A cross-sectional study to detect the prevalence of hyperhomocysteinemia in cases of deep vein thrombosis

Review of biomarkers to assess the effects of switching from cigarettes to modified risk tobacco products

Context: One approach to reducing the harm caused by cigarette smoking, at both individual and population level, is to develop, assess and commercialize modified risk alternatives that adult smokers can switch to. Studies to demonstrate the exposure and risk reduction potential of such products generally involve the measuring of biomarkers, of both exposure and effect, sampled in various biological matrices.Objective: In this review, we detail the pros and cons for using several biomarkers as indicators of effects of changing from conventional cigarettes to modified risk products.Materials and methods: English language publications between 2008 and 2017 were retrieved from PubMed using the same search criteria for each of the 25 assessed biomarkers. Nine exclusion criteria were applied to exclude non-relevant publications.Results: A total of 8876 articles were retrieved (of which 7476 were excluded according to the exclusion criteria). The literature indicates that not all assessed biomarkers return to baseline levels following smoking cessation during the study periods but that nine had potential for use in medium to long-term studies.Discussion and conclusion: In clinical studies, it is important to choose biomarkers that show the biological effect of cessation within the duration of the study.

Association of Homozygous Thrombophilia Polymorphisms and Venous Thromboembolism in Shahrekord, Iran

BACKGROUND

Venous thromboembolism (VTE) is a major cause of mortality. Factor V Leiden (FVL), methylenetetrahydrofolate reductase (MTHFR) C677T, and prothrombin (FII) G20210A polymorphisms are the main inherited risk factors for VTE. Since evidence is limited on homozygotes, the aim of this study was to investigate the association between homozygous variants of these polymorphisms and VTE in Shahrekord, southwest Iran.

MATERIALS AND METHODS

In this case-control study, blood samples of 72 VTE patients admitted to Hajar Hospital, Shahrekord and 306 sex- and age-matched healthy volunteers as controls were taken in EDTA Vacutainers. The polymorphisms of FVL, MTHFR C677T, and FIIG20210A were investigated by PCR-RFLP. The data were analyzed by descriptive statistics and independent t-test.

RESULTS

The frequency of all homozygous polymorphisms was found to be 16.77% in patients and 4.90% in controls with a significant difference (P=0.004). Homozygous FVL mutation was more frequent in patients than in controls with no significant difference. Regarding the frequency of homozygous MTHFR C677T, a significant difference was noted between patients and controls (P=0.03). There was no significant difference in homozygous FIIG20210A and heterozygous variants of the above-mentioned polymorphisms between the patients and controls.

CONCLUSION

Homozygous MTHFR C677T polymorphism is associated with VTE in Shahrekord. Control of the acquired risk factors may be necessary in homozygous form of this polymorphism. VTE patients with this polymorphism may need to be managed differently.

A preliminary study of inherited thrombophilic risk factors in different clinical manifestations of venous thromboembolism in central Iran

Background & objectives:

Inherited thrombophilia is known to be an important risk factor for developing venous thromboembolism. Whether such abnormalities may impact the development of deep vein thrombosis (DVT) and pulmonary embolism (PE) differently is not well defined. This preliminary study was undertaken to compare thrombophilic polymorphism in patients with DVT and PE.

Methods:

A total of 35 DVT, 23 DVT/PE, and 37 PE patients admitted to the Hajar Hospital, Shahrekord, Iran, between October 2009 and February 2011 were included in the study and 306 healthy volunteers matched by age and sex from the same geographical area with no history of venous or arterial diseases were included as control group. Factor V Leiden (FV 1691G/A, rs6025), prothrombin (FII 20210G/A), methylene tetrahydrofulate reductase (MTHFR 677C/T, rs1801133), and PLA2 polymorphisms of platelet glycoprotein IIb/IIIa (GpIIIa 1565T/C, rs5918) were investigated by polymerase chain reaction-restriction fragment length polymorphism.

Results:

The number of patients with the investigated polymorphisms and homozygous carriers was significantly different among the groups (P<0.05). No significant difference was observed in the presence of FV 1691G/A and FII 20210G/A between any of the patients groups and the control group. GpIIIa 1565T/C and homozygous MTHFR 677C/T polymorphisms were higher in DVT patients compared with the control group (OR=6.65, 95% CI=3.09-14.30 and OR=4.08, 95% CI=1.35-12.38, respectively).

Interpretation & conclusions:

As none of the investigated polymorphisms were associated with PE, other thrombophilia polymorphisms may have a role in the pathogenesis of PE in these patients and should be investigated. Because of different prognostic risk factors among different types of patients, the treatment approach could be different.

Effect of Platelet Glycoprotein IIb/IIIa PLA2 Polymorphism on Severity of Pulmonary Thromboembolism

BACKGROUND

Pulmonary thromboembolism (PTE) is among the leading causes of death following surgery and/or hospital admission. Role of thrombophilic risk factors in the etiology of PTE is well known; But not much data is available on their role in severity of PTE. The aim of this study was to investigate the role of thrombotic risk factors especially PLA2 polymorphism of platelet glycoprotein IIb/IIIa in the severity of PTE.

MATERIALS AND METHODS

Genotyping from Factor-V (FVL) and prothrombin 20210A (PT20210A) mutations were shown to be significant risk factors for PTE and recurrent PTE. The plasma concentrations of platelet glycoprotein IIb/IIIa PLA2 polymorphism, presence of FVL and PT20210A mutations were studied in 37 patients with PTE.

RESULTS

Eleven of these patients had recurrent PTE. Lung perfusion scans were scored according to the percentage of vascular obstruction. Patients who had a pulmonary vascular obstruction (PVO) score >50%were compared to those with PVO score<50%. There was no significant difference between patients with PVO score>50% and those with PVO score<50% with regard to the presence of FVL and PT20210A mutations. However, patients with PVO score>50% had a significantly higher frequency of platelet glycoprotein IIb/IIIaPLA2 polymorphism than those with PVO score <50%.

CONCLUSION

Our data suggest that presence of PLA2 is associated with an increased risk of PTE in the Iranian population. The association between recurrent events and coinheritance of more than one thrombophilic genetic risk factor shows that such carriers are at a higher risk of PTE.