ROLUL P-SELECTINEI ÎN TROMBEMBOLISMUL PULMONAR
DOI:
https://doi.org/10.52692/1857-0011.2025.1-81.17Cuvinte cheie:
P-selectină, embolie pulmonară, tromboembolism venos, biomarkeriRezumat
Tromboembolismul pulmonar (TEP), componentă majoră a trombembolismului venos (TEV), este o afecțiune cu potențial letal, implicând mecanisme complexe inflamatorii și procoagulante. P-selectina, o moleculă de adeziune celulară exprimată pe suprafața celulelor endoteliale și a trombocitelor activate, joacă un rol central în patogeneza trombozei prin facilitarea interacțiunilor leucocite-trombocite-endoteliu și activarea cascadelor de coagulare. Nivelurile crescute de P-selectină au fost asociate cu un risc crescut de tromboză venoasă profundă și embolie pulmonară, fiind propuse ca biomarker de diagnostic și prognostic. De asemenea, această moleculă este implicată în multiple alte patologii, precum cancerul, sindroamele inflamatorii cronice și trombofiliile ereditare. Terapia țintită anti-P-selectină, prin anticorpi monoclonali și alți inhibitori specifici, reprezintă o nouă direcție promițătoare în prevenția și tratamentul evenimentelor trombotice. Lucrarea de față analizează în detaliu rolul fiziopatologic, valoarea predictivă și potențialul terapeutic al P-selectinei în contextul TEP și al altor afecțiuni trombotice.
Referințe
=Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2020;41:543–603. doi:10.1093/eurheartj/ehz405.
Tarbox AK, Swaroop M. Pulmonary embolism. Int J Crit Illn Inj Sci. 2013;3(1):69–72.
Horlander KT, Mannino DM, Leeper KV. Pulmonary embolism mortality in the United States. Arch Intern Med. 2003;163(14):1711–1717.
Wendelboe AM. Global health burden of venous thromboembolism. Arterioscler Thromb Vasc Biol. 2024;44:1007–1011.
Kumar DR, Hanlin A, Glurich I, Mazza JJ, Yale SH. Virchow’s contribution to the understanding of thrombosis and cellular biology. Clin Med Res. 2010;8(3–4):168–172.
Shah IK, Patel B, Desai M, Johnson C, Vora R, Lee J, et al. Pathophysiology and management of pulmonary embolism. Int J Angiol. 2022;31(3):143–149.
Turetz M, Sideris AT, Friedman OA, Triphathi N, Horowitz JM. Epidemiology, pathophysiology, and natural history of pulmonary embolism. Semin Intervent Radiol. 2018;35(2):92–98.
Escopy S, Chaikof EL. Targeting the P-selectin/ PSGL-1 pathway: discovery of disease-modifying therapeutics for disorders of thromboinflammation. Blood Vessels Thromb Haemost. 2024;1(3):100015.
Ludwig RJ, Berghoff AS, Gerdes S, Scholz J, Tandler N, Utikal J, et al. P-selectin – a common therapeutic target for cardiovascular disorders, inflammation, and tumour metastasis. Expert Opin Ther Targets. 2007;11(8):1043–1053.
McEver RP. Selectins: initiators of leucocyte adhesion and signalling at the vascular wall. Cardiovasc Res. 2015;107(3):331–339.
Lorant DE, Topham MK, Whatley RE, McEver RP, McIntyre TM, Prescott SM, et al. Inflammatory roles of P-selectin. J Clin Invest. 1993;92(2):559–570.
Ramos CL, Huo Y, Jung U, Ghosh S, Manka DR, Sarembock IJ, et al. Direct demonstration of P-selectin- and VCAM-1-dependent mononuclear cell rolling in early atherosclerotic lesions of apolipoprotein E-deficient mice. Circ Res. 1999;84(11):1237–1244. doi:10.1161/01.res.84.11.1237.
Nabi F, Spiro TP, Johnson CJ, Van Wagoner DR, Ahmad M. Effect of P-selectin on phosphatidylserine exposure and surface-dependent thrombin generation on monocytes. Arterioscler Thromb Vasc Biol. 2005;25(5):1065–1070.
Kutlar A, Kutlar F, Embury SH. Cellular adhesion and the endothelium. Hematol Oncol Clin North Am. 2014;28(2):323–339. doi:10.1016/j.hoc.2013.11.008.
Mezouar S, Frère C, Darbousset R, Mege D, Crescence L, Dignat-George F, et al. Role of P-Selectin in Cancer- Associated Thrombosis and Tumor Progression. Int J Mol Sci. 2021;22(15):7942.
Karki NR. P-Selectin Blockade in the Treatment of Painful Vaso-Occlusive Crises in Sickle Cell Disease: A Spotlight on Crizanlizumab. J Pain Res. 2021;14:849–856.
Purdy M, Al-Tamimi M, Lip GYH, Watson SP, Pasi KJ. P- and E-selectin in venous thrombosis and non-venous pathologies. J Thromb Haemost. 2022;20:1056–1066.
Swamy S, Sundararajan V, Karunakaran D, Jayaraman B. Plasma levels of P-selectin and future risk of incident venous thromboembolism. J Thromb Haemost. 2023;21(9):2451–2460.
Mario-Oblitas C, Ramos Y, Marín-Restrepo LM, Espinoza J, Alfaro RA, Sanchez JL, et al. Evaluation of soluble P-selectin as a predictive biomarker in acute symptomatic pulmonary embolism. Eur J Haematol. 2024;113(2):141–148.
Erpenbeck L, Schön MP. Deadly allies: The fatal interplay between platelets and metastasizing cancer cells. Blood. 2010;115:3427–3436.
Yeini E, Satchi-Fainaro R. The role of P-selectin in cancer-associated thrombosis and beyond. Thromb Res. 2022;213(Suppl 1):S22–S28.
Fernandes LFB, Tricarico PM, Cesselli D, Castiglia G, Bulfoni M, Tell G, et al. Role of P-selectin in thromboembolic events in patients with cancer. Mol Clin Oncol. 2017;8(1):188–196.
de Williage SU, Schmidt R, Grammer TB, Kleber ME, Delgado G, März W. Selectin haplotypes and the risk of venous thrombosis: influence of linkage disequilibrium with the factor V Leiden mutation. J Thromb Haemost. 2008;6:478–485.
Diz-Kucukkaya R, Hancer VS, Sari I, Buyukasik Y, Haznedaroglu IC, Goker H. P-selectin glycoprotein ligand-1 VNTR polymorphisms and risk of thrombosis in the antiphospholipid syndrome. Ann Rheum Dis. 2007;66(10):1378–1380.
Mehta A, Lee SJ, Finkelstein D, Greenberg JA, Halene S, Kentsis A, et al. Plasma P-selectin is an early marker of thromboembolism in COVID-19. J Emerg Med. 2021. doi:10.1101/2021.07.10.21260293.
Voskaridou E, Christoulas D, Zervas K, Katodritou E, Terpos E. Soluble P-Selectin Levels in Patients with Sickle Cell Disease Reflect Platelets’ Activation Rather Than Endothelial Dysfunction. Blood. 2019;134(Suppl 1):4829.
Schneider DJ, Sobel BE, Dai X, McMahon TJ, Lefer AM. Association between increased platelet P-selectin expression and obesity in patients with type 2 diabetes. Diabetes Care. 2009;32(5):944–949.
Gerlach H. The influence of sex hormones on thrombosis and platelet activation: implications for female cardiovascular health. Thromb Res. 2016;139:19–25.
Ramacciotti E, Hawley AE, Farris DM, Ballard NE, Wrobleski SK, Myers DD, et al. P-selectin/PSGL- 1 inhibitors versus enoxaparin in the resolution of venous thrombosis: A meta-analysis. Thromb Res. 2010;125(4):e138–e142.
Escopy S, Chaikof EL. Targeting the P-selectin/ PSGL-1 pathway: discovery of disease-modifying therapeutics for disorders of thromboinflammation. Blood Vessels Thromb Haemost. 2024;1(3):100015
Descărcări
Publicat
Număr
Secțiune
##category.category##
Licență
Copyright (c) 2025 Buletinul Academiei de Științe a Moldovei. Științe medicale
Această lucrare este licențiată în temeiul Creative Commons Attribution 4.0 International License.
