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Published on: May 24, 2024
Recent Advances on the Molecular Mechanism and Clinical Trials of Venous Thromboembolism
Shao-Li Huang1,2,3, Hong-Yi Xin4,5, Xiao-Yan Wang4,5
1Medical Laboratory Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, 524400, People's Republic of China.
Insights
Venous thromboembolism (VTE), a common cardiovascular disease, involves complex molecular mechanisms. Research highlights the roles of inflammation, microRNAs, and extracellular vesicles in VTE development and progression.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Molecular Biology
Background:
- Venous thromboembolism (VTE), encompassing deep vein thrombosis and pulmonary embolism, is a major cardiovascular disease.
- Emerging evidence links VTE to immune system dysregulation and inflammatory processes.
- Key molecular players like P-selectin, microRNAs (miRNAs), plasminogen activator inhibitor-1 (PAI-1), neutrophil extracellular traps (NETs), and extracellular vesicles (EVs) are implicated in VTE pathogenesis.
Purpose of the Study:
- To review the current understanding of molecular mechanisms underlying venous thrombosis.
- To explore the role of inflammation-related biomarkers and novel factors in VTE.
- To discuss recent advancements in understanding extracellular vesicles' role in VTE.
Main Methods:
- Literature review of existing research on molecular mechanisms of venous thrombosis.
- Analysis of studies investigating inflammatory biomarkers, miRNAs, NETs, and EVs in VTE.
- Examination of relevant clinical trials and their findings.
Main Results:
- Inflammatory factors, P-selectin, dysregulated miRNAs, elevated PAI-1, NETs, and EVs are significantly involved in VTE.
- These factors contribute to platelet-monocyte aggregation, vascular inflammation, and thrombosis.
- Extracellular vesicles play a complex regulatory role in the coagulation process.
Conclusions:
- A comprehensive understanding of these molecular mechanisms is crucial for advancing VTE treatment strategies.
- Further research is needed to elucidate the full impact of these factors on VTE.
- Targeting these pathways may offer novel therapeutic opportunities for venous thromboembolism.
Abstract:
Venous thromboembolism is a condition that includes deep vein thrombosis and pulmonary embolism. It is the third most common cardiovascular disease behind acute coronary heart disease and stroke. Over the past few years, growing research suggests that venous thrombosis is also related to the immune system and inflammatory factors have been confirmed to be involved in venous thrombosis. The role of inflammation and inflammation-related biomarkers in cerebrovascular thrombotic disease is the subject of ongoing debate. P-selectin leads to platelet-monocyte aggregation and stimulates vascular inflammation and thrombosis. The dysregulation of miRNAs has also been reported in venous thrombosis, suggesting the involvement of miRNAs in the progression of venous thrombosis. Plasminogen activator inhibitor-1 (PAI-1) is a crucial component of the plasminogen-plasmin system, and elevated levels of PAI-1 in conjunction with advanced age are significant risk factors for thrombosis. In addition, it has been showed that one of the ways that neutrophils promote venous thrombosis is the formation of neutrophil extracellular traps (NETs). In recent years, the role of extracellular vesicles (EVs) in the occurrence and development of VTE has been continuously revealed. With the advancement of research technology, the complex regulatory role of EVs on the coagulation process has been gradually discovered. However, our understanding of the causes and consequences of these changes in venous thrombosis is still limited. Therefore, we review our current understanding the molecular mechanisms of venous thrombosis and the related clinical trials, which is crucial for the future treatment of venous thrombosis.
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