Erschienen in:
01.09.2006 | Special Article
Acute lung injury and the coagulation pathway: potential role of gene polymorphisms in the protein C and fibrinolytic pathways
verfasst von:
Anil Sapru, Joseph L. Wiemels, John S. Witte, Lorraine B. Ware, Michael A. Matthay
Erschienen in:
Intensive Care Medicine
|
Ausgabe 9/2006
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Abstract
There is evidence that dysregulation of coagulation and fibrinolysis may
participate in the pathogenesis of acute lung injury (ALI) and the acute
respiratory distress syndrome (ARDS). Altered concentrations of several
proteins of the coagulation and fibrinolytic pathways in plasma and
pulmonary edema fluid from patients with acute lung injury have been related
to the severity of lung injury and clinical outcomes. Polymorphisms in the
genes encoding for proteins of the protein C and fibrinolysis pathways are
known to regulate the production of the respective proteins. It is plausible
that these polymorphisms may be associated with the susceptibility to and
severity of illness in ALI and ARDS. Well-designed studies that examine the
association of these polymorphisms with susceptibility and severity of ALI
and ARDS are needed to test the influence of both genetic and environmental
factors on the clinical outcomes in patients with ALI and ARDS. There are
several important considerations in the design of these genetic association
studies, including selection of candidate genes with the most biological
plausibility, definition of the phenotype, selection of appropriate
controls, determination of the appropriate sample size and assessment of
Hardy–Weinberg equilibrium among controls as a measure of internal
validity.