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The value of using polymorphisms in anti-platelet therapy

Frontiers in Biology 2017年第5期12卷 349-356页

作者： Habib Haybar Zeinab Deris Zayeri Golestan Hospital Clinical Research Development Unit Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran

OBJECTIVES and BACKGROUNDS： Cardiovascular events occure as a result of various risk factors, such as uric acid （UA）, inflammation, hormones and other materials that induce C- reactive protein （CRP） expression. These factors lead to complement activation, and endothelial damages. Damaged endothelial cells release heparan sulfate which inhibits tissue factor activity and von Willed brand factor （VWVF） and causes aggregation. Finally this cascade of events cause platelets aggregation and leads to heart ischemia and cardiovascular events. DISCUSSION： anti-platelet therapy is an interesting premise. anti-platelet resistance patients and bleeding as a result of using ticagrelor and prasugrel should be considered in this treatment methods. anti-platelet drugs such as clopidogrel are prescribed in cardiovascular events. platelets have VWF receptors and P2Y12 receptors on their surface, and thus, targeting these receptors can be useful in treatment. The active metabolites of clopidogrel bind to P2Y12R and inhibit ADP binding; thus, clopidogrel inhibits aggregation by interfering in several events as a result of the inhibition of ADP attachment to P2Y12R of the platelet. However, the polymorphisms of P2~ 12 and other genes mentioned in Table 1 showed treatment resistance in anti-platelet therapy, highlighting that these SNPs can be helpful in anti-platelet therapy. CONCLUSION： The knowledge of these SNPs may decrease the number of unwanted effects that endanger patients with cardiovascular diseases and avoids ineffective anti-platelet therapy in several patients. Clopidogrel, ticagrelor, prasugrel, and aspirin and CYP2C19 and their SNPs are very important subjects in anti-platelet therapy. To present the importance of using phannacogenetics in anti-platelet therapy, we discuss here the association between these drugs and the SNPs for therapeutic resistance.

关键词： cardiovascular events clopidogrel CYP2C19 polymorphisms anti-platelet drugs

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Chronic hepatitis B： role of anti-platelet therapy in inflammation control

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Cellular & Molecular Immunology 2015年第3期12卷 264-268页

作者： Roberto Aiolfi Giovanni Sitia Division of Immunology Transplantation and Infectious Diseases IRCCS San Raffaele Scientific Institute Milan Italy

platelets play a known role in the maintenance of vascular homeostasis, but these cells are emerging as important cellular mediators of acute and chronic inflammatory diseases. platelets are key elements in the pathogenesis of acute and chronic liver disease associated with hepatitis B virus （HBV） infection by promoting the accumulation of virus-specific CD8＋ T cells and nonspecific inflammatory cells into the liver parenchyma. This review discusses major platelet functions in immune and inflammatory responses, with an emphasis on recent pre-clinical studies that suggest that the inhibition of platelet activation pathways represent an alternative therapeutic strategy with potential use in the reduction of virus-specific T cell-mediated chronic inflammation, liver fibrosis and hepatocellular carcinoma in patients who are chronically infected with HBV.

关键词： anti-platelet drugs CD8+ T cells chronic hepatitis B hepatocellular carcinoma platelets

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