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Blood, 1 October 2006, Vol. 108, No. 7, pp. 2237-2243.
Prepublished online as a Blood First Edition Paper on June 27, 2006; DOI 10.1182/blood-2006-02-005991.
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HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY
Enhanced susceptibility to arterial thrombosis in a murine model of hyperhomocysteinemia
Sanjana Dayal,
Katina M. Wilson,
Lorie Leo,
Erland Arning,
Teodoro Bottiglieri, and
Steven R. Lentz
From the Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City; Baylor Institute of Metabolic Disease, Dallas, TX; and Veterans Affairs Medical Center, Iowa City, IA.
Hyperhomocysteinemia is a risk factor for thrombosis, but the mechanisms are not well defined. We tested the hypothesis that hyperhomocysteinemia accelerates arterial thrombosis in mice. Mice heterozygous for a targeted disruption of the cystathionine -synthase gene (Cbs+/) and wild-type littermates (Cbs+/+) were fed either a control diet or a high methionine/low folate (HM/LF) diet for 6 to 8 months to produce graded hyperhomocysteinemia. The time to occlusion of the carotid artery after photochemical injury was shortened by more than 50% in Cbs+/+ or Cbs+/ mice fed the HM/LF diet (P < .001 versus control diet). Carotid artery thrombosis was not accelerated in mice deficient in endothelial nitric oxide synthase (Nos3), which suggests that decreased endothelium-derived nitric oxide is not a sufficient mechanism for enhancement of thrombosis. Cbs+/+ and Cbs+/ mice fed the HM/LF diet had elevated levels of reactive oxygen species in the carotid artery, increased aortic expression of the NADPH oxidase catalytic subunit, Nox4, and decreased activation of anticoagulant protein C in the aorta (P < .05 versus control diet). We conclude that hyperhomocysteinemia enhances susceptibility to arterial thrombosis through a mechanism that is not caused by loss of endothelium-derived nitric oxide but may involve oxidative stress and impairment of the protein C anticoagulant pathway.

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