Venous Thromboembolism
Conditions
Keywords
venous thromboembolism, VTE, sequelae, immunothrombosis, platelets, inflammatory receptors
Brief summary
Venous thromboembolic disease (VTE) is a frequent and potentially serious pathology. Therapeutic management has improved considerably over the last few decades, enabling the application of codified management in line with the recently updated French management recommendations. One of the main remaining difficulties concerns VTE sequelae, mainly post-thrombotic syndrome after deep vein thrombosis, and post-pulmonary embolism syndrome after pulmonary embolism. The mechanisms leading to the absence of complete repermeabilization of vessels affected by Venous thromboembolic disease (VTE) are still poorly understood. The concept of immunothrombosis, closely associating immunity, inflammation and thrombosis, could (in part) explain the appearance of these sequelae. Platelets appear to play a key role in the onset of sequelae: Platelets are known to be involved both in the onset of a VTE episode and in the inflammatory response. This involvement is illustrated by the expression of inflammatory receptors such as TLR (toll-like receptor) 2 and TLR4. Th aim to investigate the role of platelets in the occurrence of sequelae, mainly via their role in the inflammatory response, in Venous thromboembolic disease (VTE) patients.
Interventions
BIOLOGICALblood sample
at Day 1 - date of patient inclusion at time of VTE diagnosis
Sponsors
Centre Hospitalier Universitaire de Saint Etienne
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with Venous ThromboEmbolic (VTE) / Proximal Deep vein thrombosis (DVT) of the lower limb and/or pulmonary embolism ≤ 72heures * Patients are 18 years of age or older at diagnosis. * Patients received informed written consent * Patients benefiting from social security coverage
Exclusion criteria
* Diagnosis of Venous ThromboEmbolic (VTE) more than 72 hours old * Isolated sub-segmental pulmonary embolism * Patients on antiplatelet agents * Patients on non-steroidal anti-inflammatory drugs (NSAIDs) * Life expectancy \> 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| expression of TLR2/ TRL4 | at day1 and at 6 months | The characteristic membrane profile of the inflammatory role of platelets is quantified by TLR2/TLR4 receptors expression using flow cytometry. This profile will be compared between patients with VTE sequelae (objectified during follow-up, and defined in accordance with good practice recommendations) 20,21 and patients without VTE sequelae. o A patient with sequelae corresponds to patients who will present during follow-up with a post-thrombotic syndrome (defined by a Villalta score greater than or equal to 5) and/or a post-pulmonary post-pulmonary embolism syndrome (defined by NYHA stage II, III or IV dyspnea, and the presence of perfusion perfusion sequelae on lung scintigraphy). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Analysis of characteristic soluble profile of the inflammatory role of platelets | at day1 and at 6 months | The characteristic soluble profile of the inflammatory role of platelets associated with the existence of sequelae remote from the acute episode of VTE, is quantified by blood assay of platelet immunomodulatory factors (ELISA technique): soluble CD62P, HMGB1, RANTES, PF4, soluble CD40L |
Countries
France
Outcome results
None listed