Interplay between genetics and epigenetics in modulating the risk of venous thromboembolism : A new challenge for personalized therapy

Copyright © 2019 Elsevier Ltd. All rights reserved..

Although venous thromboembolism (VTE) shows a polygenic nature, the crossroad between genome and environment is not fully understood. Genetics explains only a part of VTE hereditability and not defined molecular causes are found in approximately 50% of thrombotic patients. Thus, a major understanding of molecular mechanisms may clarify the missing hereditability. Concerning epigenetics, a particular histone modification (citrullination) plays a key role in increasing the rate of venous occlusive events by inducing neutrophil apoptosis and expulsion of neutrophil extra-cellular traps (NETs), which may be useful biomarkers of active disease. Moreover, an over-expression of miR-320a/b, miR-582, miR-195, miR-424-5p, and miR-532, or a down-regulation of miR495, miR-136-5p and miR-26a may improve the accuracy of VTE diagnosis. No clinical studies have focused on DNA methylation in VTE. Nowadays, no validated epigenetics biomarkers are routinely used for diagnosis and prevention of VTE. In the era of personalized therapy, several clinical trials are investigating the putative role of statins, a class of lipid-lowering epigenetic-based drugs, as additional therapeutic agents in VTE. Furthermore, single nucleotide polymorphisms (SNPs) in CYP2C9, VKORC1, and MIR133 genes can help physicians to predict individual warfarin dose requirement. Consequently, a comprehensive understanding of the mechanisms involved in the control of blood clot development is crucial to design novel therapeutic strategies. This review summarizes the current clinical concepts both in genetic and epigenetic VTE framework. Furthermore, we discuss the contribution of the innovative network medicine paradigm into advancing our knowledge about molecular underpinnings needed to support novel VTE diagnostic and therapeutic options.

Medienart:

E-Artikel

Erscheinungsjahr:

2019

Erschienen:

2019

Enthalten in:

Zur Gesamtaufnahme - volume:177

Enthalten in:

Thrombosis research - 177(2019) vom: 15. Mai, Seite 145-153

Sprache:

Englisch

Beteiligte Personen:

Benincasa, Giuditta [VerfasserIn]
Costa, Dario [VerfasserIn]
Infante, Teresa [VerfasserIn]
Lucchese, Roberta [VerfasserIn]
Donatelli, Francesco [VerfasserIn]
Napoli, Claudio [VerfasserIn]

Links:

Volltext

Themen:

DNA polymorphism
Epigenetics
Journal Article
MicroRNAs
Network medicine
Personalized therapy
Review
Venous thromboembolism

Anmerkungen:

Date Completed 06.01.2020

Date Revised 06.01.2020

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.thromres.2019.03.008

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM295263881