agonists in the endothelium that highlights the endothelial response programs that are at the basis of regulating hemostasis.</p>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":" ","pages":""},"PeriodicalIF":5.5,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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