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Platelet membrane glycoprotein IIb/IIIa in the view of its genetic changes


Authors: J. Gumulec 1;  M. Penka 2;  R. Richterová 1;  M. Brejcha 1;  D. Klodová 1;  M. Wróbel 1;  P. Janotová 1;  K. Klaricová 1;  M. Kneiflová 1;  M. Kučerová 1;  M. Radina 1
Authors‘ workplace: Centrum pro trombózu a hemostázu při Onkologickém centru J. G. Mendla, Nový Jičín, přednosta prim. MUDr. Jaromír Gumulec 1;  Oddělení klinické hematologie FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Miroslav Penka, CSc. 2
Published in: Vnitř Lék 2005; 91(7 a 8): 845-853
Category: 128th Internal Medicine Day - 21rd Vanysek's Day Brno 2005

Jako přehled bylo publikováno také formou přednášky v únoru 2004 na X. Pařízkově dni v Novém Jičíně a v listopadu 2004 na X. sympoziu MEFA v Brně

Overview

Uniqueness of the role of thrombocytes in a genesis of arterial thrombotic occlusions turns the attention to the platelets and platelet glycoproteins, which are involved in the process of platelet thrombus formation. Genetic variants of platelet glycoproteins originating from point mutations of their genes can be associated with increased thrombocyte aggregability (GP IIIa PlA1/PlA2). GP IIIa PlA2 (complex GP IIb/IIIa) variant significantly increases thrombocyte aggregability and mediates smooth muscle cells proliferation changes. Pl(A) polymorphism seems to interfere in the aetiopathogenesis of coronary disease and MI so that men with PlA2 allele have more frequently thin-walled vulnerable coronary plaques predisposed to ruptures with subsequent massive (fatal) thrombosis. On the other hand PlA1/PlA1 genotype is more frequently associated with the presence of fixed plaques when MI originates from the coronary stenosis progression. Meta-analyses of clinical trials results identify this polymorphism to be mild risk factor for coronary disease, occurrence of myocardial infarction, restenosis after percutaneous revascularisation interventions, occlusions in the site of aortocoronary bypass grafting and cerebral vascular event.

Key words:
thrombocytes – arterial thrombotic occlusions – platelet glycoproteins – glycoprotein IIb/III – coronary disease


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