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Marchi R, Meunier S, Rezigue H, Fretigny M, Alotaibi S, Neerman-Arbez M, de Mazancourt P, Casini A. Perinatal stroke and hypofibrinogenemia: Is the new missense fibrinogen variant γ p.Gly310Glu the cause of the procoagulant state? Thromb Res 2024; 241:109106. [PMID: 39096848 DOI: 10.1016/j.thromres.2024.109106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/03/2024] [Accepted: 07/29/2024] [Indexed: 08/05/2024]
Affiliation(s)
- Rita Marchi
- Division of Angiology and Hemostasis, Department of Medicine, University Hospitals of Geneva, University of Geneva, Switzerland.
| | - Sandrine Meunier
- Hospices Civils de Lyon, Unité d'Hémostase clinique Centre de Référence Maladies Hémorragiques Rares (CR-MHR) Groupement Hospitalier Est, Bron Cedex, France
| | - Hamdi Rezigue
- Laboratoire d'hématologie, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Mathilde Fretigny
- Service d'hématologie biologique, Groupement Hospitalier Centre, Hospices Civils de Lyon, Bron, France
| | - Ssakher Alotaibi
- Hospices Civils de Lyon, Unité d'Hémostase clinique Centre de Référence Maladies Hémorragiques Rares (CR-MHR) Groupement Hospitalier Est, Bron Cedex, France; Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marguerite Neerman-Arbez
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Philippe de Mazancourt
- UMR1179, Versailles-Saint-Quentin University, Montigny le Bretonneux, France; Biochemistry Laboratory, Ambroise Paré Hospital, APHP Paris-Saclay, Boulogne-Billancourt, France
| | - Alessandro Casini
- Division of Angiology and Hemostasis, Department of Medicine, University Hospitals of Geneva, University of Geneva, Switzerland
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Martinez-Vargas M, Courson J, Gardea L, Sen M, Yee A, Rumbaut R, Cruz MA. The impact of von Willebrand factor on fibrin formation and structure unveiled with type 3 von Willebrand disease plasma. Blood Coagul Fibrinolysis 2024; 35:256-264. [PMID: 38973517 PMCID: PMC11232922 DOI: 10.1097/mbc.0000000000001309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Normally, von Willebrand factor (VWF) remains inactive unless its A1A2 domains undergo a shear stress-triggered conformational change. We demonstrated the capacity of a recombinant A2 domain of VWF to bind and to affect fibrin formation, altering the fibrin clot structure. The data indicated that VWF contains an additional binding site for fibrin in the A2 domain that plays a role in the incorporation of VWF to the polymerizing fibrin. This study is to examine the hypothesis that active plasma VWF directly influence fibrin polymerization and the structure of fibrin clots. The study used healthy and type 3 von Willebrand disease (VWD) plasma, purified plasma VWF, fibrin polymerization assays, confocal microscopy and scanning electron microscopy. The exposed A2 domain in active VWF harbors additional binding sites for fibrinogen, and significantly potentiates fibrin formation (P < 0.02). Antibody against the A2 domain of VWF significantly decreased the initial rate of change of fibrin formation (P < 0.002). Clot analyses revealed a significant difference in porosity between normal and type 3 VWD plasma (P < 0.008), further supported by scanning electron microscopy, which demonstrated thicker fibrin fibers in the presence of plasma VWF (P < 0.0003). Confocal immunofluorescence microscopy showed punctate VWF staining along fibrin fibrils, providing visual evidence of the integration of plasma VWF into the fibrin matrix. The study with type 3 VWD plasma supports the hypothesis that plasma VWF directly influences fibrin polymerization and clot structure. In addition, a conformational change in the A1A2 domains exposes a hidden fibrin(ogen) binding site, indicating that plasma VWF determines the fibrin clot structure.
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Affiliation(s)
- Marina Martinez-Vargas
- Section of Cardiovascular Research
- Department of Medicine
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center
| | - Justin Courson
- Department of Medicine
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center
| | - Luis Gardea
- Department of Pediatrics, Baylor College of Medicine
| | - Mehmet Sen
- University of Houston, Houston, Texas, USA
| | - Andrew Yee
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center
- Department of Pediatrics, Baylor College of Medicine
| | - Rolando Rumbaut
- Department of Medicine
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center
| | - Miguel A Cruz
- Section of Cardiovascular Research
- Department of Medicine
- Center for Translational Research on Inflammatory Diseases (CTRID), Michael E. DeBakey VA Medical Center
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Marchi R, Durual S, Pecheux O, Neerman-Arbez M, Casini A. Physiological correction of hereditary mild hypofibrinogenemia during pregnancy. Haemophilia 2023; 29:836-843. [PMID: 36757142 DOI: 10.1111/hae.14754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/09/2023] [Accepted: 01/23/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Hereditary hypofibrinogenemia is a rare fibrinogen disorder characterised by decreased levels of fibrinogen. Pregnant women with hypofibrinogenemia are at risk of adverse obstetrical outcomes, depending on the fibrinogen level. AIM We investigated how the physiological changes of hemostasis throughout the pregnancy impact the hemostatic balance in a woman with hereditary mild hypofibrinogenemia. METHODS Fibrin clot properties were analyzed by turbidimetry and scanning electron microscopy, clot weight and red blood cells retention were measured by whole clot contraction, and in vitro thrombin generation was assessed by calibrated automated thrombogram and ex vivo by TAT. RESULTS Throughout the pregnancy, the fibrinogen levels increased reaching normal values in the third trimester (activity 3.1 g/L, antigen 3.2 g/L). In parallel, the fibrin polymerisation increased, the fibrinolysis decreased, the fibrin clot network became denser with thicker fibrin fibers, and the fibrin clot weight and red blood cells retention increased, reaching control's value at the third trimester. Similarly, in vitro and ex vitro thrombin generation increased, reaching maximum values at the delivery. CONCLUSION In this case of hereditary mild hypofibrinogenemia we observed a physiological increase of fibrinogen and thrombin generation. Future studies should focus on moderate and severe hypofibrinogenemia, to assess fibrinogen variation and the overall impact of increased TG on the hemostasis balance.
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Affiliation(s)
- Rita Marchi
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Durual
- Biomaterials Laboratory, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Océane Pecheux
- Division of Obstetric, University Hospitals of Geneva, Geneva, Switzerland
| | - Marguerite Neerman-Arbez
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alessandro Casini
- Division of Angiology and Hemostasis, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
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Mehic D, Pabinger I, Ay C, Gebhart J. Fibrinolysis and bleeding of unknown cause. Res Pract Thromb Haemost 2021; 5:e12511. [PMID: 34027290 PMCID: PMC8117813 DOI: 10.1002/rth2.12511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/21/2021] [Accepted: 03/10/2021] [Indexed: 12/04/2022] Open
Abstract
Patients with bleeding of unknown cause (BUC) present with a variety of mild to moderate bleeding symptoms, but no hemostatic abnormalities can be found. Hyperfibrinolysis is rarely evaluated as the underlying cause for bleeding in clinical practice, and well-established global assays for abnormal fibrinolysis are lacking. Few patients with definitive fibrinolytic disorders, including α2-antiplasmin deficiency, plasminogen activator inhibitor 1 deficiency, or Quebec platelet disorder, have been reported. This review aims to summarize data on established fibrinolytic disorders and to discuss assessments of fibrinolysis in prior bleeding cohorts. Furthermore, we review available global tests with the potential to measure fibrinolysis, such as turbidity fibrin clot assays and rotational thromboelastometry, and their relevance in the workup of patients with BUC. We conclude that, due to the lack of adequate global tests, hyperfibrinolysis might be an underdiagnosed cause for a bleeding disorder. The diagnosis of hyperfibrinolytic bleeding disorders would improve patient care as effective treatment with antifibrinolytic agents is available.
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Affiliation(s)
- Dino Mehic
- Clinical Division of Hematology and HemostaseologyDepartment of Medicine IMedical University of ViennaViennaAustria
| | - Ingrid Pabinger
- Clinical Division of Hematology and HemostaseologyDepartment of Medicine IMedical University of ViennaViennaAustria
| | - Cihan Ay
- Clinical Division of Hematology and HemostaseologyDepartment of Medicine IMedical University of ViennaViennaAustria
| | - Johanna Gebhart
- Clinical Division of Hematology and HemostaseologyDepartment of Medicine IMedical University of ViennaViennaAustria
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Marchi R, Neerman-Arbez M, Gay V, Mourey G, Fiore M, Mouton C, Gautier P, De Moerloose P, Casini A. Comparison of different activators of coagulation by turbidity analysis of hereditary dysfibrinogenemia and controls. Blood Coagul Fibrinolysis 2021; 32:108-114. [PMID: 33443927 DOI: 10.1097/mbc.0000000000001000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Turbidity analysis is widely used as a quantitative technique in hereditary dysfibrinogenemia. We aimed to compare several coagulation triggers in hereditary dysfibrinogenemia and control plasmas. We included 20 patients with hereditary dysfibrinogenemia, 19 with hotspot mutations Aα Arg35His (n = 9), Aα Arg35Cys (n = 2), γ Arg301His (n = 6), γ Arg301Cys (n = 2), and one with Aα Phe27Tyr, and a commercial pooled normal plasma. Fibrin polymerization was activated by bovine or human thrombin or tissue factor (TF), in the presence or absence of tissue type plasminogen activator. The lag time (min), slope (mOD/s), maximum absorbance (MaxAbs, mOD), and area under the curve (AUCp, OD s) were calculated from the fibrin polymerization curves and the time for 50% clot degradation (T50, min), AUCf (OD s) and the overall fibrinolytic potential from fibrinolysis curves. The lag time was significantly shorter and AUC increased in Aα Arg35His patients with bovine thrombin as compared with human thrombin. The MaxAbs and AUCp were significantly higher in γArg301His patients with bovine thrombin compared with human thrombin. Fibrin polymerization parameters of patients' samples were closer to those of control when assessed with TF compared with both human and bovine thrombin. T50 and overall fibrinolytic potential were similar in all samples regardless of the coagulation trigger used, however, with TF the AUCf of Aα Arg35His and γ Arg301His groups were significantly decreased compared with control. Bovine and human thrombin cannot be used equally for studying fibrin polymerization in hotspot hereditary dysfibrinogenemia or control plasmas.
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Affiliation(s)
- Rita Marchi
- Experimental Medicine, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela.,Faculty of Medicine
| | - Marguerite Neerman-Arbez
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Valérie Gay
- Haemophilia Treatment Centre, Centre hospitalier Métropole Savoie, Chambery
| | - Guillaume Mourey
- Haemophilia Treatment Centre, University Hospital of Besançon.,Hemostasis Laboratory, Etablissement Français du Sang, Besançon
| | - Mathieu Fiore
- Service d'Hématologie biologique, CHU de Bordeaux-GH Sud - Hôpital Haut-Lévêque, Bordeaux
| | - Christine Mouton
- Service d'Hématologie biologique, CHU de Bordeaux-GH Sud - Hôpital Haut-Lévêque, Bordeaux
| | | | | | - Alessandro Casini
- Faculty of Medicine.,Division of Angiology and Hemostasis, University Hospitals of Geneva, Geneva, Switzerland
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Boender J, Nederlof A, Meijer K, Mauser‐Bunschoten EP, Cnossen MH, Fijnvandraat K, van der Bom JG, de Meris J, Laros‐van Gorkom BAP, van Galen KPM, Eikenboom J, de Maat MPM, Leebeek FWG. ADAMTS-13 and bleeding phenotype in von Willebrand disease. Res Pract Thromb Haemost 2020; 4:1331-1339. [PMID: 33313472 PMCID: PMC7695560 DOI: 10.1002/rth2.12442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/10/2020] [Accepted: 06/20/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The bleeding phenotype of von Willebrand disease (VWD) varies highly between patients and can only partly be explained by von Willebrand factor (VWF) parameters. By cleaving large VWF multimers into smaller, less active multimers, ADAMTS-13 is an important regulator of VWF activity. However, it is unknown what the role of ADAMTS-13 is in individuals with VWD. OBJECTIVES We therefore studied how ADAMTS-13 activity is associated with the laboratory and bleeding phenotype in individuals with VWD. METHODS We measured ADAMTS-13 activity using the fluorescence resonance energy transfer substrate VWF 73 assay in 638 individuals with VWD in the nationwide cross-sectional Willebrand in the Netherlands study and in 36 healthy controls. The bleeding phenotype was assessed using the Tosetto bleeding score. RESULTS ADAMTS-13 activity was similar in individuals with VWD (109% ± 20.6%) and controls (110% ± 19.7%). ADAMTS-13 activity was higher in individuals with VWD with type 3 than those with type 1 (mean difference, 11.8%; 95% confidence interval [CI], 2.9%-20.8%) or type 2 (mean difference, 16.1%; 95% CI, 7.1%-25.1%). ADAMTS-13 activity was not associated with the Tosetto bleeding score (0.1 Tosetto bleeding score increase per 10% ADAMTS-13 increase, 95% CI, -0.2 to 0.3). Furthermore, ADAMTS-13 activity did not differ between individuals with and without a bleeding event during the year preceding blood sampling (mean difference, 1.4%; 95% CI, -2.1% to 4.9%). CONCLUSION ADAMTS-13 activity was highest in individuals with type 3 VWD, but it had only minor associations with VWF parameters. ADAMTS-13 activity does not influence the bleeding phenotype in individuals with VWD.
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Affiliation(s)
- Johan Boender
- Department of HematologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Angelique Nederlof
- Department of HematologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Department of Pediatric HematologyErasmus MC, University Medical Center RotterdamSophia Children's HospitalRotterdamThe Netherlands
| | - Karina Meijer
- Department HematologyUniversity Medical Center GroningenGroningenThe Netherlands
| | | | - Marjon H. Cnossen
- Department of Pediatric HematologyErasmus MC, University Medical Center RotterdamSophia Children's HospitalRotterdamThe Netherlands
| | - Karin Fijnvandraat
- Department of Pediatric HematologyEmma Children’s HospitalAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
- Department of Plasma ProteinsSanquin ResearchAmsterdamNetherlands
| | - Johanna G. van der Bom
- Department Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
- Jon J van Rood Center for Clinical Transfusion MedicineSanquin ResearchLeidenThe Netherlands
| | - Joke de Meris
- Netherlands Hemophilia SocietyNijkerkThe Netherlands
| | | | - Karin P. M. van Galen
- van Creveld kliniek/Department Benign HematologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Jeroen Eikenboom
- Department Internal Medicine division Thrombosis and HemostasisLeiden University Medical CenterLeidenThe Netherlands
- Einthoven Laboratory for Vascular and Regenerative MedicineLeiden University Medical CenterLeidenThe Netherlands
| | - Moniek P. M de Maat
- Department of HematologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Frank W. G. Leebeek
- Department of HematologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
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Heubel-Moenen FCJI, Henskens YMC, Verhezen PWM, Wetzels RJH, Schouten HC, Beckers EAM. Fibrinolysis in patients with chemotherapy-induced thrombocytopenia and the effect of platelet transfusion. J Thromb Haemost 2019; 17:1073-1084. [PMID: 31033178 DOI: 10.1111/jth.14465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/04/2019] [Accepted: 04/23/2019] [Indexed: 01/11/2023]
Abstract
Essentials Bleeding in chemotherapy induced thrombocytopenia (CIT) might be influenced by hyperfibrinolysis. t-PA-thromboelastography is a fast and reliable assay for hyperfibrinolysis in CIT patients. Clots of CIT patients are more susceptible to t-PA induced lysis compared to healthy individuals. Besides platelets, other factors are likely to influence clot lysis in CIT patients. BACKGROUND Bleeding events in chemotherapy-induced thrombocytopenic (CIT) patients with similar platelet counts might be influenced by changes in clot lysis potential. OBJECTIVES To investigate, in an observational study, thromboelastographic lysis parameters, alterations in clot strength and susceptibility to clot lysis in CIT patients. To identify factors associated with fibrinolytic profiles, and to evaluate the effects of platelet transfusions. METHODS Independent determinants of tissue-type plasminogen activator (t-PA)-ROTEM lysis parameters were identified with multivariable linear regression. Clot formation, strength and lysis parameters were compared with the results of healthy individuals. Characteristics of CIT patients with and without hyperfibrinolytic profiles were compared. t-PA-ROTEM results before, 1 hour after and 24 hours after platelet transfusion were compared. RESULTS A total of 72 consecutive CIT patients were included. t-PA-ROTEM lysis parameters correlated with changes in fibrinolytic proteins. Clot formation time was longer, maximum clot firmness was weaker and lysis times were shorter than in healthy individuals. CIT patients had low plasminogen activator inhibitor-1 and thrombin-activatable fibrinolysis inhibitor levels, and 40% showed hyperfibrinolytic profiles. Platelet transfusions resulted in less hyperfibrinolytic profiles in many, but not all CIT patients. Patients without hyperfibrinolytic profiles had higher fibrinogen, factor VIII and α2 -antiplasmin levels. CONCLUSIONS t-PA-ROTEM can be used as a fast and reliable assay to detect hyperfibrinolytic profiles in CIT patients. CIT patients have weaker clots, which are more susceptible to clot lysis, than healthy individuals. Besides platelets, other factors are likely to influence clot susceptibility to fibrinolysis in CIT patients. The impact of a hyperfibrinolytic t-PA-ROTEM profile on bleeding remains to be investigated.
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Affiliation(s)
- Floor C J I Heubel-Moenen
- Department of Hematology, Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Yvonne M C Henskens
- Central Diagnostic Laboratory, Unit for Hemostasis and Transfusion, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Paul W M Verhezen
- Central Diagnostic Laboratory, Unit for Hemostasis and Transfusion, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Rick J H Wetzels
- Central Diagnostic Laboratory, Unit for Hemostasis and Transfusion, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Harry C Schouten
- Department of Hematology, Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Erik A M Beckers
- Department of Hematology, Internal Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
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9
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Cushing MM, Fitzgerald MM, Harris RM, Asmis LM, Haas T. Influence of cryoprecipitate, Factor XIII, and fibrinogen concentrate on hyperfibrinolysis. Transfusion 2017; 57:2502-2510. [PMID: 28734018 DOI: 10.1111/trf.14259] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Hyperfibrinolysis is a potentially life-threatening condition associated with poor clot integrity and excessive bleeding. Although antifibrinolytics are an effective treatment, more liberal use of these drugs may lead to a prothrombotic risk, and an earlier and potentially safer treatment option would be desirable. Hyperfibrinolysis has been shown to be attenuated by in vitro supplementation of purified human Factor (F)XIII concentrate. Cryoprecipitate represents an alternative source of FXIII and the only approved source of concentrated FXIII in some countries. The aim of this study was to investigate whether cryoprecipitate, FXIII, and fibrinogen concentrate mitigate hyperfibrinolysis. STUDY DESIGN AND METHODS Ten citrate blood specimens from healthy subjects were spiked with tissue plasminogen activator (t-PA) and subsequently supplemented with cryoprecipitate, FXIII, fibrinogen concentrate, and ɛ-aminocaproic acid (EACA). Thromboelastometry tests were performed at baseline, after t-PA, and after supplementation. Hyperfibrinolysis was assessed using the clot lysis index at 60 minutes (LI60; reciprocal of maximum lysis). RESULTS The LI60 was significantly improved (fibrinolysis attenuated) after cryoprecipitate supplementation compared to t-PA alone and compared to FXIII and fibrinogen concentrate. Hyperfibrinolysis was only fully reversed using EACA. In addition, cryoprecipitate demonstrated the least variability in the attenuation of hyperfibrinolysis among 10 healthy subjects, compared to FXIII and fibrinogen concentrate. CONCLUSION This is the first study to show that cryoprecipitate is able to significantly mitigate hyperfibrinolysis in an in vitro model. Further investigations are warranted to determine whether cryoprecipitate may have a previously unrecognized benefit and should be administered earlier in resuscitation protocols.
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Affiliation(s)
- Melissa M Cushing
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York and
| | - Meghann M Fitzgerald
- Department of Anesthesiology, Weill Cornell Medical College, New York, New York and
| | - Rebecca M Harris
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York and
| | - Lars M Asmis
- Unilabs, Coagulation Lab & Centre for Perioperative Thrombosis and Haemostasis, Zurich, Switzerland
| | - Thorsten Haas
- Department of Anesthesia, Zurich University Children's Hospital, Zurich, Switzerland
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10
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Abdul S, Boender J, Malfliet JJMC, Eikenboom J, Fijn van Draat K, Mauser-Bunschoten EP, Meijer K, de Meris J, Laros-van Gorkom BAP, van der Bom JG, Leebeek FWG, Rijken DC, Uitte de Willige S. Plasma levels of plasminogen activator inhibitor-1 and bleeding phenotype in patients with von Willebrand disease. Haemophilia 2017; 23:437-443. [DOI: 10.1111/hae.13206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2017] [Indexed: 11/30/2022]
Affiliation(s)
- S. Abdul
- Department of Hematology; Erasmus University Medical Center Rotterdam; Rotterdam The Netherlands
| | - J. Boender
- Department of Hematology; Erasmus University Medical Center Rotterdam; Rotterdam The Netherlands
| | - J. J. M. C. Malfliet
- Department of Hematology; Erasmus University Medical Center Rotterdam; Rotterdam The Netherlands
| | - J. Eikenboom
- Department of Thrombosis and Hemostasis; Leiden University Medical Center; Leiden The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine; Leiden University Medical Center; Leiden The Netherlands
| | - K. Fijn van Draat
- Pediatric Hematology; Emma Children's Hospital AMC; Amsterdam The Netherlands
| | - E. P. Mauser-Bunschoten
- Van Creveldkliniek department of benign Hematology; University Medical Center Utrecht; Utrecht The Netherlands
| | - K. Meijer
- Hematology; University Medical Center Groningen; Groningen The Netherlands
| | - J. de Meris
- Netherlands Hemophilia Society; Leiden The Netherlands
| | | | - J. G. van der Bom
- Department of Clinical Epidemiology; Leiden University Medical Center; Leiden The Netherlands
- Jon J Van Rood Center for Clinical Transfusion Medicine, Sanquin Research; Leiden The Netherlands
| | - F. W. G. Leebeek
- Department of Hematology; Erasmus University Medical Center Rotterdam; Rotterdam The Netherlands
| | - D. C. Rijken
- Department of Hematology; Erasmus University Medical Center Rotterdam; Rotterdam The Netherlands
| | - S. Uitte de Willige
- Department of Hematology; Erasmus University Medical Center Rotterdam; Rotterdam The Netherlands
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Chapin JC, Hajjar KA. Fibrinolysis and the control of blood coagulation. Blood Rev 2015; 29:17-24. [PMID: 25294122 PMCID: PMC4314363 DOI: 10.1016/j.blre.2014.09.003] [Citation(s) in RCA: 446] [Impact Index Per Article: 49.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 09/02/2014] [Indexed: 12/11/2022]
Abstract
Fibrin plays an essential role in hemostasis as both the primary product of the coagulation cascade and the ultimate substrate for fibrinolysis. Fibrinolysis efficiency is greatly influenced by clot structure, fibrinogen isoforms and polymorphisms, the rate of thrombin generation, the reactivity of thrombus-associated cells such as platelets, and the overall biochemical environment. Regulation of the fibrinolytic system, like that of the coagulation cascade, is accomplished by a wide array of cofactors, receptors, and inhibitors. Fibrinolytic activity can be generated either on the surface of a fibrin-containing thrombus, or on cells that express profibrinolytic receptors. In a widening spectrum of clinical disorders, acquired and congenital defects in fibrinolysis contribute to disease morbidity, and new assays of global fibrinolysis now have potential predictive value in multiple clinical settings. Here, we summarize the basic elements of the fibrinolytic system, points of interaction with the coagulation pathway, and some recent clinical advances.
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Affiliation(s)
- John C Chapin
- Division of Hematology-Oncology, Department of Medicine, Weill Cornell Medical College, 520 East 70th Street, New York, NY 10065, USA.
| | - Katherine A Hajjar
- Division of Hematology-Oncology, Department of Medicine, Weill Cornell Medical College, 520 East 70th Street, New York, NY 10065, USA; Division of Hematology-Oncology, Department of Pediatrics, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA; Department of Cell and Developmental Biology, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA.
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