The aim of this thesis was to study the role of ADAMTS13 in arterial
thrombosis, a disease that comprises both environmental and genetic
factors. We determined ADAMTS13 in ischemic stroke patients and
controls. Also in a study of myocardial infarction, stroke and
peripheral arterial disease patients, ADAMTS13 was determined. In all
studies we found lower levels of ADAMTS13 in patients compared with
controls. Moreover, patients with lower levels of ADAMTS13 had also
higher OR’s than controls. Polymorphisms in the ADAMTS13 gene, studied
in arterial thrombosis patients, were not of influence on the levels nor
on the risk of arterial thrombosis. A polymorphism in the Von
Willebrand Factor gene was studied in arterial thrombosis. The frequency
of the rare allele was very low.
Furthermore ADAMTS13 was studied in other conditions associated with
thrombotic complications, such as meningococcal sepsis and liver
cirrhosis.
In children with meningococcal sepsis the levels of ADAMTS13 were
strongly reduced and levels of VWF were strongly elevated.
Liver cirrhosis is often accompanied by alterations in the haemostatic
system. In our group of liver cirrhosis patients we found highly
elevated VWF and a large variation in levels of ADAMTS13. No clear
explanation for this variation was found yet.
At least we studied several assays in TTP patients and liver cirrhosis
patients. We concluded that for TTP patients all assays were suitable.
Overall we can conclude that ADAMTS13 plays an important role in
arterial thrombosis, especially in coronary heart disease patients.
However, these results were form case-controle studies and need to be
further studied in prospective studies.http://repub.eur.nl/res/pub/21819/101209_Bongers%2C%20Tamara%20Natascha.pdf
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