Platelet Thrombus Formation in Flowing Blood

Development of a novel lectin-based gold nanoparticle point-of-care immunoassay for rapid diagnosis of patients with severe Dengue infection

Rapid diagnosis of patients with severe Dengue infection can be useful for the efficient clinical management of cases caused by the Dengue virus. Lateral Flow Immunoassay (LFIA) have been broadly used for rapid Dengue diagnosis, because of their quick readouts with the human eye, simplicity of use, and affordability. Despite the availability of several commercial Dengue point-of-care assays, none has shown to be successful in discriminating between severe and nonsevere forms of Dengue infection. In the current study, for the first time, a novel lectin-based point-of-care assay for the early detection of patients with severe Dengue infection with gold-adorned sheets as detection labels is being reported. In this assay, Dengue severity was diagnosed by detecting the glycosylation profile of vitronectin, a known Dengue severity marker. Two lectins were employed namely DSA (Datura stramonium) and MAA (Maackia amurensis) that can recognize specific glycans like galactose Gal-(1-4) GlcNAc and sialic acid in an (α2-3) linkage, which displayed high sensitivity and high specificity, i.e. 90% and 85% for DSA and 90.91% and 95% for MAA. The new assay has a detection limit of 5 µg µl-1 and enables the quick (30 min) and sensitive detection of severe Dengue cases. The reported point-of-care immunoassay exhibits considerable promise for early identification of patients with Dengue severity.

Coarse-grained simulations of von Willebrand factor adsorption to collagen with consequent platelet recruitment

A multimeric glycoprotein of blood plasma-Von Willebrand factor (VWF)-mediates platelet adhesion to the fibrillar collagen of the subendothelial matrix if the blood vessel walls are damaged. The adsorption of VWF to collagen is thus essential for the initial stages of platelet hemostasis and thrombosis, as it plays a role of a molecular bridge between the injury and platelet adhesion receptors. Biomechanical complexity and sensitivity to the hydrodynamics are inherent in this system, therefore, modern computational methods supplement experimental studies of biophysical and molecular mechanisms that underlie platelet adhesion and aggregation in the blood flow. In the present paper, we propose a simulation framework for the VWF-mediated platelet adhesion to a plane wall with immobilized binding sites for VWF under the action of shear flow. VWF multimers and platelets are represented in the model by particles connected by elastic bonds and immersed in a viscous continuum fluid. This work complements the scientific field by taking into account the shape of a flattened platelet, but keeping a compromise between the detail of the description and the computational complexity of the model.

Biomechanical activation of blood platelets via adhesion to von Willebrand factor studied with mesoscopic simulations

Platelet adhesion and activation are essential initial processes of arterial and microvascular hemostasis, where high hydrodynamic forces from the bloodflow impede coagulation. The process relies on von Willebrand factor (VWF)-a linear multimeric protein of blood plasma plays a pivotal role in mechanochemical regulation of shear-induced platelet aggregation (SIPA). Adhesive interactions between VWF and glycoprotein receptors GPIb are crucial for platelet recruitment under high shear stress in fluid. Recent advances in experimental studies revealed that mechanical tension on the extracellular part of GPIb may trigger a cascade of biochemical reactions in platelets leading to activation of integrins [Formula: see text] (also known as GPIIb/IIIa) and strengthening of the adhesion. The present paper is aimed at investigation of this process by three-dimensional computer simulations of platelet adhesion to surface-grafted VWF multimers in pressure-driven flow of platelet-rich plasma. The simulations demonstrate that GPIb-mediated mechanotransduction is a feasible way of platelet activation and stabilization of platelet aggregates under high shear stress. Quantitative understanding of mechanochemical processes involved in SIPA would potentially promote the discovery of new anti-platelet medication and the development of multiscale numerical models of platelet thrombosis and hemostasis.

Multi-Constituent Simulation of Thrombus Deposition

In this paper, we present a spatio-temporal mathematical model for simulating the formation and growth of a thrombus. Blood is treated as a multi-constituent mixture comprised of a linear fluid phase and a thrombus (solid) phase. The transport and reactions of 10 chemical and biological species are incorporated using a system of coupled convection-reaction-diffusion (CRD) equations to represent three processes in thrombus formation: initiation, propagation and stabilization. Computational fluid dynamic (CFD) simulations using the libraries of OpenFOAM were performed for two illustrative benchmark problems: in vivo thrombus growth in an injured blood vessel and in vitro thrombus deposition in micro-channels (1.5 mm × 1.6 mm × 0.1 mm) with small crevices (125 μm × 75 μm and 125 μm × 137 μm). For both problems, the simulated thrombus deposition agreed very well with experimental observations, both spatially and temporally. Based on the success with these two benchmark problems, which have very different flow conditions and biological environments, we believe that the current model will provide useful insight into the genesis of thrombosis in blood-wetted devices, and provide a tool for the design of less thrombogenic devices.

A novel blood incubation system for the in-vitro assessment of interactions between platelets and biomaterial surfaces under dynamic flow conditions: The Hemocoater

Hemocompatibility evaluation of biomaterials necessitates the use of blood incubation systems which simulate physiological flow conditions. However, most of the current systems have various limitations, especially restricted material variability, poor access to the test surface or damage of blood cells due to the use of a pump. In this paper, we combined the advantages of existent setups and developed a new planar shaped incubation test bench to lift those restrictions and mimic the pulsatile in-vivo situation. The adjustable flow conditions at the tested material surface were defined and corresponded to those in blood vessels. Platelet/material-interaction, as major aspect of hemocompatibility, was investigated for four common polymeric materials (polyoxymethylene, polypropylene, polyethylene and silicone elastomer) with platelet deprivation and platelet adhesion tests. Highly significant differences in the adhesion of platelets onto the tested material surfaces were measured. The number of adhered platelets on the most hydrophobic sample (silicone elastomer) was four-times higher than on the most hydrophilic sample (polyoxymethylene). These findings were confirmed with a scanning microscopic analysis and demonstrated the suitability of the testing device for the evaluation of platelet/material interactions. Moreover, hemolysis measurements demonstrated that the system did not provoke blood damage. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 2430-2440, 2016.

New Fundamentals in Hemostasis

Hemostasis encompasses the tightly regulated processes of blood clotting, platelet activation, and vascular repair. After wounding, the hemostatic system engages a plethora of vascular and extravascular receptors that act in concert with blood components to seal off the damage inflicted to the vasculature and the surrounding tissue. The first important component that contributes to hemostasis is the coagulation system, while the second important component starts with platelet activation, which not only contributes to the hemostatic plug, but also accelerates the coagulation system. Eventually, coagulation and platelet activation are switched off by blood-borne inhibitors and proteolytic feedback loops. This review summarizes new concepts of activation of proteases that regulate coagulation and anticoagulation, to give rise to transient thrombin generation and fibrin clot formation. It further speculates on the (patho)physiological roles of intra- and extravascular receptors that operate in response to these proteases. Furthermore, this review provides a new framework for understanding how signaling and adhesive interactions between endothelial cells, leukocytes, and platelets can regulate thrombus formation and modulate the coagulation process. Now that the key molecular players of coagulation and platelet activation have become clear, and their complex interactions with the vessel wall have been mapped out, we can also better speculate on the causes of thrombosis-related angiopathies.

Continuous separation of microparticles in a microfluidic channel via the elasto-inertial effect of non-Newtonian fluid

Pure separation and sorting of microparticles from complex fluids are essential for biochemical analyses and clinical diagnostics. However, conventional techniques require highly complex and expensive labeling processes for high purity separation. In this study, we present a simple and label-free method for separating microparticles with high purity using the elasto-inertial characteristic of a non-Newtonian fluid in microchannel flow. At the inlet, particle-containing sample flow was pushed toward the side walls by introducing sheath fluid from the center inlet. Particles of 1 μm and 5 μm in diameter, which were suspended in viscoelastic fluid, were successfully separated in the outlet channels: larger particles were notably focused on the centerline of the channel at the outlet, while smaller particles continued flowing along the side walls with minimal lateral migration towards the centerline. The same technique was further applied to separate platelets from diluted whole blood. Through cytometric analysis, we obtained a purity of collected platelets of close to 99.9%. Conclusively, our microparticle separation technique using elasto-inertial forces in non-Newtonian fluid is an effective method for separating and collecting microparticles on the basis of size differences with high purity.

Separation of platelets from whole blood using standing surface acoustic waves in a microchannel

Platelet separation from blood is essential for biochemical analyses and clinical diagnosis. In this article, we propose a method to separate platelets from undiluted whole blood using standing surface acoustic waves (SSAWs) in a microfluidic device. A polydimethylsiloxane (PDMS) microfluidic channel was fabricated and integrated with interdigitated transducer (IDT) electrodes patterned on a piezoelectric substrate. To avoid shear-induced activation of platelets, the blood sample flow was hydrodynamically focused by introducing sheath flow from two side-inlets and pressure nodes were designed to locate at side walls. By means of flow cytometric analysis, the RBC clearance ratio from whole blood was found to be over 99% and the purity of platelets was close to 98%. Conclusively, the present technique using SSAWs can directly separate platelets from undiluted whole blood with higher purity than other methods.

Preparation of highly concentrated and white cell-poor platelet-rich plasma by plateletpheresis

BACKGROUND AND OBJECTIVES

Contaminating white blood cells (WBC) contribute remarkably to the overall growth factor content of locally applicable platelet-rich plasma (PRP) or platelet (PLT) gel and change the relative proportions of the contained growth factors.

MATERIALS AND METHODS

To study the independent effects of locally applicated highly concentrated PLTs, the development of preparations is needed that contain large amounts of PLTs and no or at least very few leucocytes. Therefore, 20 plateletpheresis procedures were performed in voluntary blood donors to get highly concentrated and extremely WBC-poor plateletpheresis concentrates. The degree of spontaneous PLT activation, the PLT aggregation response to agonists and the level of the growth factor TGF-beta1 (transforming growth factor beta1) were measured immediately after the donation and 1 day later.

RESULTS

The concentrates contained 1.96 +/- 0.36 x 10e11 PLTs per unit in 55.2 +/- 7.9 ml, respectively. In comparison to the donors' blood, the PLT-enrichment factor was 15.3 +/- 5.4. At the same time, the concentrates contained extremely low residual numbers of WBCs (0.8 +/- 3.3 x 10e3/ml). The concentration of the growth factor TGF-beta1 was 743.2 +/- 243.9 ng/ml. On day 1, the PLT concentration and the TGF-beta1 content of the PLT concentrates had not decreased.

CONCLUSIONS

In summary, plateletpheresis is suited to provide PRP products with higher concentrations of human platelets and platelet-derived growth factors than previously reported PRP preparation methods but with extremely low numbers of contaminating leucocytes.