Inherited thrombocytopenias (ITs) encompass a group of rare disorders characterized by diminished platelet count. Recent advancements have unveiled various forms of IT, with inherited thrombocytopenia 2 (THC2) emerging as a prevalent subtype associated with germline variants in the critical 5' untranslated region of the ANKRD26 gene. This region is crucial in regulating the gene expression of ANKRD26, particularly in megakaryocytes. THC2 is an autosomal dominant disorder presenting as mild-to-moderate thrombocytopenia with minimal symptoms, with an increased risk of myeloproliferative malignancies. In our study of a family with suspected IT, three affected individuals harbored the c.-118C>T ANKRD26 variant, while four healthy members carried the c.-140C>G ANKRD26 variant. We performed a functional analysis by studying platelet-specific ANKRD26 gene expression levels using quantitative real-time polymerase-chain reaction. Functional analysis of the c.-118C>T variant showed a significant increase in ANKRD26 expression in affected individuals, supporting its pathogenicity. On the contrary, carriers of the c.-140C>G variant exhibited normal platelet counts and no significant elevation in the ANKRD26 expression, indicating the likely benign nature of this variant. Our findings provide evidence confirming the pathogenicity of the c.-118C>T ANKRD26 variant in THC2 and suggest the likely benign nature of the c.-140C>G variant.
- MeSH
- 5' nepřekládaná oblast * MeSH
- dospělí MeSH
- genetická predispozice k nemoci MeSH
- lidé středního věku MeSH
- lidé MeSH
- mezibuněčné signální peptidy a proteiny MeSH
- rodokmen * MeSH
- trombocytopenie * genetika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
Úvod: Adekvátní substituční léčba hemofilie zahrnuje monitorování aktivity FVIII (FVIII: C), které lze provádět buď jednofázovou koagulační metodou (one-stage clotting assay – OSA), nebo metodou s chromogenními substráty (chromogenic substrate assay – CSA). S příchodem koncentrátů FVIII s prodlouženým biologickým poločasem se však prohlubuje problém diskrepancí mezi metodami z důvodu úpravy molekuly FVIII. Cíl: Hodnocení míry diskrepance výsledků FVIII: C OSA a CSA u pacientů léčených koncentráty FVIII s prodlouženým poločasem. Metody: Stanovení FVIII: C ve vzorcích pacientů léčených koncentráty efmoroctocog alfa, rurioctocog alfa pegol, turoctocog alfa pegol a damoctocog alfa pegol pomocí OSA s reagenciemi Cephascreen® (Diagnostica Stago) a Pathromtin® SL (Siemens Healthineers) a CSA BIOPHENTM FVIII: C (Hyphen BioMed). Výsledky: Výsledky obou metod dobře korelovaly u efmoroctocog alfa, rozdíly byly do 21 %. U rurioctocog alfa pegol byla FVIII: C v rozsahu cca 15–200 % metodou OSA s oběma reagenciemi lehce nižší (průměrně o 11, resp. o 18 %), zatímco výsledky FVIII: C < 10 % byly naopak dle OSA vyšší v průměru o 54 % s Cephascreen® a až o 75 % s Pathromtin® SL. Výsledky turoctocog alfa pegol byly metodou OSA nižší než CSA, pro rozsah 15–200 % průměrně o 36, resp. 25 %, přičemž pro nižší hladiny FVIII: C byly nejednoznačné, s odchýlením oběma směry. Výsledky damoctocog alfa pegol byly metodou OSA jen mírně vyšší (Cephascreen® průměrně o 18 %) pro hladiny FVIII: C > 10 %, ale výrazně vyšší než CSA u FVIII: C < 10 % (průměrně o 91 % s reagencií Cephascreen® a o 100 % u Pathromtin® SL). Závěr: Na základě našeho pozorování výsledky FVIII: C metodou OSA excelentně korelují s reagenciemi Cephascreen® a Pathromtin® SL s CSA Hyphen u pacientů léčených koncentrátem efmoroctocog alfa. Z ostatních koncentrátů korelují excelentně pouze výsledky rurioctocog alfa pegol (jen Cephascreen®) a damoctocog alfa pegol, a to pouze FVIII: C > 10 %.
Introduction: Optimal substitutional treatment includes measuring FVIII activity (FVIII: C) using the one-stage clotting assay (OSA) or chromogenic substrate assay (CSA). However, with the advent of FVIII concentrates with an extended half-life, discrepancies between methods have increased due to modifications of the FVIII molecule. Aim: Evaluation of OSA and CSA discrepancy in patients treated with extended half--life FVIII concentrates. Method: FVIII: C measurement by OSA with reagents Cephascreen® (Diagnostica Stago) and Pathromtin® SL (Siemens Healthineers) and by CSA BIOPHENTM FVIII: C (Hyphen BioMed) in patients treated with efmoroctocog alfa, rurioctocog alfa pegol, turoctocog alfa pegol and damoctocog alfa pegol. Results: The results of both methods correlated well for efmoroctocog alfa, the differences being up to 21%. The results of rurioctocog alfa pegol in the range of 15–200% were slightly lower using OSA with both reagents, on average by 11% and 18%, while the results up to 10% were higher using OSA with an average difference of 54% for Cephascreen® and up to 75% for Pathromtin® SL. The results of turoctocog alfa pegol were lower using OSA in the range of 15–200%, on average by 36% and 25%. The samples with FVIII: C above 10% of damoctocog alfa pegol were slightly higher using OSA (Cephascreen® by 18%), but samples up to 10% were significantly higher, with Cephascreen® on average by 91% and by 100% with Pathromtin® SL. Conclusions: OSA Cephascreen® or Pathromtin® SL and CSA Hyphen correlate excellently in the case of efmoroctocog alfa. Of the other concentrates, the results correlate excellently in the case of rurioctocog alfa pegol (only Cephascreen®) and damoctocog alfa pegol, and only for FVIII: C > 10%.
- MeSH
- chromogenní sloučeniny analýza MeSH
- faktor VIII * analýza farmakologie terapeutické užití MeSH
- hemofilie A farmakoterapie MeSH
- léky s prodlouženým účinkem farmakologie terapeutické užití MeSH
- lidé MeSH
- monitorování léčiv * metody MeSH
- vyšetření krevní srážlivosti metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- MeSH
- COVID-19 * klasifikace prevence a kontrola MeSH
- izolace pacientů MeSH
- lidé MeSH
- pacienti hospitalizovaní MeSH
- rizikové faktory MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- směrnice pro lékařskou praxi MeSH
The manuscript provides an overview of treatment and its changes in adult patients with haemophilia A without inhibitors in the Czech Republic between 2013 and 2021 using data from the registry of the Czech National Haemophilia Programme (CNHP). Over a 9-year period, we focused on the reduction in the annual bleeding rate (ABR), joint bleeding rate (AJBR) and factor VIII consumption when patients with severe haemophilia A switched from on-demand treatment to prophylaxis. The ABR and AJBR include both patient-reported home treatment and treated hospitalisation episodes. All adult patients with severe haemophilia A were categorised into three groups according to the therapeutic regimen. The first group was patients on prophylaxis during the follow-up period, the second group consisted of patients on on-demand treatment, and the third group was patients who received both treatment regimens during follow-up. With an increase in the proportion of patients with severe haemophilia A on prophylaxis from 37 to 74% between 2013 and 2021, the ABR for all patients with severe haemophilia A decreased approximately 6.9-fold, and the AJBR decreased 8.7-fold. Expectedly, the factor consumption increased by approximately 68.5%. In the group of patients with severe haemophilia A who had switched from an on-demand to a prophylactic regimen, the total number of bleeding events decreased 3.5-fold, and the number of joint bleeding episodes decreased 3.9-fold. Factor VIII consumption increased by 78.4%. Our study supports a previously reported positive effect of prophylaxis on bleeding control. We believe that the substantial improvement in ABR justifies the increased treatment costs.
- MeSH
- dospělí MeSH
- faktor VIII * terapeutické užití MeSH
- hemofilie A * farmakoterapie MeSH
- krvácení * chemicky indukované epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- následné studie MeSH
- registrace * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: COVID-19 affected people and countries disproportionately and continues to impact the health of people. The aim is to investigate protective health and socio-geographical factors for post-COVID-19 conditions in adults aged 50 years and older in Europe. METHODS: Using longitudinal data from the Survey of Health, Ageing and Retirement in Europe, collected from June to August 2021, protective factors against post-COVID-19 condition among 1909 respondents who self-reported a positive COVID-19 test result were investigated using multiple logistic regression models. RESULTS: Male adults living outside of Czechia, Poland, Hungary and Slovakia (Visegrad group, V4), who received the COVID-19 vaccination, tertiary or higher education, had a healthy weight (body mass index, BMI 18.5-24.9 kg/m2) and no underlying health condition/s, showed protective effects against post-COVID-19 condition. Health inequalities associated with BMI were observed in education attainment and comorbidities, with higher BMI having lower education attainment and higher comorbidities. Health inequality was particularly evident in individuals in V4 with higher obesity prevalence and lower attainment of higher education than those living in other regions in the study. CONCLUSION: Our study suggests that healthy weight and higher education attainment are predictors associated with a lower incidence of post-COVID-19 condition. Health inequality associated with education attainment was particularly relevant in V4. Our results highlight health inequality in which BMI was associated with comorbidities and educational attainment. To reduce obesity prevalence among older people with lower education, raising awareness about the risks of obesity and providing assistance in maintaining a healthy weight are needed.
- MeSH
- COVID-19 * epidemiologie MeSH
- disparity zdravotního stavu * MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- obezita epidemiologie MeSH
- senioři MeSH
- socioekonomické faktory MeSH
- vakcíny proti COVID-19 MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Evropa MeSH
- Publikační typ
- abstrakt z konference MeSH
