# Model system of oral contraceptive-induced VTE: integrating genomic, transcriptomic, and proteomic discovery with functional biology

> **NIH NIH R33** · JOHNS HOPKINS UNIVERSITY · 2022 · $626,843

## Abstract

Venous thromboembolism (VTE) is caused by a combination of blood hypercoagulability, endothelial
dysregulation, and blood stasis. This biologic dysregulation has environmental and inherited sources that
interact to modulate thrombotic risk. Female sex-hormone-based oral contraceptives (OCs) are an important
environmental cause of thrombosis in young women, increasing the risk of VTE 2 to 4-fold. Ultimately, a pre-
menopausal woman’s risk of VTE is multifactorial: no single inherited or environmental factor satisfactorily
explains why some women who use OCs are at greater risk of a thrombotic event than others who use OCs.
Assessing thrombotic risk in women before initiating OC use can help identify women who may be at higher
risk of a clinical event. A risk-prediction model should account for the diverse and unique biology of each
woman and how it responds to the challenge of OC hormones. The aim of this application is to elucidate
mechanisms by which exogenous female sex hormones (OCs) increase the risk of VTE in premenopausal
women. Over the course of the 2-phase project, we will develop and expand a model system that accounts for
individual-specific and hormone-specific variables and that can be used to predict risk of thrombosis in women
using OCs. Our approach is to use panomics technology to discover biology relevant to VTE in premenopausal
women using OCs, and to apply panomics findings to understand the functional effects of OCs on vascular
cells and blood composition. Our proposal has 4 aims, which will drive biologic discovery and functional
experimentation. R61 Overview: Discovery. We will identify new genes, protein markers, and biologic
pathways associated with OC use and VTE risk using “panomic” resources (genomic, transcriptomic, and
proteomic) and functional cell biology and biochemistry techniques. Aim 1: Identify novel genes that contribute
to VTE in premenopausal women using OCs in 3 well- characterized, case-control studies of VTE. Aim 2:
Characterize effects of OCs on endothelial cell (EC) transcriptomic and proteomic responses, EC procoagulant
activity, and ability to promote clot formation. R33 Overview: Validation and Functional Testing. We will
validate candidate genes and proteins identified in the R61 phase, characterizing their function in an in vitro
cell-based model of coagulation. We will characterize interactions between EC dysregulation and plasma
hypercoagulability to promote the formation of prothrombotic clots in a blood-endothelial interface model. Aim
3: Characterize candidate genes and proteins in human populations, focusing on Aim 2 discoveries. Aim 4:
Characterize the novel candidate genes identified through discovery and validation in the aims above, and
determine effects of each gene on EC procoagulant activity in normal and hypercoagulable plasmas.
Collectively, these aims integrate discovery and functional-analysis information to identify biologic variation that
promotes OC-induced VTE. This study will...

## Key facts

- **NIH application ID:** 10418628
- **Project number:** 5R33HL141791-06
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** CHARLES J LOWENSTEIN
- **Activity code:** R33 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $626,843
- **Award type:** 5
- **Project period:** 2020-05-25 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10418628

## Citation

> US National Institutes of Health, RePORTER application 10418628, Model system of oral contraceptive-induced VTE: integrating genomic, transcriptomic, and proteomic discovery with functional biology (5R33HL141791-06). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10418628. Licensed CC0.

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