Publications by authors named "David Alexandre Tregouet"

Background: Cerebral small vessel disease (cSVD) is a leading cause of stroke and dementia. Its underlying mechanisms remain elusive and specific mechanism-based drugs are lacking.

Method: We integrated more than 2,800 CSF and 4,600 plasma pQTL, derived from the largest proteomic studies so far (SOMAscan 7k and 4k; in up to 35,559 individuals), and the two most prevalent MRI-markers of cSVD (MRI-cSVD, white matter hyperintensities and perivascular spaces burden; in up to 48,454 individuals) in a Mendelian Randomization (MR) framework to identify causal and druggable targets for cSVD.

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Venous thromboembolism (VT) is a frequent (annual incidence of 1 to 2 per 1,000) and potentially life-threatening (case-fatality rate up to 10%) disease. VT is associated with serious short-term and long-term complications including a recurrence rate of approximately 20% within five years. Anticoagulant therapy, the mainstay of VT treatment, drastically reduces the risk of early VT recurrence, but it exposes patients to a substantial risk of bleeding.

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Background: Although heritability of venous thromboembolism (VTE) is high, the thrombophilia screening appears to be positive only in a minority of VTE patients. Adding rare variants screening to identify VTE missing heritability still requires further assessment.

Objectives: We report the results of a panel strategy after 3 years of application.

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Background: Clonal hematopoiesis of indeterminate potential (CHIP) was initially linked to a twofold increase in atherothrombotic events. However, recent investigations have revealed a more nuanced picture, suggesting that CHIP may confer only a modest rise in myocardial infarction (MI) risk. This observed lower risk might be influenced by yet unidentified factors that modulate the pathological effects of CHIP.

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  • * A large study involving nearly 10,000 DCM cases and close to a million controls identified 70 significant genetic locations linked to the disease, revealing the importance of heart muscle cells in its development.
  • * The research also indicates that factors like higher body weight and blood pressure may contribute to DCM, and genetic risk scores can help predict the condition across different populations.
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  • Dilated cardiomyopathy (DCM) is a major cause of heart failure, and this study analyzes genetic factors by examining 14,256 DCM cases and 36,203 participants from the UK Biobank for related traits.
  • Researchers discovered 80 genomic risk loci and pinpointed 62 potential effector genes tied to DCM, including some linked to rare variants.
  • The study uses advanced transcriptomics to explore how cellular functions contribute to DCM, showing that polygenic scores can help predict the disease in the general population and emphasize the importance of genetic testing and development of precise treatments.
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Background: The long-term recurrence risk after a pregnancy-associated venous thromboembolism (VTE) is sparsely assessed.

Objectives: To determine the rate of recurrence after a pregnancy-associated VTE and identify associated risk factors.

Methods: Five hundred eighty-seven women with a history of first VTE occurring during pregnancy or up to 3 months after delivery were referred to La Timone Hospital, Marseille, France.

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Background: Inherited platelet diseases are bleeding disorders characterized by either defects in platelet count or platelet function, the latter being less common and very heterogeneous. Numerous gene variants associated with abnormal receptors, granules, and signaling pathways have been reported. Despite significant advancements in our understanding, many patients still lack a precise diagnosis.

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  • Factor V (FV) is crucial for the blood coagulation process, and its plasma levels are linked to various health issues like blood clots and diabetes.
  • The researchers used a specific statistical method called the Brown-Forsythe methodology to analyze genetic factors affecting FV levels in 4505 individuals from four different studies.
  • They identified a significant genetic variant (rs75463553) associated with the variability in FV plasma levels, highlighting the interaction between neutrophil-related genes and FV biology.
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Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) offer great potential for drug screening and disease modeling. However, hiPSC-CMs remain immature compared to the adult cardiac cells. Cardiomyocytes isolated from adult human hearts have a typical rod-shaped morphology.

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  • Genetic studies have highlighted the need for more diverse research on plasma fibrinogen levels, as previous studies largely focused on Europeans, leading to gaps in understanding and missing heritability.
  • By analyzing data from whole-genome sequencing and genotype data from large cohorts, researchers identified 18 genetic loci related to fibrinogen levels, some of which are more common in African populations and include variants that may impact protein function.
  • The study's findings indicate a connection between fibrinogen levels and various health conditions, emphasizing the importance of whole-genome sequencing in discovering genetic factors in diverse populations and enhancing knowledge about fibrinogen regulation.
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Background: Integrative multiomics can elucidate pulmonary arterial hypertension (PAH) pathobiology, but procuring human PAH lung samples is rare.

Methods: We leveraged transcriptomic profiling and deep phenotyping of the largest multicenter PAH lung biobank to date (96 disease and 52 control) by integration with clinicopathologic data, genome-wide association studies, Bayesian regulatory networks, single-cell transcriptomics, and pharmacotranscriptomics.

Results: We identified 2 potentially protective gene network modules associated with vascular cells, and we validated , coding for asporin, as a key hub gene that is upregulated as a compensatory response to counteract PAH.

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  • Cerebral small vessel disease (cSVD) is a major contributor to stroke and dementia, and currently lacks specific treatments, prompting a study using Mendelian randomization to identify protein associations.
  • The research combined cerebrospinal fluid (CSF) and plasma data with genetic studies to identify 49 proteins linked to cSVD, highlighting 16 that appeared in both fluids and showing connections to immune response and extracellular matrix pathways.
  • Notably, many identified proteins were associated with stroke and dementia, with some already having known drug targets, paving the way for potential new biomarkers and therapies for cSVD.
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  • This study investigates the genetic factors influencing pancreatic adenocarcinoma (PDAC) risk and its relationship with type 2 diabetes (T2D) and venous thromboembolism (VTE).
  • It analyzed data from 8,803 PDAC patients and 67,523 controls, using genetic analysis to identify 16 associated genes, including six novel ones.
  • Findings suggest that specific genes (HNF4G and PDX1) may link PDAC to T2D, while ABO may indicate a causal relationship of VTE affecting PDAC, calling for more research on these genetic influences.
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  • Venous thromboembolism (VTE) poses significant health risks, with a notable difference in incidence rates between Black and White Americans.
  • Researchers developed polygenic risk scores (PRSs) for VTE using data from both European and African-ancestry populations to enhance predictive capability.
  • Results showed that multi-ancestry PRSs slightly outperformed ancestry-specific ones in predicting VTE risk, indicating potential benefits in using diverse data for better risk assessment across populations.
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  • The thrombin generation assay (TGA) measures how well plasma can produce thrombin, which helps assess an individual's blood clotting ability.
  • The study sought to find new biological factors affecting thrombin generation by analyzing data from 770 venous thrombosis patients and validating findings in 536 healthy individuals.
  • Results showed that complement proteins C5 and C9 were significantly linked to thrombin generation, with C9 having a notable impact when tested in the lab, suggesting these proteins could influence clotting, though more research is needed to clarify their roles.
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  • Increased risk of venous thromboembolism (VTE) is a critical concern for individuals using oral contraceptives (OCs) or hormone therapy (HT), prompting research into genetic factors that may increase this risk.
  • A gene-by-environment case-only meta-analysis of genome-wide association studies (GWAS) examined genetic predispositions in OC and HT users, identifying potential risk variants associated with VTE events.
  • While primary GWAS results did not find significant genetic variants, the analysis of 138 candidate variants revealed two noteworthy associations: F5 rs6025 (previously noted) and F11 rs2036914 (newly identified), offering insight into genetic risks related to OC and HT use.
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  • A study involving 5170 older adults aimed to determine if genetic factors influence how lifestyle choices affect the risk of developing dementia.* -
  • Researchers used the Lifestyle for BRAin health risk score (LIBRA) to assess modifiable lifestyle factors, finding that higher scores correlated with increased dementia incidence, regardless of genetic predisposition.* -
  • The results suggest that lifestyle interventions could be beneficial in preventing dementia, regardless of an individual's genetic risk factors like the APOE ε4 allele.*
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Background: Drug-induced QT prolongation (diLQT) is a feared side effect that could expose susceptible individuals to fatal arrhythmias. The occurrence of diLQT is primarily attributed to unintended drug interactions with cardiac ion channels, notably the hERG (human ether-a-go-go-related gene) channels that generate the delayed-rectifier potassium current (I) and thereby regulate the late repolarization phase. There is an important interindividual susceptibility to develop diLQT, which is of unknown origin but can be reproduced in patient-specific induced pluripotent stem cell-derived cardiomyocytes (iPS-CMs).

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This invited review follows the oral presentation "To Sequence or Not to Sequence, That Is Not the Question; But 'When, Who, Which and What For?' Is" given during the State of the Art session "Translational Genomics in Thrombosis: From OMICs to Clinics" of the International Society on Thrombosis and Haemostasis 2023 Congress. Emphasizing the power of next-generation sequencing technologies and the diverse strategies associated with DNA variant analysis, this review highlights the unresolved questions and challenges in their implementation both for the clinical diagnosis of venous thromboembolism and in translational research.

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Background: Thrombo-inflammation and neutrophil extracellular traps (NETs) are exacerbated in severe cases of COVID-19, potentially contributing to disease exacerbation. However, the mechanisms underpinning this dysregulation remain elusive. We hypothesised that lower DNase activity may be associated with higher NETosis and clinical worsening in patients with COVID-19.

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  • * Discovery of 7 new genetic loci associated with FVIII and 1 new locus for VWF, supporting their roles in thrombotic outcomes via Mendelian randomization.
  • * Functional testing revealed that silencing genes like B3GNT2 and CD36 impacted FVIII and VWF release from endothelial cells, indicating their potential regulatory roles.
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  • Venous thromboembolism (VTE) significantly affects health outcomes and shows disparities in incidence between Black and White Americans, necessitating improved risk assessment methods.* -
  • Polygenic risk scores (PRSs) derived from diverse ancestry data performed better than traditional PRSs, indicating their potential for accurately identifying high-risk individuals for VTE in both European and African ancestries.* -
  • The study found that using multi-ancestry PRSs could enhance risk stratification, with individuals in the highest risk category having a substantially increased likelihood of VTE, suggesting a path towards personalized treatment approaches.*
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  • People with cancer often face higher risks of developing venous thromboembolism (VTE), but the link between VTE and cancer risk isn't fully understood.
  • A study used genetic data to examine whether VTE could be a risk factor for various cancers and vice versa, but found no strong causal connection.
  • Although there was a slight association between VTE risk and pancreatic cancer, it was influenced by blood type and didn't indicate a direct cause-and-effect relationship; overall, the findings suggest that existing links between VTE and cancer are likely due to other factors related to cancer itself.
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