Telomere shortening

端粒缩短
  • 文章类型: Journal Article
    最近越来越多的证据表明,端粒长度(TL)的缩短与骨骼健康受损有关;然而,TL和骨坏死之间的遗传因果关系仍然不确定。本研究旨在使用双向双样本孟德尔随机化(MR)研究TL与骨坏死之间的潜在因果关系。TL的全基因组关联研究摘要统计来自IEU开放全基因组关联研究项目,而骨坏死数据来自FinnGenBiobank数据库。一系列MR方法-包括方差逆加权,MR-Egger,加权中位数,简单模式,和加权模式-用于分析,以及用于水平多效性评估的MR-Egger截距方法,以及CochranQ和留一法进行异质性检验。前向MR分析表明,TL和骨坏死之间存在显著的因果关系,提示遗传预测的较短TL与骨坏死的风险升高相关(OR=0.611,95%置信区间0.394-0.948,P=0.028).反向MR分析显示骨坏死对TL无显著影响(OR=0.999,95%置信区间0.994-1.005,P=.802)。对异质性和水平多效性的分析产生了稳健的结果。我们的研究表明,TL较短的个体患骨坏死的风险增加,而骨坏死对TL没有影响。
    Recent mounting evidence suggests that shortening of telomere length (TL) is associated with impaired bone health; yet, a genetic causal relationship between TL and osteonecrosis remains uncertain. This study aimed to investigate the potential causal relationship between TL and osteonecrosis using bidirectional two-sample Mendelian randomization (MR). Genome-wide association study summary statistics for TL were sourced from the IEU Open genome-wide association study project, while osteonecrosis data were obtained from the FinnGen Biobank database. A range of MR methodologies-including inverse variance weighting, MR-Egger, weighted median, simple mode, and weighted mode-were utilized for analysis, along with the MR-Egger intercept method for horizontal pleiotropy assessment, and Cochran Q and leave-one-out methods for heterogeneity testing. The forward MR analysis indicated a significant causal relationship between TL and osteonecrosis, suggesting that genetically predicted shorter TL is associated with an elevated risk of developing osteonecrosis (OR = 0.611, 95% confidence interval 0.394-0.948, P = .028). The reverse MR analysis revealed no significant influence of osteonecrosis on TL (OR = 0.999, 95% confidence interval 0.994-1.005, P = .802). Analyses for heterogeneity and horizontal pleiotropy yielded robust results. Our study demonstrates that individuals with shorter TL have an increased risk of developing osteonecrosis, whereas osteonecrosis has no effect on TL.
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  • 文章类型: Journal Article
    煤是几种化学物质的混合物,其中许多具有诱变和致癌作用,是造成全球死亡率和疾病负担的关键因素。以前的研究表明,煤炭与职业暴露个体的端粒缩短有关,然而,人们对采矿和燃烧煤炭对居住在附近的人的端粒的影响知之甚少。因此,这项调查的主要目的是评估邻近燃煤电厂和煤矿对环境暴露个体基因组不稳定性的影响,在探索与个体特征的潜在关联的同时,氧化应激,炎症反应,和无机元素的存在。这项研究涉及来自热电厂周围三个城市和一个未接触煤炭和副产品的城市的80名男性参与者。从每个参与者的外周血样本中提取DNA,使用定量实时聚合酶链反应(qPCR)方法评估端粒长度(TL)。与未暴露组(5638±2452bp)相比,暴露个体(6227±2884bp)之间没有观察到显着差异。然而,TL降低与年龄和心血管疾病的风险有关;并且发现更长的TL与血液样品中硅和磷浓度的增加有关。在TL与彗星测定(视觉评分)之间没有观察到相关性,微核试验,氧化应激,和炎症结果。需要进一步的研究来确定这些变化与疾病发作和过早死亡之间的潜在相关性。
    Coal is a mixture of several chemicals, many of which have mutagenic and carcinogenic effects and are a key contributor to the global burden of mortality and disease. Previous studies suggest that coal is related to telomeric shortening in individuals occupationally exposed, however little is known about the effects of mining and burning coal on the telomeres of individuals living nearby. Therefore, the primary objective of this investigation was to assess the impact of proximity to coal power plants and coal mines on the genomic instability of individuals environmentally exposed, while also exploring potential associations with individual characteristics, oxidative stress, inflammatory responses, and the presence of inorganic elements. This study involved 80 men participants from three cities around a thermoelectric power plant and one city unexposed to coal and byproducts. DNA was extracted from peripheral blood samples obtained from each participant, and the telomeres length (TL) was assessed using quantitative real-time polymerase chain reaction (qPCR) methodology. No significant difference was observed between exposed individuals (6227 ± 2884 bp) when compared to the unexposed group (5638 ± 2452 bp). Nevertheless, TL decrease was associated with age and risk for cardiovascular disease; and longer TL was found to be linked with increased concentrations of silicon and phosphorus in blood samples. No correlations were observed between TL with comet assay (visual score), micronucleus test, oxidative stress, and inflammatory results. Additional research is required to ascertain the potential correlation between these changes and the onset of diseases and premature mortality.
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  • 文章类型: Journal Article
    了解端粒生物学的复杂动力学对于衰老与癌症之间的紧密联系很重要。端粒,染色体末端的保护帽,是这方面的核心参与者。虽然它们由于复制而逐渐缩短,通过触发DNA修复机制限制了肿瘤的扩张,它还促进染色体内的致癌变化,从而维持肿瘤发生。端粒酶,负责维持端粒长度,在这种情况下,它是一个核心参与者。它在癌细胞中的表达有利于端粒的保存,允许它们规避短端粒的生长限制效应。有趣的是,端粒酶的影响超出了端粒的维持,它通过替代途径参与促进细胞生长。在这种情况下,炎症加速端粒缩短,导致端粒功能障碍,端粒元素也在调节炎症反应中发挥作用。对这种相互作用的认识促进了以端粒酶抑制为中心的新型治疗方法的发展。这篇综述提供了该领域的全面概述,强调知识的最新进展和对癌症生物学理解的意义。
    Understanding the complex dynamics of telomere biology is important in the strong link between aging and cancer. Telomeres, the protective caps at the end of chromosomes, are central players in this connection. While their gradual shortening due to replication limits tumors expansion by triggering DNA repair mechanisms, it also promotes oncogenic changes within chromosomes, thus sustaining tumorigenesis. The enzyme telomerase, responsible for maintaining telomere length, emerges as a central player in this context. Its expression in cancer cells facilitates the preservation of telomeres, allowing them to circumvent the growth-limiting effects of short telomeres. Interestingly, the influence of telomerase extends beyond telomere maintenance, as evidenced by its involvement in promoting cell growth through alternative pathways. In this context, inflammation accelerates telomere shortening, resulting in telomere dysfunction, while telomere elements also play a role in modulating the inflammatory response. The recognition of this interplay has promoted the development of novel therapeutic approaches centered around telomerase inhibition. This review provides a comprehensive overview of the field, emphasizing recent progress in knowledge and the implications in understanding of cancer biology.
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  • 文章类型: Journal Article
    背景:端粒是染色体末端的核蛋白复合物,受遗传和环境触发因素的控制。加速的端粒缩短与疾病发病率的增加有因果关系。地中海饮食最近被认为是一种可以预防疾病的饮食。这篇综述旨在确定地中海饮食的每个组成部分对端粒长度动力学的影响。突出了潜在的分子机制。
    方法:搜索PubMed以确定相关研究,以提取数据进行叙述性综述。
    结果:地中海饮食可减轻许多疾病的临床表现。专注于自身免疫性疾病,地中海饮食可以预防炎症,线粒体功能障碍,端粒酶活性异常。此外,每个地中海饮食成分似乎通过端粒长度的维持或延长来减轻衰老,提供对潜在分子机制的见解。多酚,维生素,矿物,脂肪酸似乎在端粒体内平衡中是必不可少的,因为它们抑制炎症反应,DNA损伤,氧化应激,线粒体功能障碍,和细胞死亡并诱导端粒酶活化。
    结论:地中海饮食有利于维持端粒动力学和减轻与年龄有关的疾病。这篇综述全面概述了横截面,观察,以及关于地中海饮食中每种成分对端粒长度和慢性疾病管理的有益影响的随机对照试验。
    BACKGROUND: Telomeres are nucleoprotein complexes at the ends of chromosomes that are under the control of genetic and environmental triggers. Accelerated telomere shortening is causally implicated in the increasing incidence of diseases. The Mediterranean diet has recently been identified as one that confers protection against diseases. This review aimed to identify the effect of each component of the Mediterranean diet on telomere length dynamics, highlighting the underlying molecular mechanisms.
    METHODS: PubMed was searched to identify relevant studies to extract data for conducting a narrative review.
    RESULTS: The Mediterranean diet alleviates clinical manifestations in many diseases. Focusing on autoimmune diseases, the Mediterranean diet can be protective by preventing inflammation, mitochondrial malfunction, and abnormal telomerase activity. Also, each Mediterranean diet constituent seems to attenuate aging through the sustenance or elongation of telomere length, providing insights into the underlying molecular mechanisms. Polyphenols, vitamins, minerals, and fatty acids seem to be essential in telomere homeostasis, since they inhibit inflammatory responses, DNA damage, oxidative stress, mitochondrial malfunction, and cell death and induce telomerase activation.
    CONCLUSIONS: The Mediterranean diet is beneficial for maintaining telomere dynamics and alleviating age-related illnesses. This review provides a comprehensive overview of cross-sectional, observational, and randomized controlled trials regarding the beneficial impact of every constituent in the Mediterranean diet on telomere length and chronic disease management.
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  • 文章类型: Journal Article
    严重急性呼吸道综合征冠状病毒2(SARS-CoV-2)引起病毒诱导的衰老。2019年冠状病毒病(COVID-19)患者的端粒长度(TL)较短与住院之间存在关联,严重程度,甚至死亡。然而,目前尚不清楚病毒诱导的衰老是否可逆。我们的目的是评估重症监护病房(ICU)康复1年后COVID-19患者的TL动态。纵向研究纳入49例因COVID-19入院的ICU患者(2020年8月至2021年4月)。在住院时(基线)和出院后1年(1年随访),通过单色多重定量PCR(MMqPCR)测定对全血中的相对端粒长度(RTL)进行定量。RTL与ICU住院时间(LOS)之间的关联,有创机械通气(IMV),俯卧位,评估1年访视时肺纤维化的发展。中位年龄为60岁,71.4%为男性,中位ICU-LOS为12天,73.5%要求IMV,38.8%的人需要俯卧位。ICU-LOS较长或需要IMV的患者在随访期间显示出更大的RTL缩短。需要内旋的患者在随访期间有更大的RTL缩短。发生肺纤维化的IMV患者在1年访视时显示出更大的RTL降低和更短的RTL。ICU-LOS较长的患者和需要IMV的患者外周血RTL较短,出院后1年观察。此外,需要IMV并发展为肺纤维化的患者端粒缩短更大,在1年的访问中显示较短的端粒。这些患者可能更容易发生细胞衰老和肺部相关并发症;因此,可能需要更密切的监测。
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes virus-induced-senescence. There is an association between shorter telomere length (TL) in coronavirus disease 2019 (COVID-19) patients and hospitalization, severity, or even death. However, it remains unknown whether virus-induced-senescence is reversible. We aim to evaluate the dynamics of TL in COVID-19 patients 1 year after recovery from intensive care units (ICU). Longitudinal study enrolling 49 patients admitted to ICU due to COVID-19 (August 2020 to April 2021). Relative telomere length (RTL) quantification was carried out in whole blood by monochromatic multiplex real-time quantitative PCR (MMqPCR) assay at hospitalization (baseline) and 1 year after discharge (1-year visit). The association between RTL and ICU length of stay (LOS), invasive mechanical ventilation (IMV), prone position, and pulmonary fibrosis development at 1-year visit was evaluated. The median age was 60 years, 71.4% were males, median ICU-LOS was 12 days, 73.5% required IMV, and 38.8% required a prone position. Patients with longer ICU-LOS or who required IMV showed greater RTL shortening during follow-up. Patients who required pronation had a greater RTL shortening during follow-up. IMV patients who developed pulmonary fibrosis showed greater RTL reduction and shorter RTL at the 1-year visit. Patients with longer ICU-LOS and those who required IMV had a shorter RTL in peripheral blood, as observed 1 year after hospital discharge. Additionally, patients who required IMV and developed pulmonary fibrosis had greater telomere shortening, showing shorter telomeres at the 1-year visit. These patients may be more prone to develop cellular senescence and lung-related complications; therefore, closer monitoring may be needed.
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  • 文章类型: Journal Article
    镰状细胞性贫血(SCA)是一种遗传性血液疾病,其特征是存在异常血红蛋白,导致镰刀形红细胞的形成。虽然广泛的研究揭示了SCA的遗传和分子基础的许多方面,端粒动力学在疾病进展中的作用仍然是一个相对未被探索的前沿.这篇综述旨在在SCA的背景下提供端粒生物学的全面检查,旨在阐明其对分子衰老和疾病进展的潜在影响。探讨了氧化应激对SCA端粒动力学的影响,特别关注增加的活性氧(ROS)如何导致加速的端粒缩短和基因组不稳定性。此外,研究了SCA中端粒功能障碍与细胞衰老之间的潜在关系,阐明端粒动力学如何导致该群体中细胞的过早衰老。该综述总结了主要发现,并提出了针对端粒动力学的潜在治疗策略,以减轻SCA中的疾病进展。它还确定了当前理解中的差距,并为未来的研究提供了途径。强调进一步研究端粒生物学的重要性,以促进我们对镰状细胞性贫血的分子老化和疾病进展的理解。这种对SCA中端粒动力学的全面探索提供了对分子衰老和疾病进展的潜在机制的见解。为有针对性的治疗干预和改善疾病管理铺平道路。
    Sickle Cell Anemia (SCA) is a hereditary blood disorder characterized by the presence of abnormal hemoglobin, leading to the formation of sickle-shaped red blood cells. While extensive research has unraveled many aspects of the genetic and molecular basis of SCA, the role of telomere dynamics in disease progression remains a relatively unexplored frontier. This review seeks to provide a comprehensive examination of telomere biology within the context of SCA, aiming to elucidate its potential impact on molecular aging and the progression of the disease. The impact of oxidative stress on telomere dynamics in SCA is explored, with a particular focus on how increased reactive oxygen species (ROS) may contribute to accelerated telomere shortening and genomic instability. Furthermore, the potential relationship between telomere dysfunction and cellular senescence in SCA is investigated, shedding light on how telomere dynamics may contribute to the premature aging of cells in this population. The review concludes by summarizing key findings and proposing potential therapeutic strategies targeting telomere dynamics to mitigate disease progression in SCA. It also identifies gaps in current understanding and suggests avenues for future research, emphasizing the importance of further investigating telomere biology to advance our understanding of molecular aging and disease progression in Sickle Cell Anemia. This comprehensive exploration of telomere dynamics in SCA offers insights into potential mechanisms of molecular aging and disease progression, paving the way for targeted therapeutic interventions and improved disease management.
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  • 文章类型: Journal Article
    据报道,较短的白细胞端粒长度(LTL)与年龄相关的疾病有关。包括骨质疏松症.许多研究试图确定LTL和骨质疏松症之间的关联,尽管它仍然有争议。这项研究旨在确定在前瞻性纵向队列中,骨质疏松症是否与LTL缩短独立相关。KBASE研究是韩国独立的多中心前瞻性队列研究,始于2014年。我们比较了每个参与者在基线和2年随访期间的LTL值。箱线图用于显示根据骨质疏松症在2年随访中LTL变化的差异。进行多变量线性回归以确定骨质疏松症是否与端粒缩短率独立相关。来自KBASE队列的总共233名受试者(55至88岁)最终被纳入研究。我们观察到LTL在2年内减少了约1.2kbp。虽然LTL随着年龄的增长而下降,LTL缩短率不随年龄增长而增加。多变量线性回归分析表明,只有骨质疏松症与2年的快速LTL缩短独立相关(B,-8.08;p=0.038)。我们试图在一个独立的前瞻性队列中确定骨质疏松症与LTL缩短之间的关联。我们发现,患有骨质疏松症的参与者在2年内的LTL缩短明显快于没有骨质疏松症的参与者。我们希望这项研究将有助于阐明LTL与骨质疏松症之间关系的潜在机制。
    A shorter leukocyte telomere length (LTL) is reported to be associated with age-related diseases, including osteoporosis. Many studies have tried identifying the association between LTL and osteoporosis, although it remains controversial. This study aimed to determine whether osteoporosis is independently associated with LTL shortening in a prospective longitudinal cohort. The KBASE study is an independent multicenter prospective cohort in South Korea, which began in 2014. We compared the LTL values for each participant at baseline and over a 2-year follow-up period. Boxplots were used to demonstrate the differences in the change in LTL over a 2-year follow-up according to osteoporosis. Multivariable linear regression was conducted to identify whether osteoporosis is independently associated with the rate of telomere shortening. A total of 233 subjects (from 55 to 88 years) from the KBASE cohort were finally enrolled in the study. We observed that the LTL decreased by approximately 1.2 kbp over 2 years. While the LTL decreased as age increased, the rate of LTL shortening did not increase with age. Multivariable linear regression analysis indicated that only osteoporosis was independently associated with rapid LTL shortening over 2 years (B, -8.08; p = 0.038). We sought to identify an association between osteoporosis and LTL shortening in an independent prospective cohort. We found that participants with osteoporosis had significantly faster LTL shortening over 2 years than those without osteoporosis. We hope this study will help elucidate the underlying mechanisms in the relationship between LTL and osteoporosis in the future.
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  • 文章类型: Journal Article
    端粒是染色质结构的一部分,含有重复的DNA序列,作为染色体末端的保护帽,防止DNA降解和重组,从而确保基因组的完整性。虽然端粒长度(TL)可以遗传,TL缩短与衰老和多种异种生物和生物活性物质有关。TL已被表征为发展为慢性病变及其进展的倾向的可靠生物标志物。这篇叙述性综述旨在提供支持将TL测量纳入复杂的慢性病变的预后和诊断组中的论据,以及评估不同药理活性分子对端粒生物学的影响的重要性。用于心血管疾病管理的药物,糖尿病,精神分裂症,更年期激素替代疗法,达那唑,褪黑激素,已经研究了益生菌对TL缩短的积极保护作用。本综述对所有这些类药物进行了分析,特别关注所涉及的分子机制。
    Telomeres are part of chromatin structures containing repeated DNA sequences, which function as protective caps at the ends of chromosomes and prevent DNA degradation and recombination, thus ensuring the integrity of the genome. While telomere length (TL) can be genetically inherited, TL shortening has been associated with ageing and multiple xenobiotics and bioactive substances. TL has been characterised as a reliable biomarker for the predisposition to developing chronic pathologies and their progression. This narrative review aims to provide arguments in favour of including TL measurements in a complex prognostic and diagnostic panel of chronic pathologies and the importance of assessing the effect of different pharmacologically active molecules on the biology of telomeres. Medicines used in the management of cardiovascular diseases, diabetes, schizophrenia, hormone replacement therapy at menopause, danazol, melatonin, and probiotics have been studied for their positive protective effects against TL shortening. All these classes of drugs are analysed in the present review, with a particular focus on the molecular mechanisms involved.
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  • 文章类型: Journal Article
    白细胞端粒长度(LTL)作为衰老的重要生物标志物。勃起功能障碍(ED)是中老年男性中常见的疾病。本研究的目的是探索LTL与ED之间的潜在关联。
    我们利用国家健康和营养检查调查(NHANES)的数据来检查LTL和ED之间的关联。加权多元回归分析作为主要的统计方法。进行了亚组分析以调查特定的人群亚群,和有限三次样条(RCS)分析用于评估LTL和ED之间的非线性关系。
    加权多元回归分析的结果显示,LTL与ED风险之间呈负相关。与没有ED的人相比,有ED的人表现出更短的LTL。对于每增加一个单位的LTL,ED风险降低54%(比值比[OR]0.46,95%置信区间[CI]0.25~0.85).当LTL被视为分类变量时,与LTL(Q1)最短的组相比,LTL(Q5)最长的组ED风险降低44%(OR0.56,95%CI0.39~0.81).在TL和ED之间观察到非线性关系。进行了各种敏感性分析,以验证结果的稳定性,并获得一致的结果。
    白细胞LTL与ED之间的负相关表明,延迟LTL的缩短可能会降低ED的风险。
    UNASSIGNED: Leukocyte telomere length (LTL) serves as a significant biomarker of aging. Erectile dysfunction (ED) is a commonly observed condition among middle-aged and older men. The objective of this study is to explore the potential association between LTL and ED.
    UNASSIGNED: We utilized data from the National Health and Nutrition Examination Survey (NHANES) to examine the association between LTL and ED. Weighted multivariate regression analyses were performed as the primary statistical method. Subgroup analyses were conducted to investigate specific population subsets, and restricted cubic spline (RCS) analyses were employed to assess the non-linear relationship between LTL and ED.
    UNASSIGNED: The results of weighted multivariate regression analyses revealed a negative correlation between LTL and the risk of ED. Individuals with ED exhibited shorter LTL compared to those without ED. For each unit increase in LTL, there was a 54% reduction in the risk of ED (odds ratios[OR] 0.46, 95% confidence intervals[CI] 0.25-0.85). When LTL was considered as a categorical variable, the group with the longest LTL (Q5) had a 44% lower risk of ED compared to the group with the shortest LTL(Q1) (OR 0.56, 95% CI 0.39-0.81). A non-linear relationship was observed between TL and ED. Various sensitivity analyses were conducted to validate the stability of the results, and consistent findings were obtained.
    UNASSIGNED: The negative association between leukocyte LTL and ED suggests that delaying the shortening of LTL may decrease the risk of ED.
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  • 文章类型: Journal Article
    背景:端粒防止编码DNA的损伤,因为末端核苷酸在有丝分裂过程中丢失。端粒维持基因的突变会导致端粒过度缩短,一种称为短端粒综合征(STS)的疾病。STS中记录的一种肝脏表现是门窦血管疾病(PSVD)。
    方法:由于许多PSVD病例的病因尚不清楚,这项研究探讨了特发性PSVD患者端粒短的程度.
    结果:这项单中心横断面研究包括组织学定义的特发性PSVD患者。使用荧光原位杂交和流式细胞术评估6个外周血白细胞亚群中的端粒长度。使用高通量外显子组测序鉴定端粒相关基因的变异体。总的来说,包括22名患者,根据年龄调整的参考范围,其中16(73%)的端粒短(9/22)或非常短(7/22)。14例(64%)患有临床上显着的门静脉高压症。较短的端粒在男性(p=0.005)和合并间质性肺病的患者(p<0.001)中更为常见,慢性肾脏病(p<0.001),和红细胞巨细胞增多(p=0.007)。门静脉高压症(p=0.021),低血清白蛋白水平(p<0.001),低血小板计数(p=0.007),高胆红素血症(p=0.053)也与端粒较短有关。在4例VSTel患者和1例STel患者中鉴定出已知STS相关基因的变异。
    结论:特发性PSVD患者端粒短和非常短,31%的人在端粒相关基因中出现变异。端粒生物学可能在血管性肝病的发生发展中起重要作用。临床医生应考虑在任何出现PSVD的患者中测量端粒。
    BACKGROUND: Telomeres prevent damage to coding DNA as end-nucleotides are lost during mitosis. Mutations in telomere maintenance genes cause excessive telomere shortening, a condition known as short telomere syndrome (STS). One hepatic manifestation documented in STS is porto-sinusoidal vascular disorder (PSVD).
    METHODS: As the etiology of many cases of PSVD remains unknown, this study explored the extent to which short telomeres are present in patients with idiopathic PSVD.
    RESULTS: This monocentric cross-sectional study included patients with histologically defined idiopathic PSVD. Telomere length in 6 peripheral blood leukocyte subpopulations was assessed using fluorescent in situ hybridization and flow cytometry. Variants of telomere-related genes were identified using high-throughput exome sequencing. In total, 22 patients were included, of whom 16 (73%) had short (9/22) or very short (7/22) telomeres according to age-adjusted reference ranges. Fourteen patients (64%) had clinically significant portal hypertension. Shorter telomeres were more frequent in males (p = 0.005) and patients with concomitant interstitial lung disease (p < 0.001), chronic kidney disease (p < 0.001), and erythrocyte macrocytosis (p = 0.007). Portal hypertension (p = 0.021), low serum albumin level (p < 0.001), low platelet count (p = 0.007), and hyperbilirubinemia (p = 0.053) were also associated with shorter telomeres. Variants in known STS-related genes were identified in 4 patients with VSTel and 1 with STel.
    CONCLUSIONS: Short and very short telomeres were highly prevalent in patients with idiopathic PSVD, with 31% presenting with variants in telomere-related genes. Telomere biology may play an important role in vascular liver disease development. Clinicians should consider measuring telomeres in any patient presenting with PSVD.
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