了解遗传变异是发生静脉血栓栓塞(VTE)的危险因素

S. Srivastava
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引用次数: 2

摘要

静脉血栓形成(VT)是世界范围内的一个主要健康问题,在世界范围内的几个人群中发病率很高。其两种临床表现为深静脉血栓形成(DVT)和肺栓塞(PE)。静脉血栓栓塞(venous thromboembolism, VTE)的发病机制尚不完全清楚,但有明确证据表明该过程是遗传和环境因素复杂相互作用的结果,其中遗传危险因素起主要作用。这些已知易导致静脉血栓栓塞的众多条件通常被称为“危险因素”。静脉血栓栓塞的典型危险因素包括高龄、长期固定、手术、使用口服避孕药或激素、怀孕、癌症等。然而,近几十年来,研究表明了新的遗传风险因素的主要作用。这些遗传危险因素包括与止血系统和凝血级联有关的基因。了解这些基因作为静脉血栓形成易感因素的作用是更好地了解血栓形成发病机制的关键一步。目前已研究的在VTE中起作用的基因有:V莱顿因子(FVL)、抗凝血酶(AT)、蛋白C、蛋白S、凝血酶原、纤维蛋白原等。当单独研究时,与每个遗传缺陷相关的风险可能相对微不足道,但同时涉及几个突变会增加易感性的风险。除此之外,获得性风险因素与一种或多种遗传变异的相互作用进一步增加了静脉血栓栓塞的风险。这篇综述是为了询问在许多研究中调查的几个遗传和获得性风险因素在不同人群中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Understanding Genetic Variations as Risk Factors for Development Venous Thrombo-Embolism (VTE)
Venous thrombosis (VT) possess a major health problem worldwide and has a high incidence in several populations across the world. Its two clinical manifestations include deep vein thrombosis (DVT) and pulmonary embolism (PE). The pathogenetic mechanism of venous thromboembolism (VTE) is still not completely elucidated, however there are clear evidences that the process occurs by complex interaction of genetic and environmental factors, wherein, genetic risk factors plays a major role. These numerous conditions that are known for predisposition of venous thromboembolism are commonly referred to as ‘risk factors’. Classical risk factors for VTE include advancing age, prolonged immobilization, surgery, use of oral contraceptives or hormones, pregnancy, cancer etc. However, in the recent decades, studies have emerged that indicating a major role of novel genetic risk factors. These genetic risk factors include genes related to haemostatic system and coagulation cascade. Understanding the of role of these genes as predisposing factors for VTE represent a crucial step for a better understanding of pathogenesis of thrombosis. Several genes that have been studied for their mutations playing a role in VTE are factor V Leiden (FVL), antithrombin (AT), protein C, protein S, prothrombin, fibrinogen etc. The risk associated with each genetic defect might be relatively insignificant when studied individually but simultaneous involvement of several mutations increase the risk of susceptibility. In addition to this, acquired risk factors interacting with one or more genetic variations further add to the risk of VTE. This review has been complied to interrogate the role of several genetic and acquired risk factors across various populations as investigated in numerous studies.
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