Research ArticleCOAGULATION

Targeting STUB1–tissue factor axis normalizes hyperthrombotic uremic phenotype without increasing bleeding risk

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Science Translational Medicine  22 Nov 2017:
Vol. 9, Issue 417, eaam8475
DOI: 10.1126/scitranslmed.aam8475

Striking a balance for anticoagulation

Patients with chronic kidney disease can present a therapeutic conundrum because they are not only at increased risk of blood vessel thrombosis but also more likely to experience bleeding complications when treated with anticoagulants. Shashar et al. examined the mechanism of thrombosis in mouse models of renal disease and found a potential therapeutic target in a protein called STUB1. STUB1 is a ubiquitin ligase that interacts with tissue factor, a vascular wall protein that triggers the coagulation signaling cascade. The authors demonstrated that increase in STUB1 can prevent thrombosis but does not prolong bleeding in mouse models of kidney disease, suggesting that this may be a viable approach to antithrombotic management of patients.

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