Blood:口服Bruton酪氨酸激酶抑制剂可选择性阻滞动脉粥样硬化斑块触发的血栓形成

2018-03-22 MedSci MedSci原创

血管性血友病因子(VWF)和血小板糖蛋白(GP)Ib的相互作用,以及胶原蛋白和GPVI的相互作用,对创伤处血栓形成或侵蚀性动脉粥样硬化斑块形成均至关重要。GPIb和GPVI信号均是通过Bruton酪氨酸激酶(Btk)发挥作用;口服依鲁替尼,一种具有良好的长期安全性治疗慢性淋巴细胞白血病(CLL)的药物,能不可逆的抑制Btk。Kristina Busygina等人发现依鲁替尼和新型Btk抑制剂aca

血管性血友病因子(VWF)和血小板糖蛋白(GP)Ib的相互作用,以及胶原蛋白和GPVI的相互作用,对创伤处血栓形成或侵蚀性动脉粥样硬化斑块形成均至关重要。GPIb和GPVI信号均是通过Bruton酪氨酸激酶(Btk)发挥作用;口服依鲁替尼,一种具有良好的长期安全性治疗慢性淋巴细胞白血病(CLL)的药物,能不可逆的抑制Btk。

Kristina Busygina等人发现依鲁替尼和新型Btk抑制剂acalabrutinib和ONO/GS-4509可阻断暴露在人类血小板均浆和胶原蛋白下时血液中发生的GPVI依赖性静态血小板聚集,但不能阻断暴露在ADP或花生四烯酸时引起的血小板聚集。

而且,Btk抑制剂可预防血小板在人类动脉粥样硬化斑块中形成血栓,并可分散动脉血流中的血小板组织;与此同时,生理性止血的重要过程——整合素α2β1和VWF-依赖性的血小板黏附(黏附到胶原蛋白),不受影响。此外,研究人员在服用450mg依鲁替尼的CLL患者中和间歇性服用小剂量依鲁替尼的志愿者中都观察到了上述这种选择性血小板抑制作用。

总而言之,本研究提示Btk抑制剂通过靶向GPIb和GPVI信号转导,抑制血小板血栓形成、从流动的血液中到动脉粥样硬化斑块中堆积,并保留血小板的止血功能。Btk抑制剂是首个可引起病灶聚焦的口服抗血小板药物,并且低剂量用药时仍然有效。

原始出处:

Kristina Busygina,et al.Oral Bruton tyrosine kinase inhibitors selectively block atherosclerotic plaque-triggered thrombus formation. Blood  2018  :blood-2017-09-808808;  doi: https://doi.org/10.1182/blood-2017-09-808808

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    2018-09-24 jklm09
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