Association of Thrombophilia and Inflammation with Post-Thrombotic Syndrome

血栓形成倾向和炎症与血栓后综合征的关联

基本信息

批准号：
7393101
负责人：
MARY CUSHMAN
金额：
$ 33.37万
依托单位：
UNIVERSITY OF VERMONT & ST AGRIC COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-05-12 至 2011-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7393101
关键词：
Address Adipocytes Adult Affect Age Anatomy Anticoagulant therapy Anticoagulants Anticoagulation Arteries Basic Science Bilateral Biological Biological Markers Blood Case-Control Studies Chronic Chronic Disease Clinical Clinical Trials Collaborations Complication DNA Deep Vein Thrombosis Depth Development Diagnosis Disease Edema Embolism Enzyme-Linked Immunosorbent Assay Epidemiology Ethnic Origin Evaluation Follow-Up Studies Functional disorder Funding General Population Genetic Genetic Predisposition to Disease Genotype Hereditary Disease Hospitalization Incidence Inflammation Inflammatory Inherited Intervention Investigation Laboratories Lead Leg Lower Extremity Lung Measures Medical Medical History Minor Molecular Molecular Epidemiology Molecular Genetics Natural History Numbers Obesity Obstruction Operative Surgical Procedures Orthopedic Surgery procedures Other Finding Participant Patient Care Patients Peripheral Persons Physical Examination Population Population Study Postoperative Period Postphlebitic Syndrome Protein C Deficiency Proteins Proteomics Range Rate Recording of previous events Recurrence Reflux Relative Risks Reporting Research Research Personnel Review, Systematic (PT)Risk Risk Marker Role Sampling Severities Skin Source Specimen Staging Stroke Structure of superficial vein Symptoms Syndrome Techniques Testing Thinking Thrombophilia Thrombosis Time Translating Translations Trauma Ulcer Ultrasonography United States Varicose Ulcer Veins Venous Venous Thrombosis Woman Work assay development base case control chronic pain cohort cost deep vein disability disease classification experience genetic epidemiology genetic variant innovation interest kindred men monocyte multidisciplinary novel peripheral blood prevent prospective

项目摘要

Deep vein thrombosis (DVT) or pulmonary embolus affect 1-3 per 1000 yearly of the adult population, or nearly 200,000 per year, with an incidence that rises exponentially with age. The burden of venous thrombosis predominantly involves DVT, which is complicated by post-thrombotic syndrome (PTS) in 20- 50% of cases. PTS has a spectrum from mild edema to disabling symptomatic disease with trophic skin changes, chronic pain, and venous skin ulceration. While PTS is thought to occur as a result of damage to the venous valves with resultant reflux or chronic venous obstruction limiting outflow, additional etiologic determinants of PTS have not been extensively studied. We propose a population-based study to evaluate the molecular determinants of chronic peripheral venous disease (CPVD) in a multi-ethnic general population sample, the San Diego Population Study (SDPS). Participants had detailed physical examination and duplex leg ultrasound to establish presence of CPVD based on anatomic and clinical findings. We will address the following hypotheses: 1.Among those with hereditary disorders associated with the hypercoagulable state ("hereditary thrombophilia") there will be an increased risk of deep functional venous disease (DFD) assessed by duplex ultrasound and of superficial venous functional disease (SFD) when it occurs in the absence of DFD and together with clinical features of PTS. 2. There will be an increased risk of DFD or SFD with features of PTS, among participants with higher levels of biomarkers reflecting different aspects inflammation. 3. Given the association of obesity with the risk of CPVD and PTS, there will be an increased risk of DFD or SFD with features of PTS in association with higher levels of biomarkers reflecting adipocyte products. To test these hypotheses phenotypic and genetic molecular biomarkers will be measured in stored biological specimens of the SDPS participants including 370 control participants and 370 cases of CPVD, focusing on post-thrombotic syndrome. Findings will allow hypotheses to be formed concerning etiologic factors in the development of PTS after clinically diagnosed or clinically silent DVT. PTS and CPVD affect -2.5 million people in the United States; 20% develop severe disease with venous ulcers. Resultant disability is estimated at 2 million lost workdays/year and medical costs as $300 million yearly. Findings here can form the basis for development of new therapies to treat, and moreover prevent,PTS.

深静脉血栓形成（DVT）或肺栓塞每年每年的成年人口1-3，或每年将近200,000，其发病率随着年龄的增长而成倍增加。静脉负担血栓形成主要涉及DVT，这在20--中遭到了血栓形成综合征（PTS）的复杂性 50％的病例。 PTS具有从轻度水肿到残疾人疾病的频谱变化，慢性疼痛和静脉皮肤溃疡。虽然被认为是由于损坏而发生的静脉阀产生的回流或慢性静脉阻塞限制流出，额外的病因 PT的决定因素尚未得到广泛的研究。我们提出了一项基于人群的研究来评估多种族普通人群中慢性外周静脉疾病（CPVD）的分子决定因素样本，圣地亚哥人口研究（SDPS）。参与者进行了详细的体格检查和双工基于解剖和临床发现的腿部超声以建立CPVD的存在。我们将解决以下假设：1。在与超凝状态相关的遗传性疾病的人（“遗传性血小板”）将增加患有深层功能性静脉疾病（DFD）的风险通过双链超声和浅表静脉功能疾病（SFD）评估。没有DFD以及PT的临床特征。 2。DFD或SFD的风险会增加具有PT的功能，在具有较高生物标志物的参与者中反映了不同方面炎。 3。鉴于肥胖与CPVD和PT的风险有关，将会增加 DFD或SFD的风险具有PT的特征，以及反映脂肪细胞的更高水平的生物标志物产品。为了测试这些假设的表型和遗传分子生物标志物将在存储中测量 SDP参与者的生物标本，包括370个对照参与者和370例CPVD，专注于栓性后综合征。调查结果将允许有关病因的假设临床诊断或临床沉默的DVT后PT发展的因素。 PT和CPVD影响美国 - 250万人； 20％因静脉溃疡而患上严重疾病。导致的残疾估计每年的工作日损失了200万美元，每年的医疗费用为3亿美元。这里的发现可以形成开发新疗法以治疗和预防的基础。