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Undas A. Laboratory Testing for Fibrinogen Disorders: From Routine Investigations to Research Studies. Semin Thromb Hemost 2024. [PMID: 38889802 DOI: 10.1055/s-0044-1787725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
Congenital and acquired fibrinogen disorders often have heterogeneous clinical phenotypes and are challenging from a laboratory perspective. Fibrinogen determination using the Clauss method remains the gold standard, while the reproducibility and significance of the thrombin time and the reptilase time are limited. Molecular testing for causative mutations in fibrinogen genes is now recommended to confirm the diagnosis of congenital fibrinogen disorders. Research assays are used to evaluate alterations to fibrin formation and properties of plasma and purified fibrinogen-derived clots, characterized by fiber thickness, the number of branches, and pore sizes. Fibrin clot permeability (permeation, porosity) using a hydrostatic pressure system represents the most commonly used method for evaluating fibrin network density. Reduced clot permeability, which denotes the reduced size of an average pore in the network, results in tighter fibrin networks, typically associated with impaired susceptibility to lysis, leading to a thrombotic tendency. Biophysical properties of fibrin clots are largely assessed using rheometry, with atomic force microscopy and nanorheology being increasingly used in disease states. Thromboelastography and thromboelastometry, a simple modification of rheometry, have been used, mainly in intensive care units, for more than 50 years. Given growing evidence for altered fibrin clot properties in diseases with elevated risk of venous and arterial thromboembolism and in some bleeding disorders, further work on standardization and validation of the assessment of fibrin clot characteristics is needed. This review summarizes the current methods used to evaluate fibrinogen abnormalities in both diagnostic and research laboratories.
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Affiliation(s)
- Anetta Undas
- Department of Thromboembolic Diseases, Institute of Cardiology, Jagiellonian University Medical College, and Center for Research and Medical Technology, St. John Paul II Hospital, Cracow, Poland
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2
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Iding AFJ, Alkarithi G, Cate HT, Ariëns RAS, ten Cate-Hoek AJ. Fibrinogen levels and clot properties identify patients who benefit from catheter-directed thrombolysis after DVT. Blood Adv 2024; 8:2924-2932. [PMID: 38547453 PMCID: PMC11176944 DOI: 10.1182/bloodadvances.2023012493] [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] [Received: 12/22/2023] [Accepted: 03/19/2024] [Indexed: 06/04/2024] Open
Abstract
ABSTRACT Ultrasound-accelerated catheter-directed thrombolysis (UA-CDT) to improve patency after deep vein thrombosis (DVT) has not conclusively been shown to prevent postthrombotic syndrome (PTS) but might benefit patients who are unlikely to obtain patency with standard treatment. We hypothesized that these patients could be selected based on their fibrin clot properties. To study this, patients with acute iliofemoral DVT from the CAVA (Ultrasound-Accelerated Catheter-Directed Thrombolysis Versus Anticoagulation for the Prevention of Post-thrombotic Syndrome) trial had blood samples taken at inclusion. Fibrin clot properties in plasma were determined by turbidimetric clotting (lag time and maximal turbidity) and lysis assays (time to 50% lysis and lysis rate), permeation assay, and confocal microscopy (fiber density), as well as levels of fibrin clot modifiers fibrinogen and C-reactive protein (CRP). Patency was defined as >90% iliofemoral vein compressibility at 12-month ultrasound. PTS was defined as ≥5 Villalta score at 6 or 12 months. In total, 91 of 152 patients were included, including 43 with additional UA-CDT and 48 with standard treatment. Patients with additional UA-CDT more often obtained patency (55.8 vs 27.1%) Patients who obtained patency had longer lag times and lower maximal turbidity, fibrinogen, and CRP; only maximal turbidity and fibrinogen remained associated when adjusting for treatment, thrombus load, and body mass index. Fibrinogen levels had an optimal cutoff at 4.85 g/L. Low fibrinogen levels best predicted patency. Additional UA-CDT decreased the risk of PTS only in patients with high fibrinogen. Therefore, additional UA-CDT might prevent PTS in selected patients based on routinely measured fibrinogen levels. This study was registered at www.ClinicalTrials.gov as #NCT00970619.
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Affiliation(s)
- Aaron F. J. Iding
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Thrombosis Expertise Center, Heart + Vascular Center, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ghadir Alkarithi
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Hugo ten Cate
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Thrombosis Expertise Center, Heart + Vascular Center, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert A. S. Ariëns
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Arina J. ten Cate-Hoek
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
- Thrombosis Expertise Center, Heart + Vascular Center, Maastricht University Medical Center, Maastricht, The Netherlands
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Ullah M, Mirshahi S, Valinattaj Omran A, Aldybiat I, Crepaux S, Soria J, Contant G, Pocard M, Mirshahi M. Blood Clot Dynamics and Fibrinolysis Impairment in Cancer: The Role of Plasma Histones and DNA. Cancers (Basel) 2024; 16:928. [PMID: 38473289 DOI: 10.3390/cancers16050928] [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: 12/31/2023] [Revised: 02/05/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Blood viscoelasticity and plasma protein levels can play an important role in the diagnosis and prognosis of cancer. However, the role of histones and DNA in modulating blood clot properties remains to be investigated. This study investigates the differences in blood viscoelasticity and plasma protein levels among cancer patients, individuals with other diseases, and healthy individuals. METHODS Blood samples were collected from 101 participants, including 45 cancer patients, 22 healthy individuals, and 34 individuals with other diseases. Rheological properties of clots formed in vitro by reconstituted elements of fibrinogen or plasma were analyzed with an Anton Paar Rheometer, USA. Plasma protein levels of D-dimer, TPA, EPCR, fibrinogen, and histone H3 were measured through ELISA. Blood clots were formed with or without DNA and histones (H3) by adding thrombin and calcium to plasma samples, and were evaluated for viscoelasticity, permeability, and degradation. RESULTS Cancer patients show higher blood viscoelasticity and plasma D-dimer levels compared to healthy individuals and individuals with other diseases. Our in vitro analysis showed that the addition of histone to the plasma results in a significant decrease in viscoelasticity and mean fiber thickness of the clot formed thereafter. In parallel studies, using plasma from patients, DNA and histones were detected in fibrin clots and were associated with less degradation by t-PA. Moreover, our results show that the presence of DNA and histones not only increases clots' permeability, but also makes them more prone to degradation. CONCLUSIONS Plasma histones and DNA affect the structure of the clot formed and induce defective fibrinolysis. Moreover, the increased viscoelastic properties of plasma from cancer patients can be used as potential biomarkers in cancer prognosis.
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Affiliation(s)
- Matti Ullah
- CAP-Paris Tech., INSERM U1275, Université Paris Cité, Hôpital Lariboisière, 75010 Paris, France
- Faculty of Pharmacy, Hamdard University, Islamabad Campus, Islamabad 45550, Pakistan
| | | | - Azadeh Valinattaj Omran
- CAP-Paris Tech., INSERM U1275, Université Paris Cité, Hôpital Lariboisière, 75010 Paris, France
- Laboratoire des Sciences des Procédés et des Matériaux, Centre National de la Recherche Scientifique (UPR 3407), Université Sorbonne Paris Nord, 93430 Villetaneuse, France
| | - Iman Aldybiat
- CAP-Paris Tech., INSERM U1275, Université Paris Cité, Hôpital Lariboisière, 75010 Paris, France
| | - Sullyvan Crepaux
- CAP-Paris Tech., INSERM U1275, Université Paris Cité, Hôpital Lariboisière, 75010 Paris, France
- Prospective Research, Diagnostica Stago, 92230 Gennevilliers, France
| | - Jeannette Soria
- CAP-Paris Tech., INSERM U1275, Université Paris Cité, Hôpital Lariboisière, 75010 Paris, France
| | - Geneviève Contant
- Prospective Research, Diagnostica Stago, 92230 Gennevilliers, France
| | - Marc Pocard
- CAP-Paris Tech., INSERM U1275, Université Paris Cité, Hôpital Lariboisière, 75010 Paris, France
| | - Massoud Mirshahi
- CAP-Paris Tech., INSERM U1275, Université Paris Cité, Hôpital Lariboisière, 75010 Paris, France
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Gao C, Bao B, Bao C, Wu W. Fungi Fibrinolytic Compound 1 Plays a Core Role in Modulating Fibrinolysis, Altering Plasma Clot Structure, and Promoting Susceptibility to Lysis. Pharmaceutics 2023; 15:2320. [PMID: 37765289 PMCID: PMC10536852 DOI: 10.3390/pharmaceutics15092320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Fibrin clot structure and function are major determinants of venous and arterial thromboembolic diseases, as well as the key determinants of the efficiency of clot lysis. Studies have revealed that fungi fibrinolytic compound 1 (FGFC1) is a novel marine pyranisoindolone natural product with fibrinolytic activity. Here, we explore the impacts of FGFC1 on clot structure, lysis, and plasminogen activation in vitro using turbidimetric, enzyme-linked immunosorbent assay, confocal and electron microscopy, urokinase, or plasmin chromogenic substrate. Clots formed in the presence of FGFC1 expressed reduced fibrin polymerization rate and maximum turbidity; however, they did not influence the lag phase of fibrin polymerization. In the absence of scu-PA (single-chain urokinase plasminogen activator), microscopy revealed that FGFC1 increased the number of protofibrils within fibrin fiber and the pore diameter between protofibrils, inducing clots to form a region of thinner and looser networks separated by large pores. The effects of FGFC1 on scu-PA-mediated plasma clot structure were similar to those in the absence of scu-PA. In addition, FGFC1 promoted the lysis of clots and increased the D-dimer concentration in lysate. FGFC1 increased the generation rate of p-nitroaniline in plasma. These results show that FGFC1 has fibrinolytic activity in plasma, leading to interference with the release of fibrinopeptide B to affect lateral aggregation of protofibrils and increase clot susceptibility to fibrinolysis by altering its structure.
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Affiliation(s)
- Chunli Gao
- Department of Marine Bio-Pharmacology, College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (C.G.)
| | - Bin Bao
- Department of Marine Bio-Pharmacology, College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (C.G.)
- Shanghai Engineering Research Center of Aquatic-Product Processing and Preservation, Shanghai 201306, China
| | - Chunling Bao
- The Sixth People’s Hospital Affiliated, Shanghai Jiao Tong University, Shanghai 201306, China
| | - Wenhui Wu
- Department of Marine Bio-Pharmacology, College of Food Science and Technology, Shanghai Ocean University, Shanghai 201306, China; (C.G.)
- Putuo Sub-Center of International Joint Research Center for Marine Biological Sciences, Zhongke Road, Putuo District, Zhoushan 316104, China
- Marine Biomedical Science and Technology Innovation Platform of Lin-gang Special Area, Lane 218, Haiji Sixth Road, Shanghai 201306, China
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5
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Wolff-Trombini L, Ceripa A, Moreau J, Galinat H, James C, Westbrook N, Allain JM. Microrheology and structural quantification of hypercoagulable clots. BIOMEDICAL OPTICS EXPRESS 2023; 14:4179-4189. [PMID: 37799698 PMCID: PMC10549726 DOI: 10.1364/boe.492669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 10/07/2023]
Abstract
Hypercoagulability is a pathology that remains difficult to explain today in most cases. It is likely due to a modification of the conditions of polymerization of the fibrin, the main clot component. Using passive microrheology, we measured the mechanical properties of clots and correlated them under the same conditions with structural information obtained with confocal microscopy. We tested our approach with known alterations: an excess of fibrinogen and of coagulation Factor VIII. We observed simultaneously a rigidification and densification of the fibrin network, showing the potential of microrheology for hypercoagulability diagnosis.
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Affiliation(s)
- Laura Wolff-Trombini
- Université de Bordeaux, UMR1034, Inserm, Biology of Cardiovascular Diseases, Pessac, France
| | - Adrien Ceripa
- LMS, CNRS, Ecole Polytechnique, Institut Polytechnique de Paris, Palaiseau, France
- Inria, Palaiseau, France
| | - Julien Moreau
- Université Paris-Saclay, Institut d’Optique Graduate School, CNRS, Laboratoire Charles Fabry, Palaiseau, France
| | - Hubert Galinat
- CHU de Brest, Service d'Hématologie Biologique, Brest, France
| | - Chloe James
- Université de Bordeaux, UMR1034, Inserm, Biology of Cardiovascular Diseases, Pessac, France
- CHU de Bordeaux, Laboratoire d’Hématologie, Pessac, France
| | - Nathalie Westbrook
- Université Paris-Saclay, Institut d’Optique Graduate School, CNRS, Laboratoire Charles Fabry, Palaiseau, France
| | - Jean-Marc Allain
- LMS, CNRS, Ecole Polytechnique, Institut Polytechnique de Paris, Palaiseau, France
- Inria, Palaiseau, France
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6
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Plasma from patients with pulmonary embolism show aggregates that reduce after anticoagulation. COMMUNICATIONS MEDICINE 2023; 3:12. [PMID: 36709220 PMCID: PMC9883810 DOI: 10.1038/s43856-023-00242-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 01/12/2023] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Microclots, a term also used for amyloid fibrin(ogen) particles and henceforth named aggregates, have recently been reported in the plasma of patients with COVID-19 and long COVID. These aggregates have been implicated in the thrombotic complications of these diseases. METHODS Plasma samples from 35 patients with acute pulmonary embolism were collected and analysed by laser scanning confocal microscopy and scanning electron microscopy before and after clotting. RESULTS Here we confirm the presence of aggregates and show that they also occur in the plasma of patients with pulmonary embolism, both before and after clotting. Aggregates vary in size and consist of fibrin and platelets. We show that treatment with low-molecular weight heparin reduces aggregates in the samples of patients with pulmonary embolism. Double centrifugation of plasma does not eliminate the aggregates. CONCLUSIONS These data corroborate the existence of microclots or aggregates in diseases associated with venous thromboembolism. Important questions are raised regarding their pathophysiological relevance and further studies are warranted to investigate whether they represent cause or consequence of clinical thrombosis.
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7
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Wu J, Ngai T. In-vitro Fibrin Assembly: From the Bulk to the Interface. Curr Opin Colloid Interface Sci 2022. [DOI: 10.1016/j.cocis.2022.101661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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8
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Belcher HA, Litwa K, Guthold M, Hudson NE. The Applicability of Current Turbidimetric Approaches for Analyzing Fibrin Fibers and Other Filamentous Networks. Biomolecules 2022; 12:807. [PMID: 35740932 PMCID: PMC9221518 DOI: 10.3390/biom12060807] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 12/07/2022] Open
Abstract
Turbidimetry is an experimental technique often used to study the structure of filamentous networks. To extract structural properties such as filament diameter from turbidimetric data, simplifications to light scattering theory must be employed. In this work, we evaluate the applicability of three commonly utilized turbidimetric analysis approaches, each using slightly different simplifications. We make a specific application towards analyzing fibrin fibers, which form the structural scaffold of blood clots, but the results are generalizable. Numerical simulations were utilized to assess the applicability of each approach across a range of fiber lengths and diameters. Simulation results indicated that all three turbidimetric approaches commonly underestimate fiber diameter, and that the “Carr-Hermans” approach, utilizing wavelengths in the range of 500−800 nm, provided <10% error for the largest number of diameter/length combinations. These theoretical results were confirmed, under select conditions, via the comparison of fiber diameters extracted from experimental turbidimetric data, with diameters obtained using super-resolution microscopy.
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Affiliation(s)
- Heather A. Belcher
- Department of Physics, East Carolina University, Greenville, NC 27858, USA;
| | - Karen Litwa
- Department of Anatomy & Cell Biology, East Carolina University, Greenville, NC 27858, USA;
| | - Martin Guthold
- Department of Physics, Wake Forest University, Winston-Salem, NC 27109, USA;
| | - Nathan E. Hudson
- Department of Physics, East Carolina University, Greenville, NC 27858, USA;
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9
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Costa-Júnior JFS, Parcero GC, Machado JC. Shear Elastic Coefficient of Normal and Fibrinogen-Deficient Clotting Plasma Obtained with a Sphere-Motion-Based Acoustic-Radiation-Force Approach. ULTRASOUND IN MEDICINE & BIOLOGY 2022; 48:111-123. [PMID: 34674885 DOI: 10.1016/j.ultrasmedbio.2021.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
Blood coagulation is a process involving several chemical reactions governed by coagulation factors, during which the shear elastic coefficient, μ, varies as the medium transitions from liquid to gel phase. This work used ultrasound to measure μ during the clotting of human plasma samples by tracking the motion of a glass sphere located inside a cuvette filled with the plasma. A 2.03 MHz ultrasonic system generated an impulsive acoustic radiation force acting on the sphere, and a 4.89 MHz pulse-echo ultrasonic system tracked the sphere displacement induced by that force. Measurements of μ were determined by fitting a μ-dependent theoretical model to the motion waveform of the sphere immersed in clotting normal plasma and plasma samples with fibrinogen (FI) concentrations of 1.2 (FI-deficiency) and 3.6 (FI-normal) g/L. For normal plasma, μ started at 14.22 Pa and increased rapidly until 2 min, then slowly until it reached 210.23 Pa at 35 min after the clotting process started. A similar trend was exhibited in plasma samples with FI concentrations of 1.2 and 3.6 g/L, with μ reaching 120.55 and 679.42 Pa, respectively. A theoretical model, related to the kinetics of clot-structure formation, describes the time changes of μ for the clotting plasma samples. The sphere-motion-based acoustic-radiation-force approach allowed us to measure the shear elastic coefficient during the coagulation process of plasma samples with normal and deficient FI concentrations. Our results suggest that the method used in this study is capable of being used to detect bleeding disorders.
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Affiliation(s)
- José Francisco Silva Costa-Júnior
- Brazilian Air Force Academy, Pirassununga, Brazil; Biomedical Engineering Program-COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | | | - João Carlos Machado
- Biomedical Engineering Program-COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Post-Graduation Program on Surgical Sciences, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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10
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Feller T, Connell SDA, Ariёns RAS. Why fibrin biomechanical properties matter for hemostasis and thrombosis. J Thromb Haemost 2022; 20:6-16. [PMID: 34528378 DOI: 10.1111/jth.15531] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 08/26/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022]
Abstract
Polymeric fibrin displays unique structural and biomechanical properties that contribute to its essential role of generating blood clots that stem bleeds. The aim of this review is to discuss how the fibrin clot is formed, how protofibrils make up individual fibrin fibers, what the relationship is between the molecular structure and fibrin biomechanical properties, and how fibrin biomechanical properties relate to the risk of thromboembolic disease. Fibrin polymerization is driven by different types of bonds, including knob-hole interactions displaying catch-slip characteristics, and covalent crosslinking of fibrin polypeptides by activated factor XIII. Key biophysical properties of fibrin polymer are its visco-elasticity, extensibility and resistance to rupture. The internal packing of protofibrils within fibers changes fibrin biomechanical behavior. There are several methods to analyze fibrin biomechanical properties at different scales, including AFM force spectroscopy, magnetic or optical tweezers and rheometry, amongst others. Clinically, fibrin biomechanical characteristics are key for the prevention of thromboembolic disorders such as pulmonary embolism. Future studies are needed to address unanswered questions regarding internal molecular structure of the fibrin polymer, the structural and molecular basis of its remarkable mechanical properties and the relationship of fibrin biomechanical characteristics with thromboembolism in patients with deep vein thrombosis and ischemic stroke.
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Affiliation(s)
- Tímea Feller
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Molecular and Nanoscale Physics Group, School of Physics, University of Leeds, Leeds, UK
| | - Simon D A Connell
- Molecular and Nanoscale Physics Group, School of Physics, University of Leeds, Leeds, UK
| | - Robert A S Ariёns
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
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11
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Differential sialic acid content in adult and neonatal fibrinogen mediates differences in clot polymerization dynamics. Blood Adv 2021; 5:5202-5214. [PMID: 34555851 PMCID: PMC9153052 DOI: 10.1182/bloodadvances.2021004417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/21/2021] [Indexed: 11/20/2022] Open
Abstract
Increased sialic acid in neonatal fibrinogen influences fibrin knob-hole interactions during polymerization. Neonatal fibrin polymerization involves more B knob– and fewer A knob–mediated interactions compared with adults.
Neonates possess a molecular variant of fibrinogen, known as fetal fibrinogen, characterized by increased sialic acid, a greater negative charge, and decreased activity compared with adults. Despite these differences, adult fibrinogen is used for the treatment of bleeding in neonates, with mixed efficacy. To determine safe and efficacious bleeding protocols for neonates, more information on neonatal fibrin clot formation and the influence of sialic acid on these processes is needed. Here, we examine the influence of sialic acid on neonatal fibrin polymerization. We hypothesized that the increased sialic acid content of neonatal fibrinogen promotes fibrin B:b knob-hole interactions and consequently influences the structure and function of the neonatal fibrin matrix. We explored this hypothesis through analysis of structural properties and knob:hole polymerization dynamics of normal and desialylated neonatal fibrin networks and compared them with those formed with adult fibrinogen. We then characterized normal neonatal fibrin knob:hole interactions by forming neonatal and adult clots with either thrombin or snake-venom thrombin-like enzymes that preferentially cleave fibrinopeptide A or B. Sialic acid content of neonatal fibrinogen was determined to be a key determinant of resulting clot properties. Experiments analyzing knob:hole dynamics indicated that typical neonatal fibrin clots are formed with the release of more fibrinopeptide B and less fibrinopeptide A than adults. After the removal of sialic acid, fibrinopeptide release was roughly equivalent between adults and neonates, indicating the influence of sialic acid on fibrin neonatal fibrin polymerization mechanisms. These results could inform future studies developing neonatal-specific treatments of bleeding.
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Maksudov F, Daraei A, Sesha A, Marx KA, Guthold M, Barsegov V. Strength, deformability and toughness of uncrosslinked fibrin fibers from theoretical reconstruction of stress-strain curves. Acta Biomater 2021; 136:327-342. [PMID: 34606991 PMCID: PMC8627496 DOI: 10.1016/j.actbio.2021.09.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/31/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
Structural mechanisms underlying the mechanical properties of fibrin fibers are elusive. We combined tensile testing of uncrosslinked fibrin polymers in vitro and in silico to explore their material properties. The experimental stress (σ) - strain (ε) curves for fibrin fibers are characterized by elastic deformations with a weaker elastic response for ε<160% due to unraveling of αC tethers and straightening of fibrin protofibrils, and a stronger response for ε>160% owing to unfolding of the coiled coils and γ nodules in fibrin monomers. Fiber rupture for strains ε>212% is due to dissociation of the knob-hole bonds and rupture of D:D interfaces. We developed the Fluctuating Bilinear Spring model to interpret the σ-ε profiles in terms of the free energy for protofibril alignment ΔG0 = 10.1-11.5 kBT, Young's moduli for protofibril alignment Yu = 1.9-3.2 MPa and stretching Ya = 5.7-9.7 MPa, strain scale ε˜≈ 12-40% for fiber rupture, and protofibril cooperativity m= 3.6-8. We applied the model to characterize the fiber strength σcr≈ 12-13 MPa, deformability εcr≈ 222%, and rupture toughness U≈ 9 MJ/m3, and to resolve thermodynamic state functions, 96.9 GJ/mol entropy change for protofibril alignment (at room temperature) and 113.6 GJ/mol enthalpy change for protofibril stretching, which add up to 210.5 GJ/mol free-energy change. Fiber elongation is associated with protofibril dehydration and sliding mechanism to create an ordered protofibril array. Fibrin fibers behave like a hydrogel; protofibril dehydration and water expulsion account for ∼94-98% of the total free-energy changes for fiber elongation and rupture. STATEMENT OF SIGNIFICANCE: Structural mechanisms underlying the mechanical properties of fibrin fibers, major components of blood clots and obstructive thrombi, are elusive. We performed tensile testing of uncrosslinked fibrin polymers in vitro and in silico to explore their material properties. Fluctuating Bilinear Spring theory was developed to interpret the stress-strain profiles in terms of the energy for protofibril alignment, elastic moduli for protofibril alignment and stretching, and strain scale for fiber rupture, and to probe the limits of fiber strength, extensibility and toughness. Fibrin fibers behave like a hydrogel. Fiber elongation is defined by the protofibril dehydration and sliding. Structural rearrangements in water matrix control fiber elasticity. These results contribute to fundamental understanding of blood clot breakage that underlies thrombotic embolization.
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Affiliation(s)
- Farkhad Maksudov
- Department of Chemistry, University of Massachusetts, Lowell, MA 01854, United States
| | - Ali Daraei
- Department of Physics, Wake Forest University, Winston-Salem, NC 27109, United States
| | - Anuj Sesha
- Department of Chemistry, University of Massachusetts, Lowell, MA 01854, United States
| | - Kenneth A Marx
- Department of Chemistry, University of Massachusetts, Lowell, MA 01854, United States
| | - Martin Guthold
- Department of Physics, Wake Forest University, Winston-Salem, NC 27109, United States.
| | - Valeri Barsegov
- Department of Chemistry, University of Massachusetts, Lowell, MA 01854, United States.
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13
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Daraei A, Pieters M, Baker SR, de Lange-Loots Z, Siniarski A, Litvinov RI, Veen CSB, de Maat MPM, Weisel JW, Ariëns RAS, Guthold M. Automated Fiber Diameter and Porosity Measurements of Plasma Clots in Scanning Electron Microscopy Images. Biomolecules 2021; 11:1536. [PMID: 34680169 PMCID: PMC8533744 DOI: 10.3390/biom11101536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 12/17/2022] Open
Abstract
Scanning Electron Microscopy (SEM) is a powerful, high-resolution imaging technique widely used to analyze the structure of fibrin networks. Currently, structural features, such as fiber diameter, length, density, and porosity, are mostly analyzed manually, which is tedious and may introduce user bias. A reliable, automated structural image analysis method would mitigate these drawbacks. We evaluated the performance of DiameterJ (an ImageJ plug-in) for analyzing fibrin fiber diameter by comparing automated DiameterJ outputs with manual diameter measurements in four SEM data sets with different imaging parameters. We also investigated correlations between biophysical fibrin clot properties and diameter, and between clot permeability and DiameterJ-determined clot porosity. Several of the 24 DiameterJ algorithms returned diameter values that highly correlated with and closely matched the values of the manual measurements. However, optimal performance was dependent on the pixel size of the images-best results were obtained for images with a pixel size of 8-10 nm (13-16 pixels/fiber). Larger or smaller pixels resulted in an over- or underestimation of diameter values, respectively. The correlation between clot permeability and DiameterJ-determined clot porosity was modest, likely because it is difficult to establish the correct image depth of field in this analysis. In conclusion, several DiameterJ algorithms (M6, M5, T3) perform well for diameter determination from SEM images, given the appropriate imaging conditions (13-16 pixels/fiber). Determining fibrin clot porosity via DiameterJ is challenging.
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Affiliation(s)
- Ali Daraei
- Department of Physics, Wake Forest University, Winston-Salem, NC 27109, USA; (A.D.); (S.R.B.)
| | - Marlien Pieters
- Center of Excellence for Nutrition (CEN), Potchefstroom Campus, North-West University, Potchefstroom 2520, South Africa;
- Medical Research Council Unit for Hypertension and Cardiovascular Disease, Potchefstroom Campus, North-West University, Potchefstroom 2520, South Africa
| | - Stephen R. Baker
- Department of Physics, Wake Forest University, Winston-Salem, NC 27109, USA; (A.D.); (S.R.B.)
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS16 8FX, UK;
| | - Zelda de Lange-Loots
- Center of Excellence for Nutrition (CEN), Potchefstroom Campus, North-West University, Potchefstroom 2520, South Africa;
- Medical Research Council Unit for Hypertension and Cardiovascular Disease, Potchefstroom Campus, North-West University, Potchefstroom 2520, South Africa
| | - Aleksander Siniarski
- Department of Coronary Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, 31-202 Krakow, Poland;
- John Paul II Hospital, 31-202 Krakow, Poland
| | - Rustem I. Litvinov
- Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (R.I.L.); (J.W.W.)
| | - Caroline S. B. Veen
- Department of Hematology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (C.S.B.V.); (M.P.M.d.M.)
| | - Moniek P. M. de Maat
- Department of Hematology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (C.S.B.V.); (M.P.M.d.M.)
| | - John W. Weisel
- Department of Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (R.I.L.); (J.W.W.)
| | - Robert A. S. Ariëns
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS16 8FX, UK;
| | - Martin Guthold
- Department of Physics, Wake Forest University, Winston-Salem, NC 27109, USA; (A.D.); (S.R.B.)
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14
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McPherson HR, Duval C, Baker SR, Hindle MS, Cheah LT, Asquith NL, Domingues MM, Ridger VC, Connell SDA, Naseem KM, Philippou H, Ajjan RA, Ariëns RAS. Fibrinogen αC-subregions critically contribute blood clot fibre growth, mechanical stability, and resistance to fibrinolysis. eLife 2021; 10:e68761. [PMID: 34633287 PMCID: PMC8553339 DOI: 10.7554/elife.68761] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 10/04/2021] [Indexed: 11/24/2022] Open
Abstract
Fibrinogen is essential for blood coagulation. The C-terminus of the fibrinogen α-chain (αC-region) is composed of an αC-domain and αC-connector. Two recombinant fibrinogen variants (α390 and α220) were produced to investigate the role of subregions in modulating clot stability and resistance to lysis. The α390 variant, truncated before the αC-domain, produced clots with a denser structure and thinner fibres. In contrast, the α220 variant, truncated at the start of the αC-connector, produced clots that were porous with short, stunted fibres and visible fibre ends. These clots were mechanically weak and susceptible to lysis. Our data demonstrate differential effects for the αC-subregions in fibrin polymerisation, clot mechanical strength, and fibrinolytic susceptibility. Furthermore, we demonstrate that the αC-subregions are key for promoting longitudinal fibre growth. Together, these findings highlight critical functions of the αC-subregions in relation to clot structure and stability, with future implications for development of novel therapeutics for thrombosis.
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Affiliation(s)
- Helen R McPherson
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeedsUnited Kingdom
| | - Cedric Duval
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeedsUnited Kingdom
| | - Stephen R Baker
- Department of Physics, Wake Forest UniversityWinston SalemUnited States
| | - Matthew S Hindle
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeedsUnited Kingdom
| | - Lih T Cheah
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeedsUnited Kingdom
| | - Nathan L Asquith
- Division of Hematology, Brigham and Women’s Hospital, Harvard Medical SchoolBostonUnited States
| | - Marco M Domingues
- Instituto de Medicina Molecular - João Lobo Antunes, Faculdade de Medicina, Universidade de LisboaLisbonPortugal
| | - Victoria C Ridger
- Department of Infection, Immunity and Cardiovascular Disease, University of SheffieldSheffieldUnited Kingdom
| | - Simon DA Connell
- Molecular and Nanoscale Physics Group, University of LeedsLeedsUnited Kingdom
| | - Khalid M Naseem
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeedsUnited Kingdom
| | - Helen Philippou
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeedsUnited Kingdom
| | - Ramzi A Ajjan
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeedsUnited Kingdom
| | - Robert AS Ariëns
- Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of LeedsLeedsUnited Kingdom
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15
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Varjú I, Sorvillo N, Cherpokova D, Farkas ÁZ, Farkas VJ, Komorowicz E, Feller T, Kiss B, Kellermayer MZ, Szabó L, Wacha A, Bóta A, Longstaff C, Wagner DD, Kolev K. Citrullinated Fibrinogen Renders Clots Mechanically Less Stable, but Lysis-Resistant. Circ Res 2021; 129:342-344. [PMID: 34037437 PMCID: PMC8260470 DOI: 10.1161/circresaha.121.319061] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Imre Varjú
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, MA (I.V., N.S., D.C., D.D.W.)
- Department of Pediatrics, Harvard Medical School, Boston, MA (I.V., N.S., D.C., D.D.W.)
- Department of Biochemistry (I.V., Á.Z.F., V.J.F., E.K., L.S., K.K.), Semmelweis University, Budapest, Hungary
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, NY (I.V.)
| | - Nicoletta Sorvillo
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, MA (I.V., N.S., D.C., D.D.W.)
- Department of Pediatrics, Harvard Medical School, Boston, MA (I.V., N.S., D.C., D.D.W.)
| | - Deya Cherpokova
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, MA (I.V., N.S., D.C., D.D.W.)
- Department of Pediatrics, Harvard Medical School, Boston, MA (I.V., N.S., D.C., D.D.W.)
| | - Ádám Z Farkas
- Department of Biochemistry (I.V., Á.Z.F., V.J.F., E.K., L.S., K.K.), Semmelweis University, Budapest, Hungary
| | - Veronika J Farkas
- Department of Biochemistry (I.V., Á.Z.F., V.J.F., E.K., L.S., K.K.), Semmelweis University, Budapest, Hungary
| | - Erzsébet Komorowicz
- Department of Biochemistry (I.V., Á.Z.F., V.J.F., E.K., L.S., K.K.), Semmelweis University, Budapest, Hungary
| | - Tímea Feller
- Department of Biophysics and Radiation Biology (T.F., B.K., M.Z.K.), Semmelweis University, Budapest, Hungary
| | - Balázs Kiss
- Department of Biophysics and Radiation Biology (T.F., B.K., M.Z.K.), Semmelweis University, Budapest, Hungary
| | - Miklós Z Kellermayer
- Department of Biophysics and Radiation Biology (T.F., B.K., M.Z.K.), Semmelweis University, Budapest, Hungary
| | - László Szabó
- Department of Biochemistry (I.V., Á.Z.F., V.J.F., E.K., L.S., K.K.), Semmelweis University, Budapest, Hungary
- Department of Functional and Structural Materials (L.S.), Institute of Materials and Environmental Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - András Wacha
- Biological Nanochemistry Research Group (A.W., A.B.), Institute of Materials and Environmental Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Attila Bóta
- Biological Nanochemistry Research Group (A.W., A.B.), Institute of Materials and Environmental Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Colin Longstaff
- National Institute for Biological Standards and Control, South Mimms, United Kingdom (C.L.)
| | - Denisa D Wagner
- Program in Cellular and Molecular Medicine, Boston Children's Hospital, MA (I.V., N.S., D.C., D.D.W.)
- Department of Pediatrics, Harvard Medical School, Boston, MA (I.V., N.S., D.C., D.D.W.)
- Division of Hematology/Oncology, Boston Children's Hospital, MA (D.D.W.)
| | - Krasimir Kolev
- Department of Biochemistry (I.V., Á.Z.F., V.J.F., E.K., L.S., K.K.), Semmelweis University, Budapest, Hungary
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16
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Siniarski A, Baker SR, Duval C, Malinowski KP, Gajos G, Nessler J, Ariëns RAS. Quantitative analysis of clot density, fibrin fiber radius, and protofibril packing in acute phase myocardial infarction. Thromb Res 2021; 205:110-119. [PMID: 34298252 DOI: 10.1016/j.thromres.2021.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/04/2021] [Accepted: 06/30/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Coronary artery disease is associated with impaired clot structure. The aim of this study was to investigate acute phase myocardial infarction (AMI) and provide detailed quantitative analysis of clot ultrastructure. MATERIALS AND METHODS Clot formation and breakdown, pore size, fiber density, fiber radius and protofibril packing were investigated in plasma clots from AMI patients. These data were compared to those from healthy controls. RESULTS Analysis on clot formation using turbidity showed increased lag time, suggesting changes in protofibril packing and increased fiber size for AMI patients compared to healthy controls. Additionally, increased average rate of clotting and decreased time to maximum absorbance in AMI patients suggest that clots formed more quickly. Moreover, we observed increased time from max OD to max rate of lysis. Increased fibrinogen and decreased plasminogen in AMI patients were accounted for in represented significant differences. AMI samples showed increased time to 25% and 50% lysis, but no change in 75% lysis, representative of delayed lysis onset, but expediated lysis once initiated. These data suggest that AMI patients formed less porous clots made from more densely packed fibers with decreased numbers of protofibrils, which was confirmed using decreased permeation and increased fiber density, and decreased turbidimetry. CONCLUSIONS AMI plasma formed clots that were denser, less permeable, and lysed more slowly than healthy controls. These findings were confirmed by detailed analysis of clot ultrastructure, fiber size, and protofibril packing. Dense clot structures that are resistant to lysis may contribute to a prothrombotic milieu in AMI.
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Affiliation(s)
- Aleksander Siniarski
- Department of Coronary Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland; John Paul II Hospital, Krakow, Poland
| | - Stephen R Baker
- Leeds Thrombosis Collective, Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK; Department of Physics, Wake Forest University, Winston Salem, NC, USA.
| | - Cédric Duval
- Leeds Thrombosis Collective, Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | | | - Grzegorz Gajos
- Department of Coronary Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland; John Paul II Hospital, Krakow, Poland
| | - Jadwiga Nessler
- Department of Coronary Disease and Heart Failure, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland; John Paul II Hospital, Krakow, Poland
| | - Robert A S Ariëns
- Leeds Thrombosis Collective, Discovery and Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
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17
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Duval C, Baranauskas A, Feller T, Ali M, Cheah LT, Yuldasheva NY, Baker SR, McPherson HR, Raslan Z, Bailey MA, Cubbon RM, Connell SD, Ajjan RA, Philippou H, Naseem KM, Ridger VC, Ariëns RAS. Elimination of fibrin γ-chain cross-linking by FXIIIa increases pulmonary embolism arising from murine inferior vena cava thrombi. Proc Natl Acad Sci U S A 2021; 118:e2103226118. [PMID: 34183396 PMCID: PMC8271579 DOI: 10.1073/pnas.2103226118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The onset of venous thromboembolism, including pulmonary embolism, represents a significant health burden affecting more than 1 million people annually worldwide. Current treatment options are based on anticoagulation, which is suboptimal for preventing further embolic events. In order to develop better treatments for thromboembolism, we sought to understand the structural and mechanical properties of blood clots and how this influences embolism in vivo. We developed a murine model in which fibrin γ-chain cross-linking by activated Factor XIII is eliminated (FGG3X) and applied methods to study thromboembolism at whole-body and organ levels. We show that FGG3X mice have a normal phenotype, with overall coagulation parameters and platelet aggregation and function largely unaffected, except for total inhibition of fibrin γ-chain cross-linking. Elimination of fibrin γ-chain cross-linking resulted in thrombi with reduced strength that were prone to fragmentation. Analysis of embolism in vivo using Xtreme optical imaging and light sheet microscopy demonstrated that the elimination of fibrin γ-chain cross-linking resulted in increased embolization without affecting clot size or lysis. Our findings point to a central previously unrecognized role for fibrin γ-chain cross-linking in clot stability. They also indirectly indicate mechanistic targets for the prevention of thrombosis through selective modulation of fibrin α-chain but not γ-chain cross-linking by activated Factor XIII to reduce thrombus size and burden, while maintaining clot stability and preventing embolism.
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Affiliation(s)
- Cédric Duval
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Adomas Baranauskas
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Tímea Feller
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Majid Ali
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Lih T Cheah
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Nadira Y Yuldasheva
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Stephen R Baker
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Helen R McPherson
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Zaher Raslan
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Marc A Bailey
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Richard M Cubbon
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Simon D Connell
- School of Physics and Astronomy, University of Leeds, Leeds LS2 3AR, United Kingdom
| | - Ramzi A Ajjan
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Helen Philippou
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Khalid M Naseem
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom
| | - Victoria C Ridger
- Department of Infection, Immunity and Cardiovascular Disease, The Medical School, University of Sheffield, Sheffield S10 2RX, United Kingdom
| | - Robert A S Ariëns
- Leeds Thrombosis Collective, Discovery & Translational Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9NL, United Kingdom;
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18
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Factor XIII and Fibrin Clot Properties in Acute Venous Thromboembolism. Int J Mol Sci 2021; 22:ijms22041607. [PMID: 33562624 PMCID: PMC7914915 DOI: 10.3390/ijms22041607] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 12/31/2022] Open
Abstract
Coagulation factor XIII (FXIII) is converted by thrombin into its active form, FXIIIa, which crosslinks fibrin fibers, rendering clots more stable and resistant to degradation. FXIII affects fibrin clot structure and function leading to a more prothrombotic phenotype with denser networks, characterizing patients at risk of venous thromboembolism (VTE). Mechanisms regulating FXIII activation and its impact on fibrin structure in patients with acute VTE encompassing pulmonary embolism (PE) or deep vein thrombosis (DVT) are poorly elucidated. Reduced circulating FXIII levels in acute PE were reported over 20 years ago. Similar observations indicating decreased FXIII plasma activity and antigen levels have been made in acute PE and DVT with their subsequent increase after several weeks since the index event. Plasma fibrin clot proteome analysis confirms that clot-bound FXIII amounts associated with plasma FXIII activity are decreased in acute VTE. Reduced FXIII activity has been associated with impaired clot permeability and hypofibrinolysis in acute PE. The current review presents available studies on the role of FXIII in the modulation of fibrin clot properties during acute PE or DVT and following these events. Better understanding of FXIII’s involvement in the pathophysiology of acute VTE might help to improve current therapeutic strategies in patients with acute VTE.
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19
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Shi Y, Gauer JS, Baker SR, Philippou H, Connell SD, Ariëns RAS. Neutrophils can promote clotting via FXI and impact clot structure via neutrophil extracellular traps in a distinctive manner in vitro. Sci Rep 2021; 11:1718. [PMID: 33462294 PMCID: PMC7814028 DOI: 10.1038/s41598-021-81268-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/04/2021] [Indexed: 12/23/2022] Open
Abstract
Neutrophils and neutrophil extracellular traps (NETs) have been shown to be involved in coagulation. However, the interactions between neutrophils or NETs and fibrin(ogen) in clots, and the mechanisms behind these interactions are not yet fully understood. In this in vitro study, the role of neutrophils or NETs on clot structure, formation and dissolution was studied with a combination of confocal microscopy, turbidity and permeation experiments. Factor (F)XII, FXI and FVII-deficient plasmas were used to investigate which factors may be involved in the procoagulant effects. We found both neutrophils and NETs promote clotting in plasma without the addition of other coagulation triggers, but not in purified fibrinogen, indicating that other factors mediate the interaction. The procoagulant effects of neutrophils and NETs were also observed in FXII- and FVII-deficient plasma. In FXI-deficient plasma, only the procoagulant effects of NETs were observed, but not of neutrophils. NETs increased the density of clots, particularly in the vicinity of the NETs, while neutrophils-induced clots were less stable and more porous. In conclusion, NETs accelerate clotting and contribute to the formation of a denser, more lysis resistant clot architecture. Neutrophils, or their released mediators, may induce clotting in a different manner to NETs, mediated by FXI.
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Affiliation(s)
- Y Shi
- LIGHT Laboratories, Discovery and Translational Science Department, Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK
| | - J S Gauer
- LIGHT Laboratories, Discovery and Translational Science Department, Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK
| | - S R Baker
- LIGHT Laboratories, Discovery and Translational Science Department, Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK
- Department of Physics, Wake Forest University, Winston Salem, NC, USA
| | - H Philippou
- LIGHT Laboratories, Discovery and Translational Science Department, Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK
| | - S D Connell
- The Astbury Centre for Structural Molecular Biology, Molecular & Nanoscale Physics, University of Leeds, Leeds, LS2 9JT, UK
| | - R A S Ariëns
- LIGHT Laboratories, Discovery and Translational Science Department, Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Clarendon Way, Leeds, LS2 9LU, UK.
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20
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Impact of epicatechin on fibrin clot structure. Eur J Pharmacol 2021; 893:173830. [PMID: 33347819 DOI: 10.1016/j.ejphar.2020.173830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 11/21/2022]
Abstract
Fibrin clot structure and function are major determinants of thromboembolic diseases. The study aim was to determine the impact of epicatechin (a flavonoid with cardiovascular protective effects) on fibrin clot structure and permeability. Plasma samples from 12 healthy subjects were incubated with increasing concentrations of epicatechin. Turbidity of fibrin clot was analyzed by absorbance measurement at 405 nm. The fibrin clot nanostructure was determined by scanning spectrometry (wavelength from 500 to 800 nm) and fibrin fiber size by electron microscopy. Permeability was analyzed to assess the fibrin clot functional properties. Epicatechin addition increased the maximum absorbance from 0.34 ± 0.066 (vehicle) to 0.35 ± 0.077 (P = 0.1), 0.35 ± 0.072 (P < 0.05) and 0.34 ± 0.065 (P = 0.5) for 1, 10 and 100 μM epicatechin, respectively. Epicatechin increased the fibrin clot fiber radius (nm) from 109.2 ± 3.2 (vehicle) to 108.9 ± 4.3 (P = 0.9), 110.0 ± 3.6 (P < 0.05) and 109.5 ± 3.3 (P = 0.4), and the distance between protofibrils (nm) from 22.2 ± 1.5 (vehicle) to 22.1 ± 2.3 (P = 0.9), 22.6 ± 1.8 (P < 0.05) and 22.3 ± 1.8 (P = 0.9) for 1, 10 and 100 μM epicatechin respectively. Electron microscopy confirmed these changes. Fibrin clot permeability, expressed as Darcy's constant (Ks, cm2), increased from 2.97 ± 1.17 (vehicle) to 3.36 ± 1.21 (P < 0.05), 3.81 ± 1.41 (P < 0.01) and 3.38 ± 1.33 (P = 0.9). Upon epicatechin addition, the fibrin clot structure became less dense and more permeable.
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21
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Gauer JS, Riva N, Page EM, Philippou H, Makris M, Gatt A, Ariëns RAS. Effect of anticoagulants on fibrin clot structure: A comparison between vitamin K antagonists and factor Xa inhibitors. Res Pract Thromb Haemost 2020; 4:1269-1281. [PMID: 33313466 PMCID: PMC7695561 DOI: 10.1002/rth2.12443] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/01/2020] [Accepted: 09/12/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Abnormal clot structure has been identified in patients with thrombotic disorders. Anticoagulant therapy offers clear benefits for thrombosis prevention and treatment by reducing blood clot formation and size; nevertheless, there are limited data on the effects of different anticoagulants, where clotting is initiated with different triggers, on clot structure. OBJECTIVES Our aim was to investigate the effects of vitamin K antagonists and factor Xa inhibitors on clot structure. METHODS Clots from pooled plasma spiked with rivaroxaban, apixaban, or enoxaparin, as well as plasma from patients on warfarin, were compared to plasma without anticoagulation. The kinetic profile of polymerizing clots was obtained by turbidity, fiber density was determined by confocal microscopy, clot pore size was investigated by permeation, and fiber size was analyzed using scanning electron microscopy. Clotting agonist was either tissue factor or thrombin. RESULTS Following clotting with tissue factor, all anticoagulated clots had a significantly increased lag time, with the exception of enoxaparin. Rivaroxaban additionally led to significantly less dense and more permeable clots, with thicker fibers. In contrast, turbidity analysis following initiation with thrombin showed few effects of anticoagulation, with only enoxaparin leading to a prolonged lag time. Enoxaparin clots made with thrombin were less dense and more permeable. CONCLUSION Our results show that anticoagulants modulate clot structure particularly when induced by tissue factor, most likely due to reduction of thrombin generation. We propose that the effects of different anticoagulants could be assessed with a global clot structure measurement such as permeation or turbidity, providing information on clot phenotype.
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Affiliation(s)
- Julia S. Gauer
- Discovery and Translational Science DepartmentInstitute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Nicoletta Riva
- Department of PathologyFaculty of Medicine & SurgeryUniversity of MaltaMsidaMalta
| | - Eden M. Page
- Discovery and Translational Science DepartmentInstitute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Helen Philippou
- Discovery and Translational Science DepartmentInstitute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Michael Makris
- Sheffield Haemophilia and Thrombosis CentreUniversity of SheffieldSheffieldUK
| | - Alex Gatt
- Department of PathologyFaculty of Medicine & SurgeryUniversity of MaltaMsidaMalta
| | - Robert A. S. Ariëns
- Discovery and Translational Science DepartmentInstitute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
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22
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Mihalko E, Brown AC. Clot Structure and Implications for Bleeding and Thrombosis. Semin Thromb Hemost 2019; 46:96-104. [PMID: 31614389 DOI: 10.1055/s-0039-1696944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The formation of a fibrin clot matrix plays a critical role in promoting hemostasis and wound healing. Fibrin dynamics can become disadvantageous in the formation of aberrant thrombus development. Structural characteristics of clots, such as fiber diameter, clot density, stiffness, or permeability, can determine overall clot integrity and functional characteristics that have implications on coagulation and fibrinolysis. This review examines known factors that contribute to changes in clot structure and the presence of structural clot changes in various disease states. These insights provide valuable information in forming therapeutic strategies for disease states where alterations in clot structure are observed. Additionally, the implications of structural changes in clot networks on bleeding and thrombus development in terms of disease states and clinical outcomes are also examined in this review.
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Affiliation(s)
- Emily Mihalko
- Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Ashley C Brown
- Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
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23
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Baker SR, Zabczyk M, Macrae FL, Duval C, Undas A, Ariëns RAS. Recurrent venous thromboembolism patients form clots with lower elastic modulus than those formed by patients with non-recurrent disease. J Thromb Haemost 2019; 17:618-626. [PMID: 30725502 PMCID: PMC6487944 DOI: 10.1111/jth.14402] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Indexed: 02/03/2023]
Abstract
Essentials Venous thromboembolism (VTE) recurrence leads to decreased clot elastic modulus in plasma. Recurrent VTE is not linked to changes in clot structure, fiber radius, or factor XIII activity. Other plasma components may play a role in VTE recurrence. Prospective studies should resolve if clot stiffness can be used as predictor for recurrent VTE. SUMMARY: Background Venous thromboembolism (VTE) is associated with a high risk of recurrent events after withdrawal of anticoagulation. Objectives To determine the difference in plasma clot mechanical properties between patients with recurrent VTE (rVTE) and those with non-recurrent VTE (nrVTE). Methods We previously developed a system for determining clot mechanical properties by use of an in-house magnetic tweezers system. This system was used to determine the mechanical properties of clots made from plasma of 11 patients with rVTE and 33 with nrVTE. Plasma was mixed with micrometer-sized beads, and thrombin and calcium were added to induce clotting; the mixture was then placed in small capillary tubes, and clotting was allowed to proceed overnight. Bead displacements upon manipulation with magnetic forces were analyzed to determine clot elastic and viscous moduli. Fibrin clot structure was analyzed with turbidimetry and confocal microscopy. Factor XIII was measured by pentylamine incorporation into fibrin. Results Clots from rVTE patients showed nearly two-fold less elastic and less viscous moduli than clots from nrVTE patients, regardless of male sex, unprovoked events, family history of VTE, fibrinogen concentration, or body mass index. No differences were observed in clot structure, fibrinolysis rates, or FXIII levels. Conclusion Using magnetic tweezers for the first time in patient samples, we found that plasma clots from rVTE patients showed a reduced elastic modulus and a reduced viscous modulus as compared with clots from nrVTE patients. These data indicate a possible role for fibrin clot viscoelastic properties in determining VTE recurrence.
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Affiliation(s)
- Stephen R. Baker
- Leeds Thrombosis CollectiveDepartment of Discovery and Translational ScienceLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Michal Zabczyk
- Institute of CardiologyJagiellonian University Medical CollegeKrakowPoland
- John Paul II HospitalKrakowPoland
| | - Fraser L. Macrae
- Leeds Thrombosis CollectiveDepartment of Discovery and Translational ScienceLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Cédric Duval
- Leeds Thrombosis CollectiveDepartment of Discovery and Translational ScienceLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
| | - Anetta Undas
- Institute of CardiologyJagiellonian University Medical CollegeKrakowPoland
- John Paul II HospitalKrakowPoland
| | - Robert A. S. Ariëns
- Leeds Thrombosis CollectiveDepartment of Discovery and Translational ScienceLeeds Institute of Cardiovascular and Metabolic MedicineUniversity of LeedsLeedsUK
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