- Email: [email protected]
Insane in the membrane, insane in the brain!
Thrombosis Research 152 (2017) 98
Contents lists available at ScienceDirect
Thrombosis Research journal homepage: www.elsevier.com/locate/thromres
Editorial
Insane in the membrane, insane in the brain!
When one of your Editors-in-Chief was still attending college, back in 1993, Cypress Hill hit the charts with a single titled “Insane in the Brain”. Almost 25 years later, Thrombosis Research features a paper dealing with just that; mental illness. In this paper, Hoirisch-Clapauch and Nardi investigated a putative link between protein S deficiency and psychotic symptoms or psychotic illness in patients that were diagnosed with thrombotic disease or adverse pregnancy outcome [1]. Indeed, the authors found a link between protein S deficiency and psychotic symptoms or psychotic illness. While mental illness may be explained from the fact that thrombotic complications or adverse pregnancy outcome are traumatic events, the authors indicate that mental illness has a low prevalence in patients with thrombotic events or complicated pregnancies who do not have protein S deficiency. This leaves open the option that protein S has a profound effect on neural system. Indeed, protein S appears to promote proliferation and differentiation of adult neural stem cells. It remains, however, to be seen whether mental illness patients will be treated with protein S in the future. Back to Cypress Hill; although the correct title of the song is “Insane in the Brain”, the line "Insane in the membrane" is sometimes confused for the title. Interestingly, this issue also features a paper on an insanity of the membrane (or membrane-exposed proteins); the autoimmune disease known as Antiphospholipid Syndrome (APS). APS is associated with a high risk of thromboembolic complications, and patients diagnosed with APS receive treatment with vitamin K antagonists (VKA). Nevertheless, with the advent of the direct oral anticoagulants (DOACs) there is a need to establish whether DOACs are safe and effective in APS patients with thromboembolic disorders. Malec and
http://dx.doi.org/10.1016/j.thromres.2017.03.011 0049-3848/© 2017 Published by Elsevier Ltd.
colleagues now postulate that DOACs are as effective as VKA in APS patients, but present a lower bleeding risk [2]. However, the authors do state that larger clinical trials are urgently needed to confirm further the safety and efficacy of DOACs in APS patients. That’s it for now, we hope you will enjoy reading the papers in this issue. Excuse us while we retreat to ponder college days and play Cypress Hill one more time.
References [1] S. Hoirisch-Clapauch, E.A. Nardi, High prevalence of mental disorders in patients with inherited protein S deficiency: A case report series, Thromb. Res. 152 (2017) 1–3. [2] Z. Malec, T. Goralczyk, A. Undas, The use of direct oral anticoagulants in 56 patients with antiphospholipid syndrome, Thromb. Res. 152 (2017) 93–97.
Henri H. Versteeg Leiden University Medical Center, Albinusdreef 2, Leiden, Netherlands Corresponding author. E-mail address: [email protected] Twitter: @HenriVersteeg Marc Rodger Ottawa Hospital, Box 201, 451 Smyth rd, Ottawa, Canada E-mail address: [email protected] Twitter: @RodgerMarc
Contents lists available at ScienceDirect
Thrombosis Research journal homepage: www.elsevier.com/locate/thromres
Editorial
Insane in the membrane, insane in the brain!
When one of your Editors-in-Chief was still attending college, back in 1993, Cypress Hill hit the charts with a single titled “Insane in the Brain”. Almost 25 years later, Thrombosis Research features a paper dealing with just that; mental illness. In this paper, Hoirisch-Clapauch and Nardi investigated a putative link between protein S deficiency and psychotic symptoms or psychotic illness in patients that were diagnosed with thrombotic disease or adverse pregnancy outcome [1]. Indeed, the authors found a link between protein S deficiency and psychotic symptoms or psychotic illness. While mental illness may be explained from the fact that thrombotic complications or adverse pregnancy outcome are traumatic events, the authors indicate that mental illness has a low prevalence in patients with thrombotic events or complicated pregnancies who do not have protein S deficiency. This leaves open the option that protein S has a profound effect on neural system. Indeed, protein S appears to promote proliferation and differentiation of adult neural stem cells. It remains, however, to be seen whether mental illness patients will be treated with protein S in the future. Back to Cypress Hill; although the correct title of the song is “Insane in the Brain”, the line "Insane in the membrane" is sometimes confused for the title. Interestingly, this issue also features a paper on an insanity of the membrane (or membrane-exposed proteins); the autoimmune disease known as Antiphospholipid Syndrome (APS). APS is associated with a high risk of thromboembolic complications, and patients diagnosed with APS receive treatment with vitamin K antagonists (VKA). Nevertheless, with the advent of the direct oral anticoagulants (DOACs) there is a need to establish whether DOACs are safe and effective in APS patients with thromboembolic disorders. Malec and
http://dx.doi.org/10.1016/j.thromres.2017.03.011 0049-3848/© 2017 Published by Elsevier Ltd.
colleagues now postulate that DOACs are as effective as VKA in APS patients, but present a lower bleeding risk [2]. However, the authors do state that larger clinical trials are urgently needed to confirm further the safety and efficacy of DOACs in APS patients. That’s it for now, we hope you will enjoy reading the papers in this issue. Excuse us while we retreat to ponder college days and play Cypress Hill one more time.
References [1] S. Hoirisch-Clapauch, E.A. Nardi, High prevalence of mental disorders in patients with inherited protein S deficiency: A case report series, Thromb. Res. 152 (2017) 1–3. [2] Z. Malec, T. Goralczyk, A. Undas, The use of direct oral anticoagulants in 56 patients with antiphospholipid syndrome, Thromb. Res. 152 (2017) 93–97.
Henri H. Versteeg Leiden University Medical Center, Albinusdreef 2, Leiden, Netherlands Corresponding author. E-mail address: [email protected] Twitter: @HenriVersteeg Marc Rodger Ottawa Hospital, Box 201, 451 Smyth rd, Ottawa, Canada E-mail address: [email protected] Twitter: @RodgerMarc