Valves of the deep venous system: an overlooked risk factor
Valves of the deep venous system: an overlooked risk factor
复制标题
DOI：
10.1182/blood-2009-03-209981
复制
发表时间：
2009-08-06
期刊：
影响因子：
20.3
通讯作者：
Bovill, Edwin G.
中科院分区：
文献类型：
--
作者：
Brooks, Erin G.;Trotman, Winifred;Bovill, Edwin G.
深静脉瓣膜是深静脉血栓形成的常见部位。然而，在血栓形成风险的研究中，瓣膜窦内皮的可能作用很少受到关注。我们推测，瓣膜窦内皮细胞与静脉腔内皮细胞不同，其抗凝活性上调，促凝活性下调，以响应局部环境。在追求这一假设，我们定量内皮蛋白C受体（EPCR），血栓调节蛋白（TM），血管性血友病因子（VWF）的免疫荧光法在大隐静脉收获心脏搭桥手术。我们发现EPCR和TM在瓣膜窦内皮中的表达显著增加，与静脉腔内皮相反，VWF的表达模式相反（TM和EPCR的配对t检验，P <0.001; VWF，P = 0.01）。这些数据支持了我们的假设，并表明瓣膜窦血栓阻力的变化可能是静脉血栓形成的一个重要因素。（血。2009; 114：1276-1279）
Deep venous valves are frequent sites of deep venous thrombosis initiation. However, the possible contribution of the valvular sinus endothelium has received little attention in studies of thrombosis risk. We hypothesized that the endothelium of valve sinus differs from that of vein lumen with up-regulation of anticoagulant and down-regulation of procoagulant activities in response to the local environment. In pursuit of this hypothesis, we quantified endothelial protein C receptor (EPCR), thrombomodulin (TM), and von Willebrand factor (VWF) by immunofluorescence in great saphenous veins harvested at cardiac bypass surgery. We found significantly increased expression of EPCR and TM in the valvular sinus endothelium as opposed to the vein lumenal endothelium, and the opposite pattern with VWF (paired t test for TM and EPCR, each P < .001; for VWF, P = .01). These data support our hypothesis and suggest that variation in valvular sinus thromboresistance may be an important factor in venous thrombogenesis. (Blood. 2009; 114: 1276-1279)