ABSTRACT
BACKGROUND: Various genetic risk factors are known to increase the risk of venous thromboembolism (VTE). Increasing evidence suggests a "cross-talk" between the coagulation and inflammatory cascade. Therefore, polymorphisms in genes involved in inflammation may influence susceptibility towards VTE. The aim of the study was to investigate the role of single nucleotide polymorphisms (SNPs) in inflammation genes for susceptibility towards VTE. METHODS: The study group consisted of 108 (47 men and 61 women) Dutch patients with documented VTE and 325 healthy controls from the same geographical area (117 men and 208 women). Odds ratios (OR) and 95% confidence intervals (95% CI) for VTE separately and if indicated by gender were calculated to assess whether genotype and allele frequency were associated with thrombosis. RESULTS: Heterozygosity for SNP -899C/T of the interleukin 1-alpha gene (IL1A -899C/T) was under-represented in VTE patients compared to the control group (OR=0.51, 95% CI 0.32-0.82). The IL6 -174 CC genotype was more frequent in male patients with VTE compared to male controls (OR=4.06, 95% CI 1.43-11.5). Female patients carried significantly more IL13 (intron3) TT genotype (OR=5.60, 95% CI 1.94-18.5) compared to female controls. The allelic frequency of IL4 -589 T allele was significantly increased in female patients (OR=1.72, 95% CI 1.05-2.81) in contrast to men where no differences were observed. CONCLUSION: Four SNPs in inflammatory-related genes of IL1A, IL4, IL6, and IL13 may be associated with VTE. These results need to be confirmed in independent groups with larger number of patients.
Subject(s)
Inflammation/genetics , Polymorphism, Single Nucleotide/genetics , Venous Thromboembolism/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Confidence Intervals , Female , Gene Frequency/genetics , Genetic Predisposition to Disease , Genotype , Heterozygote , Humans , Interleukin-13/genetics , Interleukin-1alpha/genetics , Interleukin-4/genetics , Interleukin-6/genetics , Male , Middle Aged , Odds Ratio , Risk Factors , Sex Factors , Young AdultABSTRACT
INTRODUCTION: Thrombosis and infections are well known complications of central venous catheters and totally implanted access ports. These complications lead to increased costs due to prolonged hospitalisation, increased antibiotics use and need for replacement. The objectives of the study were to document the occurrence of catheter related thrombosis and infections in patients with central venous catheters and totally implanted chest ports in cancer patients and to investigate whether factor V Leiden is a risk factor for catheter related thrombosis. MATERIALS AND METHODS: Between February 2002 and November 2004, 43 patients with central venous catheter or totally implanted access port were followed up to document the occurrence of catheter related thrombosis and infections. Patients received chemotherapy either for haematological malignancy or for solid tumours. Factor V Leiden (R506Q) was determined by restriction fragment length polymorphism analysis. Follow-up period ended in April 2007. RESULTS: Catheter related thrombosis occurred in 4 patients (4/43; 9.3%) with a totally implanted access port. None of the 3 patients with factor V Leiden had catheter related infection or thrombosis. Catheter related infections occurred in 15 patients: 10 patients (23.3%; 10/43) with central venous catheter and 5 patients (11.6%; 5/43) with totally implanted access ports. Time to infection was 32.5 days in the central venous catheter group compared to 88 days in the totally implanted access port group. CONCLUSION: A higher incidence of catheter related infections was observed in patients with central venous catheters in contrast to patients with totally implanted access ports were venous thrombosis was more frequent.
