Thrombosis of the iliofemoral vein distribution represents a challenging problem because of its potential for significant morbidity and mortality despite medical and surgical intervention. Therapeutic options include anticoagulation, thrombectomy (with or without a temporary arteriovenous fistula) with anticoagulation, and thrombolysis. Although thrombectomy underwent a period of disfavor in the U.S., more recent reports indicate that it should be performed in patients with early phlegmasia cerulea dolens who do not respond to heparinization. Thrombolysis and endovascular stenting represent a promising treatment option, promoter even in the presence of phorbol ester, whereas down-regulation of either factor by antisense oligonucleotides decreased CD11d promoter activity. In contrast, overexpression of Sp3 in IM9 and Jurkat cells down-regulated CD11d promoter expression. In vivo genomic footprinting revealed that the -63 to -40 region is bound by an Sp protein in unstimulated HL60 cells but not in phorbol ester-stimulated HL60 cells. In contrast, this site is bound in both unstimulated and phorbol ester-stimulated IM9 and Jurkat cells. Together, these results show that myelomonocytic-specific phorbol ester down-regulation of CD11d is mediated through both Sp1 and Sp3.
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