Thrombosis treatment

Now, our understanding of the processes of platelet function and also coagulation have led to the development of a number of drugs or therapeutic strategies to reduce the risk of developing thrombosis. Now, it’s true that many of the underlying factors that ultimately lead to thrombosis are long-term disease, chronic disease that develops over many decades, in the case of atherosclerosis. So there’s not very much we can do at that late stage with regard to thrombosis, but what we can do is to try and inhibit or reduce the reactivity of these very rapid responses that would normally enable platelets to cause platelet aggregation or to enable coagulation to occur. So these are the basis of current drugs.

For example, aspirin is commonly used to inhibit the action of platelets as are other drugs that target the positive feedback pathways, and it’s these positive feedback pathways that seem to be particularly useful in terms of developing new therapeutic approaches, and there are other ways that are used to prevent coagulation. For example, the use of drugs, such as warfarin, and some more sophisticated, more recent developments. These effectively block some of the key factors that are able to trigger the coagulation process. Clearly, there’s a very long way to go with this, because the death rate from thrombotic disease remains very high.

We have made a great deal of progress in the last three or four decades, and the death rate from individuals who suffer from cardiovascular disease and coronary heart disease, in particular, has diminished by about 50%, but the death rate is still very, very high, and the incidence rate continues to be very, very high. So there’s a lot to do, but our key focus, and this is a focus of a great deal of research at the University of Reading, is to understand the clotting processes in normal healthy individuals and then to use this knowledge to develop better therapeutic strategies for the future.

The key challenge in the development of better ways to prevent thrombosis is that, by definition, what we try to do in reducing the risk of thrombosis, is to reduce the ability of the blood to clot, and this is a normal protective function, so we run the risk here of actually causing more bleeding, so there’s a delicate balance that has to be established between reducing the risk of an ensuing thrombosis occurring, and this could be over a long period of time, weighed up against the increased risk of bleeding.