直接口服抗凝剂的全基因组关联研究及其与出血的关系
Sofia Attelind1,2, Niclas Eriksson3,4, Mia Wadelius3
1Department of Medical Sciences, Clinical Pharmacogenomics, Uppsala University, Uppsala, Sweden. sofia.attelind@medsci.uu.se.
European journal of clinical pharmacology
|March 21, 2025
概括
在BAIAP2L2,CYP3A5,ABCG2和VWF基因中的药物基因组变异可能会增加服用直接口服抗凝剂 (DOAC) 的患者的出血风险. 需要进一步的研究来证实这些关联.
科学领域:
- 药物基因组学 药物基因组学
- 血栓塞栓症治疗方法 血栓塞栓症的治疗方法
- 血液流出风险评估
背景情况:
- 直接口服抗凝剂 (DOACs) 广泛用于预防和治疗血栓栓塞事件.
- 对DOAC反应和不良事件 (如出血) 的个体变异性需要进一步调查促成因素.
- 药物基因组因素越来越多地被认为对药物的有效性和安全性起着作用.
研究的目的:
- 调查药物基因组变异对接受DOAC治疗的患者出血风险的潜在贡献.
- 为了确定特定的遗传变异,与多阿克治疗期间增加出血风险相关.
主要方法:
- 采用病例控制研究设计,将在DOAC治疗期间经历出血事件的患者与人口和DOAC匹配的对照进行比较.
- 进行了全基因组关联研究 (GWAS),并对候选单核酸多态 (SNP) 和候选基因组进行了分析.
- 数据来源于向瑞典医疗产品局提交的出血事件报告.
主要成果:
- BAIAP2L2 rs142001534 SNP显示与任何出血和重大/临床相关的非重大 (CRNM) 出血有显著的关联.
- CYP3A5 rs776746 SNP与重大和重大/CRNM出血有显著的相关性.
- ·维勒布兰德因子 (VWF) 基因的罕见编码变异与任何出血有显著的关联,而ABCG2 rs2231142与任何出血有名义的关联.
结论:
- 在BAIAP2L2,CYP3A5,ABCG2和VWF中的遗传变异可能与接受DOACs的患者出血风险增加有关.
- 对CYP3A5和ABCG2变体的发现与之前的研究一致.
- 该研究强调了个性化DOAC治疗的潜在遗传标记,以减轻出血风险.
相关概念视频
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.1K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.1K
Genome-wide Association Studies-GWAS
12.3K
Genome-wide association studies or GWAS are used to identify whether common SNPs are associated with certain diseases. Suppose specific SNPs are more frequently observed in individuals with a particular disease than those without the disease. In that case, those SNPs are said to be associated with the disease. Chi-square analysis is performed to check the probability of the allele likely to be associated with the disease.
GWAS does not require the identification of the target gene involved in...
GWAS does not require the identification of the target gene involved in...
12.3K
Anticoagulant Drugs: Low-Molecular-Weight Heparins
585
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
585
Disorders of Hemostasis
673
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
673
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
441
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
441
Antihypertensive Drugs: Direct Renin Inhibitors
466
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
466


