Thrombosis research最新文献

英文中文

Monocyte depletion reduces late experimental post-thrombotic fibrotic injury in a stasis mouse model 单核细胞耗竭减少实验性晚期血栓后纤维化损伤在停滞小鼠模型

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-01-22 DOI: 10.1016/j.thromres.2026.109595

Mattea Pellerito , Abigail R. Dowling , Catherine E. Luke , Qing Cai , Antonio M. Pellerito , Andrew Quang , Lonnie Shea , Farouc Jaffer , Andrea Obi , Peter K. Henke

Background

Post thrombotic syndrome is a fibrotic disease related to inflammation resolution. There are no direct therapies that can ameliorate this disease. Monocyte/macrophages (Mo/MØ) are the primary leukocyte involved with later venous resolution, and likely direct vein wall responses and healing. Herein, we explored the vein wall response with Mo/MØ depletion by two methods.

Methods

Using two mouse models of venous thrombosis (VT), complete stasis and a flow restricted model, Mo/MØ depletion was accomplished using CD11b-DTR mice administered diphtheria toxin, and clodronate micelle administration in wild type mice. Tissue assays for structural histology, immunohistochemistry and western blotting were performed.

Results

Mo/MØ depletion resulted in significantly less vein wall fibrotic thickness, in the stasis model at day 14 in both the CD11b-DTR mice and those receiving clodronate micelles. No significant effect of Mo/MØ depletion was observed in the flow restricted VT model. The decrease in vein wall fibrosis was associated with fewer DDR2+ vein wall cells in the CD11b-DTR mice, but no difference in endothelial luminal coverage. Decreased cytokine and growth factor expression of IL-6, FSP-1, and VEGFa were associated with Mo/MØ depletion. Lastly, PMN depletion was associated with increased proinflammatory Mo/MØ, and a trend towards increased vein wall fibrosis as compared with controls.

Conclusion

Mo/MØ direct the post VT late fibrotic response, possibly by affecting fibroblasts and inflammatory cytokine expression. This effect was only found with the complete stasis model and is consistent with worsened PTS in humans with complete venous obstruction.

背景：血栓形成后综合征是一种与炎症消退相关的纤维化疾病。目前还没有直接的治疗方法可以改善这种疾病。单核细胞/巨噬细胞（Mo/MØ）是参与后期静脉溶解的主要白细胞，可能直接静脉壁反应和愈合。在此，我们通过两种方法探讨了Mo/MØ耗尽时的静脉壁响应。方法采用两种小鼠静脉血栓形成模型、完全停滞模型和血流受限模型，采用CD11b-DTR小鼠给予白喉毒素和氯膦酸盐胶束给予野生型小鼠，完成Mo/MØ的消耗。进行组织结构组织学、免疫组织化学和免疫印迹分析。结果smo /MØ缺失导致CD11b-DTR小鼠和接受氯膦酸胶束治疗的小鼠在第14天的停滞模型中静脉壁纤维化厚度明显减少。在受限流动的VT模型中未观察到Mo/MØ消耗的显著影响。在CD11b-DTR小鼠中，静脉壁纤维化的减少与较少的DDR2+静脉壁细胞有关，但内皮管腔覆盖没有差异。细胞因子和生长因子IL-6、FSP-1和VEGFa表达的降低与Mo/MØ缺失有关。最后，与对照组相比，PMN消耗与促炎Mo/MØ增加以及静脉壁纤维化增加的趋势相关。结论mo /MØ可能通过影响成纤维细胞和炎性细胞因子的表达，直接影响VT后晚期纤维化反应。这种影响仅在完全停滞模型中发现，并且与完全性静脉阻塞患者PTS恶化一致。

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引用次数: 0

Monitoring the Hemostatic Balance: measuring thrombin generation in a patient with acquired hemophilia A on combined pro- and anticoagulant therapy 监测止血平衡：测量获得性血友病a患者在抗凝和促凝联合治疗中的凝血酶生成。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-01-31 DOI: 10.1016/j.thromres.2026.109604

Marieke J.A. Verhagen , Saskia E.M. Schols , Sanna R. Rijpma , An K Stroobants

引用次数: 0

Simplifying the next-generation of anticoagulants: Elexians – Why a unified nomenclature for FXI/XIa inhibitors is needed 简化下一代抗凝血剂：Elexians -为什么需要FXI/Xia抑制剂的统一命名

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-02-01 DOI: 10.1016/j.thromres.2026.109608

Andaleb Kholmukhamedov

引用次数: 0

Obesity and type 2 diabetes mellitus add up to induce platelet hyperreactivity and platelet activation 肥胖和2型糖尿病共同诱发血小板高反应性和血小板活化。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-02-19 DOI: 10.1016/j.thromres.2026.109626

Giuseppe Guglielmini , Emanuela Falcinelli , Michelantonio De Fano , Anna Maria Mezzasoma , Loredana Bury , Gabriele Perriello , Pietro Minuz , Carmine Giuseppe Fanelli , Paolo Gresele

Background

Platelet hyperreactivity and in vivo platelet activation, effectors of increased cardiovascular risk, have been associated with both type 2 diabetes (T2DM) and obesity, however, whether T2DM and obesity when combined further enhance platelet activation has not been explored.

Materials and methods

We assessed several parameters of platelet reactivity and in vivo platelet activation, VWF activity and adipokine levels in 40 well characterized obese subjects without T2DM (metabolically healthy obese, MHO), non obese T2DM patients (metabolically unhealthy normal weight, MUNW), obese and T2DM patients (metabolically unhealthy obese, MUO) and age and sex-matched healthy controls (metabolically healthy normal weight, MHNW).

Results

Both MUNW and MHO subjects showed enhanced platelet thrombus formation, increased response to collagen and ADP at light transmission aggregometry, raised urinary 11-dehydro-TxB₂, higher production of platelet reactive oxygen species and impaired platelet nitric oxide formation compared to MHNW, which were further significantly worsened in MUO. VWF activity and resistin levels were significantly higher in MUO patients compared to the other groups.

Conclusions

Our data show that the concomitant presence of T2DM and obesity exert a significant additive effect on platelet hyperreactivity and in vivo platelet activation compared with only one of these risk factors, and suggest that enhanced VWF and resistin levels in MUO subjects play a pathogenic role in the modulation of the platelet response to stimuli leading to a strong platelet hyperreactivity and in vivo platelet activation, in turn favoring enhanced cardiovascular risk.

背景：血小板高反应性和体内血小板活化是心血管风险增加的效应因子，与2型糖尿病（T2DM）和肥胖均相关，然而，T2DM和肥胖合并是否进一步增强血小板活化尚未探讨。材料和方法：我们评估了40例特征明确的非T2DM肥胖受试者（代谢健康肥胖，MHO）、非肥胖T2DM患者（代谢不健康正常体重，MUNW）、肥胖和T2DM患者（代谢不健康肥胖，MUO）以及年龄和性别匹配的健康对照组（代谢健康正常体重，MHNW）的血小板反应性、体内血小板活化、VWF活性和脂肪因子水平的几个参数。结果：与MHNW相比，MUNW和MHO的受试者血小板血栓形成增强，对胶原蛋白和ADP的光透射聚集反应增强，尿11-脱氢txb2升高，血小板活性氧产生增加，血小板一氧化氮形成受损，而MUO的情况进一步显著恶化。与其他组相比，MUO患者的VWF活性和抵抗素水平明显更高。结论：我们的数据显示，与其中一个危险因素相比，T2DM和肥胖的同时存在对血小板高反应性和体内血小板活化具有显著的叠加效应，并提示MUO受试者VWF和抵抗素水平的增强在血小板对刺激反应的调节中起致病作用，导致血小板高反应性和体内血小板活化，从而有利于心血管风险的增加。

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引用次数: 0

Corrigendum to “Real-world safety and effectiveness of rurioctocog alfa pegol in 338 patients with hemophilia A in South Korea: A postmarketing surveillance study” [Thromb. Res. 253 (2025) 109402] 对韩国338例A型血友病患者ruurioctocog alfa pegol的实际安全性和有效性的更正：一项上市后监测研究[Thromb]。第253（2025）条[9402]。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI: 10.1016/j.thromres.2026.109586

Ji Yoon Kim , Taiju Hwang , Sang Kyu Park , Ki-Young Yoo , Eun Jin Choi , Soyon Kim , Chur Woo You , Eungsun Kim , Aeran Jung , Young-Shil Park

引用次数: 0

Efficacy and safety of prophylaxis and treatment of bleeding events with a novel fibrinogen concentrate from human plasma in patients with congenital fibrinogen deficiency 先天性纤维蛋白原缺乏症患者血浆中新型浓缩纤维蛋白原预防和治疗出血事件的有效性和安全性。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-02-10 DOI: 10.1016/j.thromres.2026.109616

Claudia Djambas Khayat , Amal El-Beshlawy , Naglaa Omar , Emna Gouider Belhadjali , Abderrahim Khelif , Sonia Adolf , Wolfgang Miesbach , Silke Aigner , Salomon Abraha , Joerg Schuettrumpf , Heike Boehm

Background

Congenital fibrinogen deficiency is a rare inherited coagulation disorder characterized by partial or total lack of plasma fibrinogen (hypo- or afibrinogenemia), or expression of dysfunctional fibrinogen (dysfibrinogenemia), which may cause plasma level reduction (hypodysfibrinogenemia). Loss of functional fibrinogen causes bleeding disposition. In case of trauma or surgical intervention, supplementation of human fibrinogen is required to stop or prevent extensive bleeding events.

Study design

A prospective, open-label, uncontrolled, multi-center phase I/III trial was performed to investigate pharmacokinetics, efficacy and safety of single and/or repetitive intravenous infusions of a human fibrinogen concentrate (BT524) for on-demand prophylaxis (ODP) and/or on-demand treatment (ODT) of bleeding events in patients with congenital fibrinogen deficiency.

Patients

In the phase III part of the trial reported here, 36 patients (3 children <6 years, 9 children 6–12 years, 4 adolescents and 20 adults) were treated with BT524 for 175 bleeding events, either for ODP or ODT.

Results

Fibrinogen concentrate infusion substantially improved maximum clot firmness (MCF). The overall hemostatic response was rated as good or excellent in 98.9% of bleedings. Loss of blood was considered normal in the majority of surgical interventions, and wound healing was also positively assessed. Additional evaluations, including blood product consumption and adverse events, further supported the efficacy and confirmed the favorable safety profile of the novel fibrinogen product.

Conclusion

BT524 represents a novel human fibrinogen concentrate provenly efficacious and safe both for the treatment of bleeding and for peri-operative bleeding prophylaxis in patients with congenital fibrinogen deficiency of all ages.

背景：先天性纤维蛋白原缺乏是一种罕见的遗传性凝血障碍，其特征是部分或全部血浆纤维蛋白原缺乏（低或纤原原血症），或功能失调纤维蛋白原表达（纤维蛋白原异常血症），这可能导致血浆水平降低（低纤维蛋白原异常血症）。失去功能性纤维蛋白原导致出血倾向。在创伤或手术干预的情况下，需要补充人纤维蛋白原来阻止或防止大量出血事件。研究设计：一项前瞻性、开放标签、非对照、多中心I/III期试验，旨在研究单次和/或重复静脉输注人纤维蛋白原浓缩物（BT524）用于先天性纤维蛋白原缺乏症患者出血事件的按需预防（ODP）和/或按需治疗（ODT）的药代动力学、疗效和安全性。患者：在这里报道的III期试验中，36例患者（3名儿童）。结果：纤维蛋白原浓缩输注显著改善最大凝块硬度（MCF）。在98.9%的出血中，总体止血反应被评为良好或优秀。在大多数手术干预中，失血被认为是正常的，伤口愈合也得到了积极的评估。包括血液制品消费和不良事件在内的其他评估进一步支持了这种新型纤维蛋白原产品的有效性，并证实了其良好的安全性。结论：BT524是一种新型的人纤维蛋白原浓缩物，对所有年龄的先天性纤维蛋白原缺乏症患者的出血治疗和围手术期出血预防均有效且安全。

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引用次数: 0

Barriers and facilitators to healthy lifestyle behaviours for people living with post pulmonary embolism syndrome. A qualitative study exploring participants lived experiences 肺栓塞后综合征患者健康生活方式行为的障碍和促进因素一项探讨参与者生活经历的定性研究。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-02-19 DOI: 10.1016/j.thromres.2026.109625

Caoimhe Kenny , Fiona Curran , Olive Lennon , Ann-marie O'Neill , Frederikus A. Klok , James Matthews , Fionnuala Ni Ainle , Rachel P. Rosovsky , Grainne O'Donoghue , Caoimhe Kenny

Background

People living with post-pulmonary embolism syndrome (PPES) commonly experience persistent dyspnoea, fatigue, reduced exercise tolerance, anxiety, and fear of recurrence. When symptoms continue beyond three months after effective anticoagulation, quality of life can be substantially impaired. Although healthy lifestyle behaviours may improve PPES symptoms, little is known about the barriers and facilitators influencing behaviour change from the perspective of those affected.

Aim

To explore patients' perceived barriers and facilitators to adopting healthy lifestyle behaviours following PE, in order to inform the future development of rehabilitation interventions for people with PPES.

Methodology

A purposive sample of adults with PPES took part in semi-structured interviews informed by the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation–Behaviour (COMB) model. Interviews were transcribed and analysed using a framework approach with inductive and deductive coding. Codes were grouped into categories and mapped to the 14 TDF domains and six COM-B constructs to identify behavioural influences and key barriers and facilitators.

Findings

Thirty-one participants (18 women, 13 men; aged 25–67 years) were interviewed. Ninety-eight codes were identified and organised into 35 categories, which were mapped to TDF and COM-B domains. The most frequently represented domains were Knowledge, Beliefs about Capabilities, Beliefs about Consequences, and Emotion. Key barriers and facilitators included pain, dyspnoea, healthcare professional knowledge and training, financial resources, and access to education and rehabilitation services.

Conclusions

Engagement in healthy lifestyle behaviours after PE is shaped by interacting physical, emotional, socioeconomic, and environmental factors. These findings highlight the need for comprehensive, theory-informed rehabilitation strategies that address both individual and contextual influences on behaviour change in people with PPES.

背景：肺栓塞后综合征（PPES）患者通常会经历持续的呼吸困难、疲劳、运动耐量降低、焦虑和对复发的恐惧。当有效抗凝后症状持续超过三个月时，生活质量可能会严重受损。虽然健康的生活方式行为可以改善PPES症状，但从受影响者的角度来看，对影响行为改变的障碍和促进因素知之甚少。目的：探讨PE后患者对采取健康生活方式行为的感知障碍和促进因素，为PE患者康复干预的未来发展提供信息。方法：在理论领域框架（TDF）和能力、机会、动机-行为（COMB）模型的指导下，有目的的PPES成年人样本参加了半结构化访谈。访谈记录和分析使用框架方法归纳和演绎编码。将代码分类并映射到14个TDF结构域和6个COM-B结构，以确定行为影响以及主要障碍和促进因素。研究结果：31名参与者（18名女性，13名男性，年龄在25-67岁之间）接受了采访。98个代码被识别并组织成35个类别，它们被映射到TDF和COM-B结构域。最常见的领域是知识、对能力的信念、对结果的信念和情感。主要障碍和促进因素包括疼痛、呼吸困难、保健专业知识和培训、财政资源以及获得教育和康复服务的机会。结论：体育锻炼后健康生活方式行为的参与是由身体、情绪、社会经济和环境因素相互作用形成的。这些发现强调了需要全面的、有理论依据的康复策略，以解决个人和环境对PPES患者行为改变的影响。

{"title":"Barriers and facilitators to healthy lifestyle behaviours for people living with post pulmonary embolism syndrome. A qualitative study exploring participants lived experiences","authors":"Caoimhe Kenny , Fiona Curran , Olive Lennon , Ann-marie O'Neill , Frederikus A. Klok , James Matthews , Fionnuala Ni Ainle , Rachel P. Rosovsky , Grainne O'Donoghue , Caoimhe Kenny","doi":"10.1016/j.thromres.2026.109625","DOIUrl":"10.1016/j.thromres.2026.109625","url":null,"abstract":"<div><h3>Background</h3><div>People living with post-pulmonary embolism syndrome (PPES) commonly experience persistent dyspnoea, fatigue, reduced exercise tolerance, anxiety, and fear of recurrence. When symptoms continue beyond three months after effective anticoagulation, quality of life can be substantially impaired. Although healthy lifestyle behaviours may improve PPES symptoms, little is known about the barriers and facilitators influencing behaviour change from the perspective of those affected.</div></div><div><h3>Aim</h3><div>To explore patients' perceived barriers and facilitators to adopting healthy lifestyle behaviours following PE, in order to inform the future development of rehabilitation interventions for people with PPES.</div></div><div><h3>Methodology</h3><div>A purposive sample of adults with PPES took part in semi-structured interviews informed by the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation–Behaviour (COM<img>B) model. Interviews were transcribed and analysed using a framework approach with inductive and deductive coding. Codes were grouped into categories and mapped to the 14 TDF domains and six COM-B constructs to identify behavioural influences and key barriers and facilitators.</div></div><div><h3>Findings</h3><div>Thirty-one participants (18 women, 13 men; aged 25–67 years) were interviewed. Ninety-eight codes were identified and organised into 35 categories, which were mapped to TDF and COM-B domains. The most frequently represented domains were Knowledge, Beliefs about Capabilities, Beliefs about Consequences, and Emotion. Key barriers and facilitators included pain, dyspnoea, healthcare professional knowledge and training, financial resources, and access to education and rehabilitation services.</div></div><div><h3>Conclusions</h3><div>Engagement in healthy lifestyle behaviours after PE is shaped by interacting physical, emotional, socioeconomic, and environmental factors. These findings highlight the need for comprehensive, theory-informed rehabilitation strategies that address both individual and contextual influences on behaviour change in people with PPES.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"259 ","pages":"Article 109625"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Evolving biomarkers and risk prediction models in colorectal cancer-associated venous thromboembolism 结直肠癌相关静脉血栓栓塞的生物标志物和风险预测模型的发展

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-02-13 DOI: 10.1016/j.thromres.2026.109619

Lan Sun , Jia Wang , Yi-Dan Yan , Long-Tu Li , Lin-Yu Cao , Ruo-Fei Li , Shan Chong , Meng Hu , Hou-Wen Lin , Yi-Min Cui , Zhi-Chun Gu , Qian Xiang

The pathological hypercoagulable state and associated risk of thrombosis in colorectal cancer (CRC) persist throughout the disease course. Accurate identification of patients at high risk of venous thromboembolism (VTE) and judiciously applying drug or mechanical prevention measures can significantly reduce the incidence of VTE. The review details a range of biomarkers, including platelet count, soluble P-selectin, D-dimer, and vascular endothelial growth factor (VEGF), which have been shown to correlate with increased VTE risk in CRC patients. In addition to the biomarker analysis, the review makes important recommendations for the routine monitoring of these biomarkers in CRC patients, especially those at higher risk for VTE. Furthermore, it discusses the integration of these biomarkers into clinical VTE risk prediction models, advocating for personalized and targeted thromboprophylaxis strategies. The review also explores future research directions, emphasizing the potential of antiplatelet and anticoagulant therapies in improving the prognosis of CRC patients by reducing thromboembolic events. This narrative review not only deepens our understanding of the molecular mechanisms driving cancer-associated thrombosis but also paves the way for novel therapeutic interventions aimed at preventing VTE in CRC patients.

结直肠癌（CRC）的病理性高凝状态和相关血栓形成风险在整个病程中持续存在。准确识别静脉血栓栓塞（VTE）高危患者，合理应用药物或机械预防措施，可显著降低VTE的发生率。该综述详细介绍了一系列生物标志物，包括血小板计数、可溶性p -选择素、d -二聚体和血管内皮生长因子（VEGF），这些生物标志物已被证明与结直肠癌患者静脉血栓栓塞风险增加相关。除了生物标志物分析外，该综述还对CRC患者，特别是静脉血栓栓塞风险较高的患者进行这些生物标志物的常规监测提出了重要建议。此外，它还讨论了将这些生物标志物整合到临床静脉血栓栓塞风险预测模型中，倡导个性化和有针对性的血栓预防策略。综述还探讨了未来的研究方向，强调了抗血小板和抗凝治疗通过减少血栓栓塞事件改善结直肠癌患者预后的潜力。这篇综述不仅加深了我们对癌症相关血栓形成的分子机制的理解，而且为预防结直肠癌患者静脉血栓形成的新治疗干预铺平了道路。

{"title":"Evolving biomarkers and risk prediction models in colorectal cancer-associated venous thromboembolism","authors":"Lan Sun , Jia Wang , Yi-Dan Yan , Long-Tu Li , Lin-Yu Cao , Ruo-Fei Li , Shan Chong , Meng Hu , Hou-Wen Lin , Yi-Min Cui , Zhi-Chun Gu , Qian Xiang","doi":"10.1016/j.thromres.2026.109619","DOIUrl":"10.1016/j.thromres.2026.109619","url":null,"abstract":"<div><div>The pathological hypercoagulable state and associated risk of thrombosis in colorectal cancer (CRC) persist throughout the disease course. Accurate identification of patients at high risk of venous thromboembolism (VTE) and judiciously applying drug or mechanical prevention measures can significantly reduce the incidence of VTE. The review details a range of biomarkers, including platelet count, soluble P-selectin, D-dimer, and vascular endothelial growth factor (VEGF), which have been shown to correlate with increased VTE risk in CRC patients. In addition to the biomarker analysis, the review makes important recommendations for the routine monitoring of these biomarkers in CRC patients, especially those at higher risk for VTE. Furthermore, it discusses the integration of these biomarkers into clinical VTE risk prediction models, advocating for personalized and targeted thromboprophylaxis strategies. The review also explores future research directions, emphasizing the potential of antiplatelet and anticoagulant therapies in improving the prognosis of CRC patients by reducing thromboembolic events. This narrative review not only deepens our understanding of the molecular mechanisms driving cancer-associated thrombosis but also paves the way for novel therapeutic interventions aimed at preventing VTE in CRC patients.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"259 ","pages":"Article 109619"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

aPLs seroconversion in antiphospholipid syndrome: from definition to clinical relevance 抗磷脂综合征中抗磷脂抗体血清转换：从定义到临床相关性

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-02-16 DOI: 10.1016/j.thromres.2026.109622

Angela Di Giorgio , Claudia Carnuccio , Antonio Nesci , Valerio De Stefano , Angelo Santoliquido

Antiphospholipid syndrome (APS) is an acquired coagulation disorder with an unclear pathogenesis, diagnosed in the presence of thrombotic events, obstetric complications, or non-thrombotic manifestations, alongside persistently detectable antiphospholipid antibodies. aPLs seroconversion, defined as the transition from persistent antibody positivity to sustained antibody negativity, is typically confirmed by at least two negative tests ≥12 weeks apart and maintained for over one year. This phenomenon is distinct from seronegative APS (SNAPS), in which patients present with APS-like clinical features but never fulfill laboratory criteria. Thrombotic risk remains significant in APS, particularly in patients with prior events or persistently elevated aPLs titers. Immunomodulatory therapies, such as hydroxychloroquine, rituximab, eculizumab, sirolimus, or other agents, may reduce antibody levels and contribute to improved outcomes, though evidence is limited. Among these, hydroxychloroquine is the most established agent, particularly in refractory or recurrent thrombotic cases, and is recommended as adjunctive therapy alongside anticoagulation in high-risk thrombotic and obstetric APS. While these therapies may allow cautious adjustments in anticoagulation for low-risk patients, anticoagulants should not be discontinued solely based on seroconversion or adjunctive treatment. Overall, immunomodulatory drugs should be considered strictly as adjuncts, with patient selection guided by clinical phenotype, thrombotic risk, and available evidence.

抗磷脂综合征（APS）是一种发病机制不明确的获得性凝血障碍，在存在血栓性事件、产科并发症或非血栓性表现时诊断，同时持续检测到抗磷脂抗体。apl血清转化，定义为从持续抗体阳性到持续抗体阴性的转变，通常通过至少两次间隔≥12周的阴性检测来确认，并维持一年以上。这种现象与血清阴性APS （SNAPS）不同，后者患者表现出APS样的临床特征，但从未达到实验室标准。血栓形成风险在APS中仍然显著，特别是在既往事件或持续升高的apl滴度的患者中。免疫调节疗法，如羟氯喹、利妥昔单抗、依曲单抗、西罗莫司或其他药物，可能降低抗体水平并有助于改善结果，尽管证据有限。其中，羟氯喹是最成熟的药物，特别是在难治性或复发性血栓病例中，并被推荐作为高危血栓和产科APS抗凝治疗的辅助治疗。虽然这些治疗方法可能允许对低风险患者的抗凝治疗进行谨慎的调整，但抗凝治疗不应仅仅基于血清转换或辅助治疗而停用。总的来说，免疫调节药物应严格视为辅助药物，患者选择应以临床表型、血栓形成风险和现有证据为指导。

{"title":"aPLs seroconversion in antiphospholipid syndrome: from definition to clinical relevance","authors":"Angela Di Giorgio , Claudia Carnuccio , Antonio Nesci , Valerio De Stefano , Angelo Santoliquido","doi":"10.1016/j.thromres.2026.109622","DOIUrl":"10.1016/j.thromres.2026.109622","url":null,"abstract":"<div><div>Antiphospholipid syndrome (APS) is an acquired coagulation disorder with an unclear pathogenesis, diagnosed in the presence of thrombotic events, obstetric complications, or non-thrombotic manifestations, alongside persistently detectable antiphospholipid antibodies. aPLs seroconversion, defined as the transition from persistent antibody positivity to sustained antibody negativity, is typically confirmed by at least two negative tests ≥12 weeks apart and maintained for over one year. This phenomenon is distinct from seronegative APS (SNAPS), in which patients present with APS-like clinical features but never fulfill laboratory criteria. Thrombotic risk remains significant in APS, particularly in patients with prior events or persistently elevated aPLs titers. Immunomodulatory therapies, such as hydroxychloroquine, rituximab, eculizumab, sirolimus, or other agents, may reduce antibody levels and contribute to improved outcomes, though evidence is limited. Among these, hydroxychloroquine is the most established agent, particularly in refractory or recurrent thrombotic cases, and is recommended as adjunctive therapy alongside anticoagulation in high-risk thrombotic and obstetric APS. While these therapies may allow cautious adjustments in anticoagulation for low-risk patients, anticoagulants should not be discontinued solely based on seroconversion or adjunctive treatment. Overall, immunomodulatory drugs should be considered strictly as adjuncts, with patient selection guided by clinical phenotype, thrombotic risk, and available evidence.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"259 ","pages":"Article 109622"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Rebuttal to correspondence on “Diagnostic accuracy meta-analysis of portal vein thrombosis imaging” 对“门静脉血栓成像诊断准确性荟萃分析”对应文章的反驳。

IF 3.4 3区医学 Q1 HEMATOLOGY

Thrombosis research

Pub Date : 2026-03-01 Epub Date: 2026-02-19 DOI: 10.1016/j.thromres.2026.109628

Laura Girardi , Aurélien Delluc

引用次数: 0

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