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Hudkins M, Hamilton H, Underwood SJ, Kazmierczak DE, Dewey EN, Kazmierczak SC, Messer WB, Khan A, Schreiber MA, Farrell DH. Extreme γ' fibrinogen levels in COVID-19 patients. Blood Cells Mol Dis 2024; 107:102856. [PMID: 38762921 DOI: 10.1016/j.bcmd.2024.102856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/21/2024]
Abstract
COVID-19 disease progression can be accompanied by a "cytokine storm" that leads to secondary sequelae such as acute respiratory distress syndrome. Several inflammatory cytokines have been associated with COVID-19 disease progression, but have high daily intra-individual variability. In contrast, we have shown that the inflammatory biomarker γ' fibrinogen (GPF) has a 6-fold lower coefficient of variability compared to other inflammatory markers such as hs-CRP. The aims of the study were to measure GPF in serial blood samples from COVID-19 patients at a tertiary care medical center in order to investigate its association with clinical measures of disease progression. COVID-19 patients were retrospectively enrolled between 3/16/2020 and 8/1/2020. GPF was measured using a commercial ELISA. We found that COVID-19 patients can develop extraordinarily high levels of GPF. Our results showed that ten out of the eighteen patients with COVID-19 had the highest levels of GPF ever recorded. The previous highest GPF level of 80.3 mg/dL was found in a study of 10,601 participants in the ARIC study. GPF levels were significantly associated with the need for ECMO and mortality. These findings have potential implications regarding prophylactic anticoagulation of COVID-19 patients.
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Affiliation(s)
- Matthew Hudkins
- Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA
| | - Heather Hamilton
- Department of Surgery, Oregon Health & Science University, Portland, OR 97239, USA
| | - Samantha J Underwood
- Department of Surgery, Oregon Health & Science University, Portland, OR 97239, USA
| | - Diana E Kazmierczak
- Department of Pathology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Elizabeth N Dewey
- Department of Surgery, Oregon Health & Science University, Portland, OR 97239, USA
| | - Steven C Kazmierczak
- Department of Pathology, Oregon Health & Science University, Portland, OR 97239, USA
| | - William B Messer
- Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Akram Khan
- Department of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Martin A Schreiber
- Department of Surgery, Oregon Health & Science University, Portland, OR 97239, USA
| | - David H Farrell
- Department of Surgery, Oregon Health & Science University, Portland, OR 97239, USA.
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2
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Kornblith LZ, Sadhanandhan B, Arun S, Long R, Johnson AJ, Noll J, Ramchand CN, Olynyk JK, Farrell DH. Regarding γ' fibrinogen levels as a biomarker of COVID-19 respiratory disease severity. Blood Cells Mol Dis 2024; 105:102825. [PMID: 38278055 DOI: 10.1016/j.bcmd.2024.102825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 01/28/2024]
Affiliation(s)
- Lucy Z Kornblith
- Department of Surgery, University of California, San Francisco, CA, USA
| | | | | | - Rebecca Long
- Fiona Stanley Fremantle Hospital Group, Murdoch, Western Australia, Australia; Edith Cowan University, Joondalup, Western Australia, Australia
| | - Alicia J Johnson
- Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | | | | | - John K Olynyk
- Fiona Stanley Fremantle Hospital Group, Murdoch, Western Australia, Australia; Edith Cowan University, Joondalup, Western Australia, Australia
| | - David H Farrell
- Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
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Pedersen NB, Bladbjerg EM, Juhl CB, Larsen A, Bloch Münster AM, de Maat MP, Palarasah Y. Validation of a fibrinogen γ' enzyme-linked immunosorbent assay using a new monoclonal antibody: effects of bariatric surgery. Res Pract Thromb Haemost 2024; 8:102319. [PMID: 38379712 PMCID: PMC10876905 DOI: 10.1016/j.rpth.2024.102319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 02/22/2024] Open
Abstract
Background Fibrinogen γ' is a naturally occurring 20-amino-acid splice variant of the fibrinogen γ chain. Animal studies link variations in fibrinogen to obesity, but it is unknown how fibrinogen γ' is associated with obesity in humans. Objectives To develop and validate an enzyme-linked immunosorbent assay (ELISA) for fibrinogen γ' quantification in human plasma and analyze fibrinogen γ' before and after bariatric surgery. Methods We generated C-terminal fibrinogen γ' specific mouse monoclonal antibodies and developed a γ' ELISA. Validation included measures of accuracy, sensitivity, and precision. Fibrinogen γ' and total fibrinogen were measured in 60 individuals before and 6 months after bariatric surgery and in 19 normal-weight controls and 120 blood donors. Results Highly specific fibrinogen γ' monoclonal antibodies were produced and successfully used in the ELISA. Recovery was 88%, and limits of detection and quantification were 0.003 mg/mL and 0.014 mg/mL, respectively. Coefficients of variation were 3% for repeatability and 7% for within-laboratory variation. The fibrinogen γ' reference interval was 0.25 to 0.80 mg/mL. Fibrinogen γ' concentrations were reduced after bariatric surgery and were higher in individuals with obesity than in those with normal weight. The fibrinogen γ'/total fibrinogen ratio was unchanged after surgery but was higher than the ratio in normal-weight individuals. Conclusion We developed a precise and sensitive ELISA for fibrinogen γ'. Levels of fibrinogen γ', but not the fibrinogen γ'/fibrinogen ratio, were reduced 6 months after bariatric surgery. Absolute and relative levels of fibrinogen γ' were increased in individuals with obesity compared to normal-weight individuals.
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Affiliation(s)
- Nadja Bødker Pedersen
- Unit for Thrombosis Research, Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Else-Marie Bladbjerg
- Unit for Thrombosis Research, Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Claus Bogh Juhl
- Department of Regional Health Research, University of Southern Denmark, Denmark
- Department of Medicine, Section of Endocrinology, University Hospital of Southern Denmark, Esbjerg, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
| | - Anette Larsen
- Unit for Thrombosis Research, Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Anna-Marie Bloch Münster
- Unit for Thrombosis Research, Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Moniek P.M. de Maat
- Unit for Thrombosis Research, Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Regional Health Research, University of Southern Denmark, Denmark
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Yaseelan Palarasah
- Unit for Thrombosis Research, Department of Clinical Biochemistry, University Hospital of Southern Denmark, Esbjerg, Denmark
- Department of Cancer and Inflammation Research, University of Southern Denmark, Odense, Denmark
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4
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de Vries JJ, Visser C, van Ommen M, Rokx C, van Nood E, van Gorp ECM, Goeijenbier M, van den Akker JPC, Endeman H, Rijken DC, Kruip MJHA, Weggeman M, Koopman J, de Maat MPM. Levels of Fibrinogen Variants Are Altered in Severe COVID-19. TH OPEN 2023; 7:e217-e225. [PMID: 37501780 PMCID: PMC10370639 DOI: 10.1055/a-2102-4521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 04/28/2023] [Indexed: 07/29/2023] Open
Abstract
Background Fibrinogen variants as a result of alternative messenger RNA splicing or protein degradation can affect fibrin(ogen) functions. The levels of these variants might be altered during coronavirus disease 2019 (COVID-19), potentially affecting disease severity or the thrombosis risk. Aim To investigate the levels of fibrinogen variants in plasma of patients with COVID-19. Methods In this case-control study, we measured levels of functional fibrinogen using the Clauss assay. Enzyme-linked immunosorbent assays were used to measure antigen levels of total, intact (nondegraded Aα chain), extended Aα chain (α E ), and γ' fibrinogen in healthy controls, patients with pneumococcal infection in the intensive care unit (ICU), ward patients with COVID-19, and ICU patients with COVID-19 (with and without thrombosis, two time points). Results Healthy controls and ward patients with COVID-19 ( n = 10) showed similar fibrinogen (variant) levels. ICU patients with COVID-19 who later did ( n = 19) or did not develop thrombosis ( n = 18) and ICU patients with pneumococcal infection ( n = 6) had higher absolute levels of functional, total, intact, and α E fibrinogen than healthy controls ( n = 7). The relative α E fibrinogen levels were higher in ICU patients with COVID-19 than in healthy controls, while relative γ' fibrinogen levels were lower. After diagnosis of thrombosis, only the functional fibrinogen levels were higher in ICU patients with COVID-19 and thrombosis than in those without, while no differences were observed in the other fibrinogen variants. Conclusion Our results show that severe COVID-19 is associated with increased levels of α E fibrinogen and decreased relative levels of γ' fibrinogen, which may be a cause or consequence of severe disease, but this is not associated with the development of thrombosis.
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Affiliation(s)
- Judith J de Vries
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Chantal Visser
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Casper Rokx
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Els van Nood
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Eric C M van Gorp
- Department of Internal Medicine, Erasmus MC, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Viroscience, Erasmus MC, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marco Goeijenbier
- Department of Viroscience, Erasmus MC, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Adult Intensive Care, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Henrik Endeman
- Department of Adult Intensive Care, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dingeman C Rijken
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | - Moniek P M de Maat
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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5
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Kornblith LZ, Sadhanandhan B, Arun S, Long R, Johnson AJ, Noll J, Ramchand CN, Olynyk JK, Farrell DH. γ' fibrinogen levels as a biomarker of COVID-19 respiratory disease severity. Blood Cells Mol Dis 2023; 101:102746. [PMID: 37150704 PMCID: PMC10147444 DOI: 10.1016/j.bcmd.2023.102746] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by a pro-inflammatory state associated with organ failure, thrombosis, and death. We investigated a novel inflammatory biomarker, γ' fibrinogen (GPF), in 103 hospitalized patients with COVID-19 and 19 healthy controls. We found significant associations between GPF levels and the severity of COVID-19 as judged by blood oxygen saturation (SpO2). The mean level of GPF in the patients with COVID-19 was significantly higher than in controls (69.8 (95 % CI 64.8-74.8) mg/dL compared with 36.9 (95 % CI 31.4-42.4) mg/dL, p < 0.0001), whereas C-reactive protein (CRP), lactate dehydrogenase (LDH), and total fibrinogen levels were not significantly different between groups. Mean GPF levels were significantly highest in patients with severe COVID-19 (SpO2 ≤ 93 %, GPF 75.2 (95 % CI 68.7-81.8) mg/dL), compared to mild/moderate COVID-19 (SpO2 > 93 %, GPF 62.5 (95 % CI 55.0-70.0) mg/dL, p = 0.01, AUC of 0.68, 95 % CI 0.57-0.78; Youden's index cutpoint 62.9 mg/dL, sensitivity 0.64, specificity 0.63). In contrast, CRP, interleukin-6, ferritin, LDH, D-dimers, and total fibrinogen had weaker associations with COVID-19 disease severity (all ROC curves with lower AUCs). Thus, GPF may be a useful inflammatory marker of COVID-19 respiratory disease severity.
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Affiliation(s)
- Lucy Z Kornblith
- Department of Surgery, University of California, San Francisco, CA, USA
| | | | | | - Rebecca Long
- Fiona Stanley Fremantle Hospital Group, Murdoch, Western Australia, Australia; Edith Cowan University, Joondalup, Western Australia, Australia
| | - Alicia J Johnson
- Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | | | | | - John K Olynyk
- Curtin Medical School, Curtin University, Bentley, Western Australia, Australia; Department of Gastroenterology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - David H Farrell
- Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
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6
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A mathematical model of fibrinogen-mediated erythrocyte-erythrocyte adhesion. Commun Biol 2023; 6:192. [PMID: 36801914 PMCID: PMC9938206 DOI: 10.1038/s42003-023-04560-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 02/06/2023] [Indexed: 02/19/2023] Open
Abstract
Erythrocytes are deformable cells that undergo progressive biophysical and biochemical changes affecting the normal blood flow. Fibrinogen, one of the most abundant plasma proteins, is a primary determinant for changes in haemorheological properties, and a major independent risk factor for cardiovascular diseases. In this study, the adhesion between human erythrocytes is measured by atomic force microscopy (AFM) and its effect observed by micropipette aspiration technique, in the absence and presence of fibrinogen. These experimental data are then used in the development of a mathematical model to examine the biomedical relevant interaction between two erythrocytes. Our designed mathematical model is able to explore the erythrocyte-erythrocyte adhesion forces and changes in erythrocyte morphology. AFM erythrocyte-erythrocyte adhesion data show that the work and detachment force necessary to overcome the adhesion between two erythrocytes increase in the presence of fibrinogen. The changes in erythrocyte morphology, the strong cell-cell adhesion and the slow separation of the two cells are successfully followed in the mathematical simulation. Erythrocyte-erythrocyte adhesion forces and energies are quantified and matched with experimental data. The changes observed on erythrocyte-erythrocyte interactions may give important insights about the pathophysiological relevance of fibrinogen and erythrocyte aggregation in hindering microcirculatory blood flow.
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7
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Kornblith LZ, Sadhanandhan B, Arun S, Long R, Johnson AJ, Noll J, Ramchand CN, Olynyk JK, Farrell DH. Gamma' fibrinogen levels as a biomarker of COVID-19 respiratory disease severity. RESEARCH SQUARE 2022:rs.3.rs-2160004. [PMID: 36299432 PMCID: PMC9603834 DOI: 10.21203/rs.3.rs-2160004/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is characterized by a pro-inflammatory state associated with organ failure, thrombosis, and death. We investigated a novel inflammatory biomarker, γ' fibrinogen (GPF), in 103 hospitalized patients with COVID-19 and 19 healthy controls. We found significant associations between GPF levels and the severity of COVID-19 as judged by blood oxygen saturation (SpO 2 ). The mean level of GPF in the patients with COVID-19 was significantly higher than in controls (69.8 (95% CI 64.8-74.8) mg/dL compared with 36.9 (95% CI 31.4-42.4) mg/dL, p < 0.0001), whereas C-reactive protein (CRP), lactate dehydrogenase (LDH), and total fibrinogen levels were not significantly different between groups. Mean GPF levels were significantly highest in patients with severe COVID-19 (SpO 2 ≤ 93%, GPF 75.2 (95% CI 68.7-81.8) mg/dL), compared to mild/moderate COVID-19 (SpO 2 > 93%, GPF 62.5 (95% CI 55.0-70.0) mg/dL, p = 0.01, AUC of 0.68, 95% CI 0.57-0.78; Youden's index cutpoint 62.9 mg/dL, sensitivity 0.64, specificity 0.63). In contrast, CRP, interleukin-6, ferritin, LDH, D-dimers, and total fibrinogen had weaker associations with COVID-19 disease severity (all ROC curves with lower AUCs). Thus, GPF may be a useful inflammatory marker of COVID-19 respiratory disease severity.
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Affiliation(s)
| | | | | | - Rebecca Long
- Fiona Stanley Fremantle Hospital Group, Murdoch, Western Australia, Australia and Edith Cowan University, Joondalup, Western Australia, Australia
| | | | | | | | - John K. Olynyk
- Fiona Stanley Fremantle Hospital Group, Murdoch, Western Australia, Australia and Edith Cowan University, Joondalup, Western Australia, Australia
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8
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Lentz S, Trossmann VT, Borkner CB, Beyersdorfer V, Rottmar M, Scheibel T. Structure-Property Relationship Based on the Amino Acid Composition of Recombinant Spider Silk Proteins for Potential Biomedical Applications. ACS APPLIED MATERIALS & INTERFACES 2022; 14:31751-31766. [PMID: 35786828 DOI: 10.1021/acsami.2c09590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Improving biomaterials by engineering application-specific and adjustable properties is of increasing interest. Most of the commonly available materials fulfill the mechanical and physical requirements of relevant biomedical applications, but they lack biological functionality, including biocompatibility and prevention of microbial infestation. Thus, research has focused on customizable, application-specific, and modifiable surface coatings to cope with the limitations of existing biomaterials. In the case of adjustable degradation and configurable interaction with body fluids and cells, these coatings enlarge the applicability of the underlying biomaterials. Silks are interesting coating materials, e.g., for implants, since they exhibit excellent biocompatibility and mechanical properties. Herein, we present putative implant coatings made of five engineered recombinant spider silk proteins derived from the European garden spider Araneus diadematus fibroins (ADF), differing in amino acid sequence and charge. We analyzed the influence of the underlying amino acid composition on wetting behavior, blood compatibility, biodegradability, serum protein adsorption, and cell adhesion. The outcome of the comparison indicates that spider silk coatings can be engineered for explicit biomedical applications.
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Affiliation(s)
- Sarah Lentz
- Lehrstuhl Biomaterialien, Fakultät für Ingenieurwissenschaften, Universität Bayreuth, Rüdiger-Bormann-Str. 1, 95447 Bayreuth, Germany
| | - Vanessa T Trossmann
- Lehrstuhl Biomaterialien, Fakultät für Ingenieurwissenschaften, Universität Bayreuth, Rüdiger-Bormann-Str. 1, 95447 Bayreuth, Germany
| | - Christian B Borkner
- Lehrstuhl Biomaterialien, Fakultät für Ingenieurwissenschaften, Universität Bayreuth, Rüdiger-Bormann-Str. 1, 95447 Bayreuth, Germany
| | - Vivien Beyersdorfer
- Lehrstuhl Biomaterialien, Fakultät für Ingenieurwissenschaften, Universität Bayreuth, Rüdiger-Bormann-Str. 1, 95447 Bayreuth, Germany
| | - Markus Rottmar
- Laboratory for Materials-Biology Interactions, Empa Swiss Federal Laboratories for Materials Science and Technology, CH-9014 St. Gallen, Switzerland
| | - Thomas Scheibel
- Lehrstuhl Biomaterialien, Fakultät für Ingenieurwissenschaften, Universität Bayreuth, Rüdiger-Bormann-Str. 1, 95447 Bayreuth, Germany
- Bayerisches Polymerinstitut (BPI), Bayreuther Zentrum für Kolloide und Grenzflächen (BZKG), Bayreuther Zentrum für Molekulare Biowissenschaften (BZMB), Bayreuther Materialzentrum (BayMAT), Universität Bayreuth, Universitätsstr. 30, 95440 Bayreuth, Germany
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9
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Surma S, Banach M. Fibrinogen and Atherosclerotic Cardiovascular Diseases-Review of the Literature and Clinical Studies. Int J Mol Sci 2021; 23:ijms23010193. [PMID: 35008616 PMCID: PMC8745133 DOI: 10.3390/ijms23010193] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 02/06/2023] Open
Abstract
Atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease, cerebrovascular disease, and peripheral arterial disease, represent a significant cause of premature death worldwide. Biomarkers, the evaluation of which would allow the detection of ASCVD at the earliest stage of development, are intensively sought. Moreover, from a clinical point of view, a valuable biomarker should also enable the assessment of the patient’s prognosis. It has been known for many years that the concentration of fibrinogen in plasma increases, inter alia, in patients with ASCVD. On the one hand, an increased plasma fibrinogen concentration may be the cause of the development of atherosclerotic lesions (increased risk of atherothrombosis); on the other hand, it may be a biomarker of ASCVD, as it is an acute phase protein. In addition, a number of genetic polymorphisms and post-translational modifications of fibrinogen were demonstrated that may contribute to the risk of ASCVD. This review summarizes the current data on the importance of fibrinogen as a biomarker of ASCVD, and also presents the relationship between molecular modifications of this protein in the context of ASCVD.
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Affiliation(s)
- Stanisław Surma
- Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland;
- Club of Young Hypertensiologists, Polish Society of Hypertension, 80-952 Gdansk, Poland
| | - Maciej Banach
- Department of Preventive Cardiology and Lipidology, Medical University of Lodz, 93-338 Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, 65-417 Zielona Gora, Poland
- Department of Cardiology and Adult Congenital Heart Diseases, Polish Mother’s Memorial Hospital Research Institute (PMMHRI), 93-338 Lodz, Poland
- Correspondence: ; Tel.: +48-422-711-124
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10
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Mathematical models of fibrin polymerization: past, present, and future. CURRENT OPINION IN BIOMEDICAL ENGINEERING 2021. [DOI: 10.1016/j.cobme.2021.100350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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11
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Pronto-Laborinho AC, Lopes CS, Conceição VA, Gromicho M, Santos NC, de Carvalho M, Carvalho FA. γ' Fibrinogen as a Predictor of Survival in Amyotrophic Lateral Sclerosis. Front Cardiovasc Med 2021; 8:715842. [PMID: 34568457 PMCID: PMC8458885 DOI: 10.3389/fcvm.2021.715842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/09/2021] [Indexed: 12/05/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is an aggressive neurodegenerative disorder related to neuroinflammation that is associated with increased risk of thrombosis. We aimed to evaluate γ' fibrinogen plasma level (an in vivo variant of fibrinogen) as a biomarker in ALS, and to test its role as a predictor of disease progression and survival. Sixty-seven consecutive patients with ALS were followed and the results were compared with those from 82 healthy blood donors. Patients were clinically evaluated at the time of blood sampling and on follow-up (every 3 months for the beginning of the follow-up until death) by applying the revised ALS Functional Rating Scale. Human plasma γ' fibrinogen concentration was quantified using a specific two-site sandwich kit enzyme-linked immunosorbent assay. We found, for the first time, a positive association between γ' fibrinogen concentration and survival in ALS patients: patients with higher γ' fibrinogen plasma levels survived longer, and this finding was not influenced by confounders such as age, gender, respiratory impairment, or functionality (ALSFRS-R score). Since increased levels have a positive impact on outcome, this novel biomarker should be further investigated in ALS.
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Affiliation(s)
| | - Catarina S Lopes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Vasco A Conceição
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Marta Gromicho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Nuno C Santos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Mamede de Carvalho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte (CHULN), Lisbon, Portugal
| | - Filomena A Carvalho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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12
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Becatti M, Mannucci A, Argento FR, Gitto S, Vizzutti F, Marra F, Taddei N, Fiorillo C, Laffi G. Super-Resolution Microscopy Reveals an Altered Fibrin Network in Cirrhosis: The Key Role of Oxidative Stress in Fibrinogen Structural Modifications. Antioxidants (Basel) 2020; 9:antiox9080737. [PMID: 32806658 PMCID: PMC7464401 DOI: 10.3390/antiox9080737] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023] Open
Abstract
Cirrhotic patients show a reduced synthesis of both pro- and anti-coagulant factors. Recent reports indicate that they are characterized by a higher risk of thrombotic rather than hemorrhagic complications, but the mechanisms conferring this risk are not fully elucidated. Oxidative-mediated fibrinogen modifications may explain, at least in part, a prothrombotic profile. The aim of the present pilot study was to investigate the alterations in fibrinogen structure and function in patients with cirrhosis of various severity and to correlate these findings with the mechanisms of thrombus formation. We assessed in plasma specific oxidative stress markers and measured oxidative modifications, functional and structural parameters in purified fibrinogen fractions obtained from cirrhotic patients and control subjects. We enrolled 15 cirrhotic patients (5 patients belonging to each of the three Child-Turcotte-Pugh classes) and 20 age- and sex-matched healthy controls. Plasma redox status, fibrinogen oxidative modifications, thrombin-catalyzed fibrin polymerization and fibrin resistance to plasmin-induced lysis were significantly altered in cirrhotic patients and were associated to disease severity. Importantly, clot structure obtained by stimulated emission depletion (STED) super-resolution microscopy indicated modifications in fiber diameter and in clot porosity in cirrhotic patients. Fibrin fiber diameter significantly decreased in cirrhotic patients when compared to controls, and this difference became more marked with disease progression. In parallel, fibrin pore size progressively decreased along with disease severity. In cirrhotic patients, fibrinogen clot analysis and oxidative-dependent changes reveal novel structural and functional fibrinogen modifications which may favor thrombotic complications in cirrhosis.
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Affiliation(s)
- Matteo Becatti
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (A.M.); (F.R.A.); (N.T.); (C.F.)
- Correspondence: ; Tel.: +39-0552751261
| | - Amanda Mannucci
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (A.M.); (F.R.A.); (N.T.); (C.F.)
| | - Flavia Rita Argento
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (A.M.); (F.R.A.); (N.T.); (C.F.)
| | - Stefano Gitto
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (S.G.); (F.V.); (F.M.); (G.L.)
| | - Francesco Vizzutti
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (S.G.); (F.V.); (F.M.); (G.L.)
| | - Fabio Marra
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (S.G.); (F.V.); (F.M.); (G.L.)
| | - Niccolò Taddei
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (A.M.); (F.R.A.); (N.T.); (C.F.)
| | - Claudia Fiorillo
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Viale Morgagni 50, 50134 Florence, Italy; (A.M.); (F.R.A.); (N.T.); (C.F.)
| | - Giacomo Laffi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy; (S.G.); (F.V.); (F.M.); (G.L.)
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Farrell DH, Rick EA, Dewey EN, Schreiber MA, Rowell SE. γ' fibrinogen levels are associated with blood clot strength in traumatic brain injury patients. Am J Surg 2020; 220:459-463. [PMID: 31948701 PMCID: PMC7641475 DOI: 10.1016/j.amjsurg.2019.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/20/2019] [Accepted: 12/23/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND γ' fibrinogen is an alternatively-spliced fibrinogen variant that displays different coagulation parameters in vitro than the major form of fibrinogen. Purified γ' fibrinogen has slower clotting kinetics than unfractionated fibrinogen, but forms clots that are stronger and resistant to fibrinolysis. However, these properties have only been investigated in human populations in a limited number of studies. We therefore performed a retrospective analysis to test the hypothesis that γ' fibrinogen levels influence coagulation in vivo. METHODS In the present study, we utilized blood samples that were collected from traumatic brain injury patients to probe the relationship between γ' fibrinogen levels and traditional coagulation parameters. RESULTS The results show that the levels of γ' fibrinogen were inversely associated with clotting kinetics, indicated by a shortened INR. In addition, the levels of γ' fibrinogen were associated with stronger clots by thrombelastography. However, these changes were not associated with significant changes in hemorrhage progression. CONCLUSIONS These findings verify that γ' fibrinogen properties observed in purified systems result in similar properties in a clinical setting, and may affect coagulation.
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Affiliation(s)
- David H Farrell
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
| | - Elizabeth A Rick
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Elizabeth N Dewey
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Martin A Schreiber
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Susan E Rowell
- Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Duke University School of Medicine, Durham, NC, USA
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Fabian FM, Ismail AE, Wang O, Lei Y, Velander WH. Reversible associations between human plasma fibronectin and fibrinogen γγ’ heterodimer observed by high pressure size exclusion chromatography and dynamic light scattering. Anal Biochem 2020; 598:113701. [DOI: 10.1016/j.ab.2020.113701] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 12/20/2022]
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Ozaki T, Muramatsu R, Nakamura H, Kinoshita M, Kishima H, Yamashita T. Proteomic analysis of protein changes in plasma by balloon test occlusion. J Clin Neurosci 2019; 72:397-401. [PMID: 31875829 DOI: 10.1016/j.jocn.2019.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 12/01/2019] [Indexed: 10/25/2022]
Abstract
Transient ischemia provides the tolerance against prolonged ischemia in the brain. In mouse experimental model, transient ischemia changes the composition ratio of circulating proteins, which associate with neuroprotection; however, the human evidence is lacking. Here we mimicked balloon test occlusion (BTO) of carotid artery as a transient ischemia and investigated the change of composition ratio of the circulating protein in the human plasma. We collected blood samples from nine patients (5 men and 4 women; mean age 64.2 years; range 45 to 77 years) before and 48 h after BTO and investigated the changes of circulating molecules level in the proteome using LC-MS/MS analysis. Leucine-rich alpha-2-glycoprotein and serum amyloid A-1 increased and protein AMBP decreased in the blood samples after BTO. Transient change of blood flow in the brain alters molecular expression in the plasma. Because the alteration of plasma protein composition is involved in ischemic tolerance in animal models, the proteins whose level was changed by BTO may be also involved in neuroprotection against ischemia in human.
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Affiliation(s)
- Tomohiko Ozaki
- Department of Molecular Neuroscience, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Neurosurgery, Graduate School of Medicine, Osaka University, Japan; Department of Neurosurgery, Osaka International Cancer Institute, Osaka, Japan
| | - Rieko Muramatsu
- Department of Molecular Neuroscience, Graduate School of Medicine, Osaka University, Osaka, Japan; WPI Immunology Frontier Research Center, Osaka University, Japan; Department of Molecular Pharmacology, National Institute of Neuroscience, National Center of Neurology and Neurology and Psychiatry, Kodaira, Japan.
| | - Hajime Nakamura
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Japan
| | - Manabu Kinoshita
- Department of Neurosurgery, Osaka International Cancer Institute, Osaka, Japan
| | - Haruhiko Kishima
- Department of Neurosurgery, Graduate School of Medicine, Osaka University, Japan
| | - Toshihide Yamashita
- Department of Molecular Neuroscience, Graduate School of Medicine, Osaka University, Osaka, Japan; WPI Immunology Frontier Research Center, Osaka University, Japan; Department of Molecular Neuroscience, Graduate School of Frontier Biosciences, Osaka University, Japan
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16
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Chen J, Diamond SL. Reduced model to predict thrombin and fibrin during thrombosis on collagen/tissue factor under venous flow: Roles of γ'-fibrin and factor XIa. PLoS Comput Biol 2019; 15:e1007266. [PMID: 31381558 PMCID: PMC6695209 DOI: 10.1371/journal.pcbi.1007266] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/15/2019] [Accepted: 07/08/2019] [Indexed: 01/29/2023] Open
Abstract
During thrombosis, thrombin generates fibrin, however fibrin reversibly binds thrombin with low affinity E-domain sites (KD = 2.8 μM) and high affinity γ’-fibrin sites (KD = 0.1 μM). For blood clotting on collagen/tissue factor (1 TF-molecule/μm2) at 200 s-1 wall shear rate, high μM-levels of intraclot thrombin suggest robust prothrombin penetration into clots. Setting intraclot zymogen concentrations to plasma levels (and neglecting cofactor rate limitations) allowed the linearization of 7 Michaelis-Menton reactions between 6 species to simulate intraclot generation of: Factors FXa (via TF/VIIa or FIXa), FIXa (via TF/FVIIa or FXIa), thrombin, fibrin, and FXIa. This reduced model [7 rates, 2 KD’s, enzyme half-lives~1 min] predicted the measured clot elution rate of thrombin-antithrombin (TAT) and fragment F1.2 in the presence and absence of the fibrin inhibitor Gly-Pro-Arg-Pro. To predict intraclot fibrin reaching 30 mg/mL by 15 min, the model required fibrinogen penetration into the clot to be strongly diffusion-limited (actual rate/ideal rate = 0.05). The model required free thrombin in the clot (~100 nM) to have an elution half-life of ~2 sec, consistent with measured albumin elution, with most thrombin (>99%) being fibrin-bound. Thrombin-feedback activation of FXIa became prominent and reached 5 pM FXIa at >500 sec in the simulation, consistent with anti-FXIa experiments. In predicting intrathrombus thrombin and fibrin during 15-min microfluidic experiments, the model revealed “cascade amplification” from 30 pM levels of intrinsic tenase to 15 nM prothrombinase to 15 μM thrombin to 90 μM fibrin. Especially useful for multiscale simulation, this reduced model predicts thrombin and fibrin co-regulation during thrombosis under flow. During blood clotting events, a complex series of reaction are involved. Simulation gives insights to the concentration of different enzymes which are at too low of concentration to be detected. However, the models are often large and difficult to solve for clotting under flow conditions. With a thin film approximation, we were able to simplify clotting under flow with parameters from literature, with only 3 adjusted in order to fit the experimental data. This model gave insights into the dynamics of the species involved, and the roles of γ’-fibrin and thrombin feedback activation. This reduced model may be useful in further multiscale simulations.
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Affiliation(s)
- Jason Chen
- Department of Chemical and Biomolecular Engineering, Institute for Medicine and Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Scott L. Diamond
- Department of Chemical and Biomolecular Engineering, Institute for Medicine and Engineering, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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17
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Guedes AF, Carvalho FA, Domingues MM, Macrae FL, McPherson HR, Sabban A, Martins IC, Duval C, Santos NC, Ariëns RA. Impact of γ'γ' fibrinogen interaction with red blood cells on fibrin clots. Nanomedicine (Lond) 2018; 13:2491-2505. [PMID: 30311540 DOI: 10.2217/nnm-2018-0136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM γ' fibrinogen has been associated with thrombosis. Here the interactions between γ'γ' or γAγA fibrinogen and red blood cells (RBCs), and their role on fibrin clot properties were studied. MATERIALS & METHODS Atomic Force microscopy (AFM)-based force spectroscopy, rheological, electron and confocal microscopy, and computational approaches were conducted for both fibrinogen variants. RESULTS & CONCLUSION AFM shows that the recombinant human (rh)γ'γ' fibrinogen increases the binding force and the frequency of the binding to RBCs compared with rhγAγA, promoting cell aggregation. Structural changes in rhγ'γ' fibrin clots, displaying a nonuniform fibrin network were shown by microscopy approaches. The presence of RBCs decreases the fibrinolysis rate and increases viscosity of rhγ'γ' fibrin clots. The full length of the γ' chain structure, revealed by computational analysis, occupies a much wider surface and is more flexible, allowing an increase of the binding between γ' fibers, and eventually with RBCs.
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Affiliation(s)
- Ana Filipa Guedes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal
- Thrombosis & Tissue Repair Group, Discovery & Translational Science Department, Leeds Institute of Cardiovascular & Metabolic Medicine & Multidisciplinary Cardiovascular Centre, Faculty of Medicine & Health, University of Leeds, Leeds, United Kingdom
| | - Filomena A Carvalho
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Marco M Domingues
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal
- Thrombosis & Tissue Repair Group, Discovery & Translational Science Department, Leeds Institute of Cardiovascular & Metabolic Medicine & Multidisciplinary Cardiovascular Centre, Faculty of Medicine & Health, University of Leeds, Leeds, United Kingdom
| | - Fraser L Macrae
- Thrombosis & Tissue Repair Group, Discovery & Translational Science Department, Leeds Institute of Cardiovascular & Metabolic Medicine & Multidisciplinary Cardiovascular Centre, Faculty of Medicine & Health, University of Leeds, Leeds, United Kingdom
| | - Helen R McPherson
- Thrombosis & Tissue Repair Group, Discovery & Translational Science Department, Leeds Institute of Cardiovascular & Metabolic Medicine & Multidisciplinary Cardiovascular Centre, Faculty of Medicine & Health, University of Leeds, Leeds, United Kingdom
| | - Aliaa Sabban
- Thrombosis & Tissue Repair Group, Discovery & Translational Science Department, Leeds Institute of Cardiovascular & Metabolic Medicine & Multidisciplinary Cardiovascular Centre, Faculty of Medicine & Health, University of Leeds, Leeds, United Kingdom
| | - Ivo C Martins
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Cédric Duval
- Thrombosis & Tissue Repair Group, Discovery & Translational Science Department, Leeds Institute of Cardiovascular & Metabolic Medicine & Multidisciplinary Cardiovascular Centre, Faculty of Medicine & Health, University of Leeds, Leeds, United Kingdom
| | - Nuno C Santos
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Robert As Ariëns
- Thrombosis & Tissue Repair Group, Discovery & Translational Science Department, Leeds Institute of Cardiovascular & Metabolic Medicine & Multidisciplinary Cardiovascular Centre, Faculty of Medicine & Health, University of Leeds, Leeds, United Kingdom
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Cantero Guevara ME, Cardinali B, Marchi R. Purificación del fibrinógeno gamma A/gamma prima (γA/γ') por cromatografía líquida rápida de proteínas. REVISTA COLOMBIANA DE QUÍMICA 2018. [DOI: 10.15446/rev.colomb.quim.v47n3.68891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Una fracción del fibrinógeno circulante contiene una variante de la cadena γ que se origina por empalme alternativo del ARNm, denominada γ’ cuya concentración en plasma se ha relacionado con un incremento en el riesgo de padecer enfermedades cardiovasculares. Por tanto, el objetivo de este trabajo fue diseñar un método de purificación del fibrinógeno γA/γ’ más eficiente en relación a los descritos en la literatura, a partir de plasma humano. Se purificó el fibrinógeno γA/γ’ a partir del fibrinógeno total obtenido por precipitación con β-alanina, mediante la separación por cromatografía líquida rápida de proteínas. Se confirmó la presencia de fibrinógeno γA/γ’ mediante Western blot; su concentración fue determinada por ELISA. El método mostró ventajas en comparación con los métodos clásicos de separación, por ejemplo, que cantidades menores de muestra pudieron ser fraccionadas cuantitativamente en componentes puros en menor tiempo (30 min). Por tanto, se puede concluir que la técnica utilizada para la purificación de las variantes del fibrinógeno, correspondiente al Fg gA/gA y Fg gA/g’, es un método de separación eficiente que permite purificar el Fg gA/g’ libre de contaminantes principales, como lo confirma la inmunoelectroforesis.
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19
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Schreiner PJ, Appiah D, Folsom AR. Gamma prime (γ') fibrinogen and carotid intima-media thickness: the Atherosclerosis Risk in Communities study. Blood Coagul Fibrinolysis 2017; 28:665-669. [PMID: 28885318 PMCID: PMC5865218 DOI: 10.1097/mbc.0000000000000659] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
: We assessed if γ' fibrinogen, an isoform of fibrinogen, is independently associated with subclinical atherosclerosis beyond total fibrinogen in black and white men and women participating in the Atherosclerosis Risk in Communities study. Fasting γ' fibrinogen was measured in 6847 Atherosclerosis Risk in Communities participants, ages 51-70 years, in 1993-1995. Carotid intima-media far wall thickness (CIMT) was measured by B-mode ultrasonography at the common, internal and bifurcation carotids. The association of γ' fibrinogen tertiles with overall and segment-specific mean CIMT was assessed with linear regression, controlling for fibrinogen as well as cardiovascular risk factors, including high-sensitivity C-reactive protein and D-dimer. γ' Fibrinogen values ranged from 8.0 to 80.3 mg/dl and were positively related to age, female sex, black race, smoking, BMI, lipids and SBP. Crude γ' fibrinogen was directly associated with all CIMT measures except for the internal carotid, but explained less than 1% of the variance in the associations. Adjustment for total fibrinogen eliminated these associations, and total fibrinogen remained an independent predictor of CIMT without explaining additional variance. Adjustment for potential confounding variables did not alter the observed associations, which did not differ by race or sex. In these cross-sectional data, γ' fibrinogen was not independently associated with CIMT when controlling for total fibrinogen. γ' Fibrinogen and total fibrinogen together explained a very small proportion of the variance in CIMT, regardless of the carotid site. If γ' fibrinogen adds to total fibrinogen's ability to predict subclinical atherosclerosis, it may be in younger populations.
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Affiliation(s)
- Pamela J. Schreiner
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Duke Appiah
- Department of Public Health, Texas, USA
- Tech University Health Sciences Center, Abilene, Texas, USA
| | - Aaron R. Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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20
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Vu T, Fredenburgh J, Weitz J. Zinc: An important cofactor in haemostasis and thrombosis. Thromb Haemost 2017; 109:421-30. [DOI: 10.1160/th12-07-0465] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/27/2012] [Indexed: 02/05/2023]
Abstract
SummaryThere is mounting evidence that zinc, the second most abundant transition metal in blood, is an important mediator of haemostasis and thrombosis. Prompted by the observation that zinc deficiency is associated with bleeding and clotting abnormalities, there now is evidence that zinc serves as an effector of coagulation, anticoagulation and fibrinolysis. Zinc binds numerous plasma proteins and modulates their structure and function. Because activated platelets secrete zinc into the local microenvironment, the concentration of zinc increases in the vicinity of a thrombus. Consequently, the role of zinc varies depending on the microenvironment; a feature that endows zinc with the capacity to spatially and temporally regulate haemostasis and thrombosis. This paper reviews the mechanisms by which zinc regulates coagulation, platelet aggregation, anticoagulation and fibrinolysis and outlines how zinc serves as a ubiquitous modulator of haemostasis and thrombosis.
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Guedes AF, Carvalho FA, Moreira C, Nogueira JB, Santos NC. Essential arterial hypertension patients present higher cell adhesion forces, contributing to fibrinogen-dependent cardiovascular risk. NANOSCALE 2017; 9:14897-14906. [PMID: 28949356 DOI: 10.1039/c7nr03891g] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The increase of erythrocyte aggregation by high fibrinogen levels may be an indicator of cardiovascular risk. γ' fibrinogen variant has been considered as a possible player in enhancing aggregation. Here, we assessed, at the single-cell level, the influence of fibrinogen on erythrocyte aggregation in essential arterial hypertension. We also aimed at understanding how γ' fibrinogen is altered in this disease. Using atomic force microscopy (AFM), we show that the work and force necessary for erythrocyte-erythrocyte detachment is higher for patients than for healthy donors, with these parameters further increasing in both groups when higher fibrinogen concentrations are present. This can be associated with changes in blood flow, due to transient bridging of two erythrocytes by fibrinogen, representing an important cardiovascular risk factor. γ' fibrinogen can influence the increased risk in essential arterial hypertension, as we demonstrate that its levels are significantly increased in these patients' blood. Nevertheless, this cannot be the only cause for the changes observed in the AFM data.
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Affiliation(s)
- Ana F Guedes
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
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22
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Appiah D, Heckbert SR, Cushman M, Psaty BM, Folsom AR. Lack of association of plasma gamma prime (γ') fibrinogen with incident cardiovascular disease. Thromb Res 2016; 143:50-2. [PMID: 27180117 DOI: 10.1016/j.thromres.2016.04.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 04/08/2016] [Accepted: 04/27/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The association of gamma prime (γ') fibrinogen; a fibrinogen γ chain variant generated via alternative mRNA processing, with cardiovascular disease (CVD) remains equivocal. We prospectively examine the association of plasma γ' fibrinogen with the incidence of multiple cardiovascular disease (CVD) endpoints, independent of established CVD risk factors and total fibrinogen. MATERIALS AND METHODS We measured plasma γ' fibrinogen on plasma samples collected in 1992-1993 from adults ≥65years (n=3219) enrolled in the Cardiovascular Health Study, who were followed through 2013 for incident CVD events. RESULTS AND CONCLUSIONS In multivariable Cox models adjusted for traditional CVD risk factors and total fibrinogen, the hazard ratio per 1 standard deviation (10.7mg/dl) increment of γ' fibrinogen was 1.02 (95%CI: 0.95-1.10) for coronary heart disease; 0.88 (0.77-1.00) for ischemic stroke; 1.07 (0.87-1.32) for peripheral artery disease; 1.00 (0.92-1.08) for heart failure and 1.01 (0.92-1.10) for CVD mortality. Likewise, we failed to show a statistically significant association of γ'/total fibrinogen ratio with any CVD endpoint. These results suggest that among the elderly, γ' fibrinogen does not add much to CVD prediction beyond traditional risk factors and total fibrinogen level.
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Affiliation(s)
- Duke Appiah
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Susan R Heckbert
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Mary Cushman
- Department of Medicine, University of Vermont, Burlington, VT, USA
| | - Bruce M Psaty
- Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, WA, USA; Group Health Research Institute, Group Health Cooperatives, Seattle, WA, USA
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
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23
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Folsom AR, Tang W, George KM, Heckbert SR, MacLehose RF, Cushman M, Pankow JS. Prospective study of γ' fibrinogen and incident venous thromboembolism: The Longitudinal Investigation of Thromboembolism Etiology (LITE). Thromb Res 2016; 139:44-9. [PMID: 26916295 PMCID: PMC4769380 DOI: 10.1016/j.thromres.2016.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/15/2015] [Accepted: 01/10/2016] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Epidemiological studies generally have not found plasma total fibrinogen to be a risk factor for venous thromboembolism (VTE), but several have reported associations between variants in the fibrinogen gamma gene (FGG) and VTE. A case-control study in whites suggested plasma γ' fibrinogen concentration may be associated inversely with VTE, but this was not replicated in African Americans. OBJECTIVE To examine the prospective association between γ' fibrinogen concentrations and occurrence of VTE. METHODS We used the Longitudinal Investigation of Thromboembolism Etiology (LITE), involving two pooled population-based cohorts in the United States including 16,234 participants. The cohorts comprised white and African American men and women, aged 50years and older at study onset in the early 1990s. We identified VTEs during follow-up and documented they met standardized diagnostic criteria. RESULTS During two decades of follow-up, neither γ' fibrinogen nor total fibrinogen nor their ratio was associated with VTE overall (n=521 VTEs), in subgroups defined by race, or in other subgroups. In both race groups, the minor allele of FGG rs2066865 was associated with lower γ' fibrinogen concentrations, but this allele was not associated with VTE. CONCLUSIONS A lower plasma concentration of γ' fibrinogen in healthy adults does not appear to increase VTE risk.
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Affiliation(s)
- Aaron R Folsom
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, United States.
| | - Weihong Tang
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, United States
| | - Kristen M George
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, United States
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA 98101, United States
| | - Richard F MacLehose
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, United States
| | - Mary Cushman
- Department of Medicine, University of Vermont, Burlington, VT 55446, United States; Department of Pathology, University of Vermont, Burlington, VT 05446, United States
| | - James S Pankow
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, United States
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Appiah D, Schreiner PJ, MacLehose RF, Folsom AR. Association of Plasma γ' Fibrinogen With Incident Cardiovascular Disease: The Atherosclerosis Risk in Communities (ARIC) Study. Arterioscler Thromb Vasc Biol 2015; 35:2700-6. [PMID: 26494231 DOI: 10.1161/atvbaha.115.306284] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/12/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To prospectively examine the association of plasma γ' fibrinogen with the incidence of multiple cardiovascular disease (CVD) end points, independent of established CVD risk factors, total fibrinogen, and other inflammatory markers. APPROACH AND RESULTS The Atherosclerosis Risk in Communities (ARIC) study measured γ' fibrinogen by enzyme-linked immunosorbent assay in stored plasma samples from 1993 to 1995 and related levels in 10 601 adults to incident CVD end points (coronary heart disease [n=1603], ischemic stroke [n=548], peripheral artery disease [n=599], heart failure [n=1411], and CVD mortality [n=705]) through 2012 (median follow-up, 18 years). In Cox models accounting for established CVD risk factors and total fibrinogen levels, γ' fibrinogen was associated positively with peripheral artery disease (hazard ratio [HR] per 1-SD [8.80 mg/dL] increment, 1.14 [1.04-1.24]), heart failure (HR, 1.06 [1.01-1.13]), and CVD deaths (HR, 1.12 [1.04-1.21]) but not with incident coronary heart disease (HR, 1.01 [0.96-1.07]) or ischemic stroke (HR, 0.98 [0.89-1.07]). Additional adjustment for C-reactive protein, however, eliminated the associations with peripheral artery disease and heart failure. CONCLUSIONS These findings do not lend support to the hypothesis that γ' fibrinogen influences CVD events through its prothrombotic properties. Rather, γ' fibrinogen concentrations seem to reflect general inflammation that accompanies and may contribute to atherosclerotic CVD, instead of γ' fibrinogen being a causal risk factor.
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Affiliation(s)
- Duke Appiah
- From the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis.
| | - Pamela J Schreiner
- From the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Richard F MacLehose
- From the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Aaron R Folsom
- From the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
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The contribution of genetic and environmental factors to changes in total and γ' fibrinogen over 5 years. Thromb Res 2015; 135:703-9. [PMID: 25613928 DOI: 10.1016/j.thromres.2015.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/20/2014] [Accepted: 01/11/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Increased fibrinogen is associated with cardiovascular disease risk. It is, however, not known to what extend environmental and genetic factors and/or their interaction influence changes in total and γ' fibrinogen over time. We aimed to determine how variation within the fibrinogen gene as well as environmental factors influence the change in total and γ' fibrinogen over time, and also whether gene-environment interactions influence total and γ' fibrinogen on a cross-sectional and prospective level in Africans. MATERIALS AND METHODS This prospective study consisted of 2010 participants at baseline and 1288 participants at follow-up (5 years). RESULTS The gene-environment interactions that were associated with fibrinogen concentration on a cross-sectional level were: FGA 2224 G>A (rs2070011) with age (p=0.005), FGB Arg448Lys (rs4220) with HIV status (p<0.0001) and FGB 1038 G>A (rs1800791) with HbA1c (p=0.01). The only factor that independently influenced the change in total fibrinogen levels over time, was baseline CRP (p<0.0001) and FGG 10034 C>T (rs2066865) was the only single nucleotide polymorphism that independently influenced the change in fibrinogen γ' levels over time (p=0.02). Only the FGG 9340 T>C (rs1049636) with HbA1c interaction was found to predict change in total fibrinogen concentrations over time (p=0.005). CONCLUSIONS Gene-environment interactions influenced fibrinogen levels cross-sectionally and also mediated changes in levels over time.
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Vinpocetine and pyritinol: a new model for blood rheological modulation in cerebrovascular disorders—a randomized controlled clinical study. BIOMED RESEARCH INTERNATIONAL 2014; 2014:324307. [PMID: 25548768 PMCID: PMC4274818 DOI: 10.1155/2014/324307] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Revised: 08/21/2014] [Accepted: 09/16/2014] [Indexed: 01/29/2023]
Abstract
Blood and plasma viscosity are the major factors affecting blood flow and normal circulation. Whole blood viscosity is mainly affected by plasma viscosity, red blood cell deformability/aggregation and hematocrit, and other physiological factors. Thirty patients (twenty males + ten females) with age range 50-65 years, normotensive with history of cerebrovascular disorders, were selected according to the American Heart Stroke Association. Blood viscosity and other rheological parameters were measured after two-day abstinence from any medications. Dual effects of vinpocetine and pyritinol exhibit significant effects on all hemorheological parameters (P < 0.05), especially on low shear whole blood viscosity (P < 0.01), but they produced insignificant effects on total serum protein and high shear whole blood viscosity (P > 0.05). Therefore, joint effects of vinpocetine and pyritinol improve blood and plasma viscosity in patients with cerebrovascular disorders.
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Kim PY, Vu TT, Leslie BA, Stafford AR, Fredenburgh JC, Weitz JI. Reduced plasminogen binding and delayed activation render γ'-fibrin more resistant to lysis than γA-fibrin. J Biol Chem 2014; 289:27494-503. [PMID: 25128532 DOI: 10.1074/jbc.m114.588640] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Fibrin (Fn) clots formed from γ'-fibrinogen (γ'-Fg), a variant with an elongated γ-chain, are resistant to lysis when compared with clots formed from the predominant γA-Fg, a finding previously attributed to differences in clot structure due to delayed thrombin-mediated fibrinopeptide (FP) B release or impaired cross-linking by factor XIIIa. We investigated whether slower lysis of γ'-Fn reflects delayed plasminogen (Pg) binding and/or activation by tissue plasminogen activator (tPA), reduced plasmin-mediated proteolysis of γ'-Fn, and/or altered cross-linking. Clots formed from γ'-Fg lysed more slowly than those formed from γA-Fg when lysis was initiated with tPA/Pg when FPA and FPB were both released, but not when lysis was initiated with plasmin, or when only FPA was released. Pg bound to γ'-Fn with an association rate constant 22% lower than that to γA-Fn, and the lag time for initiation of Pg activation by tPA was longer with γ'-Fn than with γA-Fn. Once initiated, however, Pg activation kinetics were similar. Factor XIIIa had similar effects on clots formed from both Fg isoforms. Therefore, slower lysis of γ'-Fn clots reflects delayed FPB release, which results in delayed binding and activation of Pg. When clots were formed from Fg mixtures containing more than 20% γ'-Fg, the upper limit of the normal level, the delay in lysis was magnified. These data suggest that circulating levels of γ'-Fg modulate the susceptibility of clots to lysis by slowing Pg activation by tPA and provide another example of the intimate connections between coagulation and fibrinolysis.
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Affiliation(s)
- Paul Y Kim
- From the Departments of Medicine, the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada
| | - Trang T Vu
- the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada Biomedical Sciences, and
| | - Beverly A Leslie
- From the Departments of Medicine, the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada
| | - Alan R Stafford
- From the Departments of Medicine, the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada
| | - James C Fredenburgh
- From the Departments of Medicine, the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada
| | - Jeffrey I Weitz
- From the Departments of Medicine, the Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada Biomedical Sciences, and Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario L8S 4L8 and
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Walton BL, Getz TM, Bergmeier W, Lin FC, Uitte de Willige S, Wolberg AS. The fibrinogen γA/γ' isoform does not promote acute arterial thrombosis in mice. J Thromb Haemost 2014; 12:680-9. [PMID: 24916154 PMCID: PMC4098759 DOI: 10.1111/jth.12534] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 02/04/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Elevated plasma fibrinogen is associated with arterial thrombosis in humans and promotes thrombosis in mice by increasing fibrin formation and thrombus fibrin content. Fibrinogen is composed of six polypeptide chains: (Aα, Bβ, and γ)2. Alternative splicing of the γ chain leads to a dominant form (γA/γA) and a minor species (γA/γ'). Epidemiological studies have detected elevated γA/γ' fibrinogen in patients with arterial thrombosis, suggesting that this isoform promotes thrombosis. However, in vitro data show that γA/γ' is anticoagulant due to its ability to sequester thrombin and suggest its expression is upregulated in response to inflammatory processes. OBJECTIVE To determine whether γA/γ' fibrinogen is prothrombotic in vivo. METHODS We separated γA/γA and γA/γ' fibrinogen from human plasma-purified fibrinogen and determined the effects on in vitro plasma clot formation and on in vivo thrombus formation and circulating thrombin-antithrombin complexes in mice. RESULTS AND CONCLUSIONS Both γA/γA and γA/γ' fibrinogen were cleaved by murine and human thrombin and were incorporated into murine and human clots. When γA/γA or γA/γ' was spiked into plasma, γA/γA increased the fibrin formation rate to a greater extent than γA/γ'. In mice, compared to controls, γA/γA infusion shortened the time to carotid artery occlusion, whereas γA/γ' infusion did not. Additionally, γA/γ' infusion led to lower levels of plasma thrombin-antithrombin complexes following arterial injury, whereas γA/γA infusion did not. These data suggest that γA/γ' binds thrombin in vivo and decreases prothrombotic activity. Together, these findings indicate that elevated levels of γA/γA fibrinogen promote arterial thrombosis in vivo, whereas γA/γ' does not.
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Affiliation(s)
- B L Walton
- Department of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Lovely R, Hossain J, Ramsey JP, Komakula V, George D, Farrell DH, Balagopal PB. Obesity-related increased γ' fibrinogen concentration in children and its reduction by a physical activity-based lifestyle intervention: a randomized controlled study. J Pediatr 2013; 163:333-8. [PMID: 23415619 DOI: 10.1016/j.jpeds.2013.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 11/12/2012] [Accepted: 01/02/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine if elevated plasma γ'-fibrinogen, typically involved in the formation of fibrinolysis-resistant clots, confers an increased risk for cardiovascular disease (CVD) and thrombosis in children as it does in adults. Although obesity-related hyperfibrinogenemia is frequently reported in children, the role of γ' fibrinogen and its response to physical activity-based lifestyle are less clear in this population. STUDY DESIGN In a randomized controlled 3-month physical activity-based lifestyle intervention, γ' fibrinogen concentration was measured in 21 children (aged 14-18 years; Tanner stage > IV), including 15 in the obese group and 6 in the normal weight group, with body mass index percentiles for age and sex of >95 and <85, respectively. RESULTS The relationships between γ' fibrinogen and other risk factors for CVD, such as markers of insulin resistance and subclinical inflammation, along with body composition (as measured by dual-energy X-ray absortiometry), were assessed before and after the intervention. γ' fibrinogen concentration was higher in the obese group compared with the normal weight group (P < .05) and was correlated with other risk factors for CVD (adjusted R(2) = 0.9; P < .05), and insulin emerged as the major predictor of γ' fibrinogen. The intervention reduced γ'-fibrinogen concentration (P < .05). CONCLUSION Our data reveal: (1) elevated γ' fibrinogen concentrations in obese insulin-resistant children compared with normal lean controls; (2) a relationship between γ' fibrinogen and other CVD risk factors; and (3) physical activity-induced reduction in γ' fibrinogen in obese children.
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Affiliation(s)
- Rehana Lovely
- Department of Cell Biology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA
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Peters SAE, Woodward M, Rumley A, Koenig W, Tunstall-Pedoe H, Lowe GDO. Direct comparisons of three alternative plasma fibrinogen assays with the von Clauss assay in prediction of cardiovascular disease and all-causes mortality: the Scottish Heart Health Extended Cohort. Br J Haematol 2013; 162:392-9. [PMID: 23701042 DOI: 10.1111/bjh.12389] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 04/03/2013] [Indexed: 11/30/2022]
Abstract
There is strong evidence from meta-analyses of prospective epidemiological studies that increasing plasma fibrinogen levels are associated with an increasing risk of cardiovascular disease (CVD) and all-cause mortality. However, there are few published direct comparisons of the several different available fibrinogen assays in association with CVD or mortality. We therefore prospectively compared the standardized von Clauss assay of clottable fibrinogen with three other assays: prothrombin time (PT)-derived clottable fibrinogen, immunonephelometric fibrinogen, and heat precipitable fibrinogen in the Scottish Heart Health Extended Cohort. Hazard ratios (HRs) for a standard deviation increase in fibrinogen for risk of CVD, adjusted for age and sex, were 1.17 (95% confidence interval [CI] 1.14; 1.21) for the von Clauss assay; 1.19 (1.06; 1.33) for the heat precipitation assay; 1.16 (1.01; 1.35) for the PT-derived assay; and 1.28 (1.10; 1.51) for the immunonephelometric assay. HRs for all-cause mortality were 1.21 (1.18; 1.24); 1.13 (1.01; 1.26), 1.17 (1.00; 1.37) and 1.17 (0.99; 1.39), respectively. No significant differences were observed between the assays in such comparisons. We therefore conclude that the choice between plasma fibrinogen assays in routine clinical haematology and biochemistry laboratories should depend on practical factors, and not on expected differences in the strength of associations.
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Vu TT, Stafford AR, Leslie BA, Kim PY, Fredenburgh JC, Weitz JI. Batroxobin binds fibrin with higher affinity and promotes clot expansion to a greater extent than thrombin. J Biol Chem 2013; 288:16862-16871. [PMID: 23612970 DOI: 10.1074/jbc.m113.464750] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Batroxobin is a thrombin-like serine protease from the venom of Bothrops atrox moojeni that clots fibrinogen. In contrast to thrombin, which releases fibrinopeptide A and B from the NH2-terminal domains of the Aα- and Bβ-chains of fibrinogen, respectively, batroxobin only releases fibrinopeptide A. Because the mechanism responsible for these differences is unknown, we compared the interactions of batroxobin and thrombin with the predominant γA/γA isoform of fibrin(ogen) and the γA/γ' variant with an extended γ-chain. Thrombin binds to the γ'-chain and forms a higher affinity interaction with γA/γ'-fibrin(ogen) than γA/γA-fibrin(ogen). In contrast, batroxobin binds both fibrin(ogen) isoforms with similar high affinity (Kd values of about 0.5 μM) even though it does not interact with the γ'-chain. The batroxobin-binding sites on fibrin(ogen) only partially overlap with those of thrombin because thrombin attenuates, but does not abrogate, the interaction of γA/γA-fibrinogen with batroxobin. Furthermore, although both thrombin and batroxobin bind to the central E-region of fibrinogen with a Kd value of 2-5 μM, the α(17-51) and Bβ(1-42) regions bind thrombin but not batroxobin. Once bound to fibrin, the capacity of batroxobin to promote fibrin accretion is 18-fold greater than that of thrombin, a finding that may explain the microvascular thrombosis that complicates envenomation by B. atrox moojeni. Therefore, batroxobin binds fibrin(ogen) in a manner distinct from thrombin, which may contribute to its higher affinity interaction, selective fibrinopeptide A release, and prothrombotic properties.
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Affiliation(s)
- Trang T Vu
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada; Departments of Medical Sciences, Hamilton, Ontario L8L 2X2, Canada
| | - Alan R Stafford
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada; Medicine, Hamilton, Ontario L8L 2X2, Canada
| | - Beverly A Leslie
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada; Medicine, Hamilton, Ontario L8L 2X2, Canada
| | - Paul Y Kim
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada; Medicine, Hamilton, Ontario L8L 2X2, Canada
| | - James C Fredenburgh
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada; Medicine, Hamilton, Ontario L8L 2X2, Canada
| | - Jeffrey I Weitz
- Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario L8L 2X2, Canada; Departments of Medical Sciences, Hamilton, Ontario L8L 2X2, Canada; Medicine, Hamilton, Ontario L8L 2X2, Canada; Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario L8L 2X2, Canada.
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Evidence that fibrinogen γ′ regulates plasma clot structure and lysis and relationship to cardiovascular risk factors in black Africans. Blood 2013; 121:3254-60. [DOI: 10.1182/blood-2012-12-471482] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Key Points
This paper describes the effect of fibrinogen γ′ on clot structure in plasma (previously shown in purified systems). This paper also describes the respective roles of total fibrinogen, fibrinogen γ′ concentration, and ratio on clot structure and lysis rates.
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35
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Rein-Smith CM, Anderson NW, Farrell DH. Differential regulation of fibrinogen γ chain splice isoforms by interleukin-6. Thromb Res 2012; 131:89-93. [PMID: 23036532 DOI: 10.1016/j.thromres.2012.09.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 09/14/2012] [Accepted: 09/20/2012] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Fibrinogen is a major structural protein in blood clots, and is also a well-known acute phase reactant. The γ chain gene of fibrinogen has two alternative splice variants, γA and γ' chains. γ' fibrinogen constitutes about 7% of total fibrinogen. Total fibrinogen levels and γ' fibrinogen levels have been associated with cardiovascular disease, but the mechanisms regulating the production of the two isoforms are unknown. Several inflammatory cytokines are known to influence the production of total fibrinogen, but the role of cytokines in the production of γ' fibrinogen has not been examined. However, epidemiologic studies have shown an association between γ' fibrinogen levels and inflammatory markers in humans. MATERIALS AND METHODS The expression of γ' fibrinogen and total fibrinogen by HepG2 liver cells was quantitated after treatment with interleukin-1β, transforming growth factor-β, tumor necrosis factor-α, and interleukin-6. RESULTS Interleukin-1β, transforming growth factor-β, and tumor necrosis factor-α, known down-regulators of total fibrinogen synthesis, also downregulate γ' fibrinogen synthesis in HepG2 cells. However, interleukin-6 differentially up-regulates the production of total and γ' fibrinogen, leading to a 3.6-fold increase in γA mRNA, but an 8.3-fold increase in γ' mRNA. CONCLUSIONS These findings indicate that γ' fibrinogen is disproportionately up-regulated by inflammatory responses induced by interleukin-6.
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Affiliation(s)
- Chantelle M Rein-Smith
- Department of Molecular and Medical Genetics, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, USA
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Santos-González M, López-Miranda J, Pérez-Jiménez F, Navas P, Villalba JM. Dietary oil modifies the plasma proteome during aging in the rat. AGE (DORDRECHT, NETHERLANDS) 2012; 34:341-58. [PMID: 21472381 PMCID: PMC3312633 DOI: 10.1007/s11357-011-9239-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Accepted: 03/15/2011] [Indexed: 05/05/2023]
Abstract
Fatty acids and other components of the diet may modulate, among others, mechanisms involved in homeostasis, aging, and age-related diseases. Using a proteomic approach, we have studied how dietary oil affected plasma proteins in young (6 months) or old (24 months) rats fed lifelong with two experimental diets enriched in either sunflower or virgin olive oil. After the depletion of the most abundant proteins, levels of less abundant proteins were studied using two-dimensional electrophoresis and mass spectrometry. Our results showed that compared with the sunflower oil diet, the virgin olive oil diet induced significant decreases of plasma levels of acute phase proteins such as inter-alpha inhibitor H4P heavy chain (at 6 months), hemopexin precursor (at 6 and 24 months), preprohaptoglobin precursor (at 6 and 24 months), and α-2-HS glycoprotein (at 6 and 24 months); antioxidant proteins such as type II peroxiredoxin (at 24 months); proteins related with coagulation such as fibrinogen γ-chain precursor (at 24 months), T-kininogen 1 precursor (at 6 and 24 months), and apolipoprotein H (at 6 and 24 months); or with lipid metabolism and transport such as apolipoprotein E (at 6 and 24 months) and apolipoprotein A-IV (at 24 months). The same diet increased the levels of apolipoprotein A-1 (at 6 and 24 months), diminishing in general the changes that occurred with age. Our unbiased analysis reinforces the beneficial role of a diet rich in virgin olive oil compared with a diet rich in sunflower oil, modulating inflammation, homeostasis, oxidative stress, and cardiovascular risk during aging.
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Affiliation(s)
- Mónica Santos-González
- Departamento de Biología Celular, Fisiología e Inmunología, University of Córdoba, Campus Rabanales Ed. Severo Ochoa, 3a planta, 14014 Córdoba, Spain
| | - José López-Miranda
- Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain
| | - Francisco Pérez-Jiménez
- Lipid and Atherosclerosis Unit, IMIBIC/Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Córdoba, Spain
| | - Plácido Navas
- Centro Andaluz de Biología del Desarrollo (CABD), University Pablo de Olavide-CSIC, Seville, Spain
- CIBER Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Sevilla, Spain
| | - José M. Villalba
- Departamento de Biología Celular, Fisiología e Inmunología, University of Córdoba, Campus Rabanales Ed. Severo Ochoa, 3a planta, 14014 Córdoba, Spain
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Silvain J, Pena A, Vignalou JB, Hulot JS, Galier S, Cayla G, Bellemain-Appaix A, Barthélémy O, Beygui F, Bal-dit-Sollier C, Drouet L, Weisel JW, Montalescot G, Collet JP. FXIII-A Leu34 genetic variant in premature coronary artery disease: a genotype--phenotype case control study. Thromb Haemost 2011; 106:511-20. [PMID: 21800001 DOI: 10.1160/th11-01-0027] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Accepted: 05/22/2011] [Indexed: 11/05/2022]
Abstract
The FXIII-A Leu34 genetic variant increases and accelerates fibrin stabilisation; however, its association with premature coronary artery disease (CAD) and thrombotic events remains controversial. FXIII Val34Leu genotype was determined in 242 young individuals (<45 years old) who survived a myocardial infarction (MI) and 242 healthy controls matched for age and gender. We evaluated its effect on long-term clinical outcome defined as a composite of cardiovascular death, recurrent MI and urgent revascularisation. In addition, fibrin clot stiffness (elastic modulus or EM) and response to rt-PA-mediated fibrinolysis (fibrinolysis rate) were measured ex vivo using the Hemodyne analyser and confocal microscopy as surrogate endpoint. FXIII-A Leu34 genetic variant was not associated with premature CAD (adj. odds ratio 0.83 [0.49-1.4]) nor did it influence clinical outcome in patients, during a median follow-up of 6.3 (± 2.4) years. Patients produced stiffer fibrin clots (median [IQR] EM = 20.3 [14.9-28.1] vs. 12.8 [9.6-17.1] kdynes/cm²; p<0.0001) and displayed reduced response to fibrinolysis with lower fibrinolysis rate (6.7 [3.4-11.0] vs. 9.0 [5.0-16.7] sec-¹ x 10(-4); p<0.0001) than healthy controls. Carriage of factor XIII-A Leu34 led to a stepwise decrease in fibrinolysis rate with a significant gene-dose-effect in patients (7.7 [4.1-12.2] vs. 4.8 [3.0-8.5] vs. 4.3 [2.4-8.1] sec-¹ x 10(-4), for wild-type, heterozygous and homozygous, p for trend = 0.003) and a non-significant trend in controls (p = 0.01). In conclusion, FXIII-A Leu34 is a polymorphism which provides a strong resistance to fibrinolysis with a gene-dose effect, but does not relate to premature CAD or to recurrent coronary events in this study.
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Affiliation(s)
- Johanne Silvain
- Institut de Cardiologie, INSERM UMRS 937, Pitié-Salpêtrière Hospital, AP-HP, Université Paris 6, Paris, France
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Lovely RS, Yang Q, Massaro JM, Wang J, D'Agostino RB, O'Donnell CJ, Shannon J, Farrell DH. Assessment of genetic determinants of the association of γ' fibrinogen in relation to cardiovascular disease. Arterioscler Thromb Vasc Biol 2011; 31:2345-52. [PMID: 21757653 DOI: 10.1161/atvbaha.111.232710] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE γ' fibrinogen is a newly emerging biomarker that is associated with cardiovascular disease (CVD). However, the genetic determinants of γ' fibrinogen levels are unknown. We therefore conducted a genome-wide association study on 3042 participants from the Framingham Heart Study Offspring Cohort. METHODS AND RESULTS A genome-wide association study with 2.5 million single-nucleotide polymorphisms (SNPs) was carried out for γ' fibrinogen levels from the cycle 7 examination. Fifty-four SNPs in or near the fibrinogen gene locus demonstrated genome-wide significance (P<5.0×10(-8)) for association with γ' fibrinogen levels. The top-signal SNP was rs7681423 (P=9.97×10(-110)) in the fibrinogen gene locus near FGG, which encodes the γ chain. Conditional on the top SNP, the only other SNP that remained genome-wide significant was rs1049636. Associations between SNPs, γ' fibrinogen levels, and prevalent CVD events were examined using multiple logistic regression. γ' fibrinogen levels were associated with prevalent CVD (P=0.02), although the top 2 SNPs associated with γ' fibrinogen levels were not associated with CVD. These findings contrast those for total fibrinogen levels, which are associated with different genetic loci, particularly FGB, which encodes the Bβ chain. CONCLUSIONS γ' fibrinogen is associated with prevalent CVD and with SNPs exclusively in and near the fibrinogen gene locus.
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Affiliation(s)
- Rehana S Lovely
- Department of Biomedical Sciences, Missouri State University, Springfield, USA
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Vu TT, Stafford AR, Leslie BA, Kim PY, Fredenburgh JC, Weitz JI. Histidine-rich glycoprotein binds fibrin(ogen) with high affinity and competes with thrombin for binding to the gamma'-chain. J Biol Chem 2011; 286:30314-30323. [PMID: 21757718 DOI: 10.1074/jbc.m111.253831] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Histidine-rich glycoprotein (HRG) is an abundant protein that binds fibrinogen and other plasma proteins in a Zn(2+)-dependent fashion but whose function is unclear. HRG has antimicrobial activity, and its incorporation into fibrin clots facilitates bacterial entrapment and killing and promotes inflammation. Although these findings suggest that HRG contributes to innate immunity and inflammation, little is known about the HRG-fibrin(ogen) interaction. By immunoassay, HRG-fibrinogen complexes were detected in Zn(2+)-supplemented human plasma, a finding consistent with a high affinity interaction. Surface plasmon resonance determinations support this concept and show that in the presence of Zn(2+), HRG binds the predominant γ(A)/γ(A)-fibrinogen and the γ-chain elongated isoform, γ(A)/γ'-fibrinogen, with K(d) values of 9 nm. Likewise, (125)I-labeled HRG binds γ(A)/γ(A)- or γ(A)/γ'-fibrin clots with similar K(d) values when Zn(2+) is present. There are multiple HRG binding sites on fibrin(ogen) because HRG binds immobilized fibrinogen fragment D or E and γ'-peptide, an analog of the COOH terminus of the γ'-chain that mediates the high affinity interaction of thrombin with γ(A)/γ'-fibrin. Thrombin competes with HRG for γ'-peptide binding and displaces (125)I-HRG from γ(A)/γ'-fibrin clots and vice versa. Taken together, these data suggest that (a) HRG circulates in complex with fibrinogen and that the complex persists upon fibrin formation, and (b) by competing with thrombin for γ(A)/γ'-fibrin binding, HRG may modulate coagulation. Therefore, the HRG-fibrin interaction may provide a novel link between coagulation, innate immunity, and inflammation.
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Affiliation(s)
- Trang T Vu
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario L8L 2X2, Canada; the Departments of Medical Sciences, McMaster University, Hamilton, Ontario L8L 2X2, Canada
| | - Alan R Stafford
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario L8L 2X2, Canada; Medicine, McMaster University, Hamilton, Ontario L8L 2X2, Canada
| | - Beverly A Leslie
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario L8L 2X2, Canada; Medicine, McMaster University, Hamilton, Ontario L8L 2X2, Canada
| | - Paul Y Kim
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario L8L 2X2, Canada; Medicine, McMaster University, Hamilton, Ontario L8L 2X2, Canada
| | - James C Fredenburgh
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario L8L 2X2, Canada; Medicine, McMaster University, Hamilton, Ontario L8L 2X2, Canada
| | - Jeffrey I Weitz
- Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario L8L 2X2, Canada; the Departments of Medical Sciences, McMaster University, Hamilton, Ontario L8L 2X2, Canada; Medicine, McMaster University, Hamilton, Ontario L8L 2X2, Canada.
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Fibrinogen β-derived Bβ(15-42) peptide protects against kidney ischemia/reperfusion injury. Blood 2011; 118:1934-42. [PMID: 21685370 DOI: 10.1182/blood-2011-02-338061] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Ischemia/reperfusion (I/R) injury in the kidney is a major cause of acute kidney injury (AKI) in humans and is associated with significantly high mortality. To identify genes that modulate kidney injury and repair, we conducted genome-wide expression analysis in the rat kidneys after I/R and found that the mRNA levels of fibrinogen (Fg)α, Fgβ, and Fgγ chains significantly increase in the kidney and remain elevated throughout the regeneration process. Cellular characterization of Fgα and Fgγ chain immunoreactive proteins shows a predominant expression in renal tubular cells and the localization of immunoreactive Fgβ chain protein is primarily in the renal interstitium in healthy and regenerating kidney. We also show that urinary excretion of Fg is massively increased after kidney damage and is capable of distinguishing human patients with acute or chronic kidney injury (n = 25) from healthy volunteers (n = 25) with high sensitivity and specificity (area under the receiver operating characteristic of 0.98). Furthermore, we demonstrate that Fgβ-derived Bβ(15-42) peptide administration protects mice from I/R-induced kidney injury by aiding in epithelial cell proliferation and tissue repair. Given that kidney regeneration is a major determinant of outcome for patients with kidney damage, these results provide new opportunities for the use of Fg in diagnosis, prevention, and therapeutic interventions in kidney disease.
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Smith NL, Huffman JE, Strachan DP, Huang J, Dehghan A, Trompet S, Lopez LM, Shin SY, Baumert J, Vitart V, Bis JC, Wild SH, Rumley A, Yang Q, Uitterlinden AG, Stott DJ, Davies G, Carter AM, Thorand B, Polašek O, McKnight B, Campbell H, Rudnicka AR, Chen MH, Buckley BM, Harris SE, Peters A, Pulanic D, Lumley T, de Craen AJM, Liewald DC, Gieger C, Campbell S, Ford I, Gow AJ, Luciano M, Porteous DJ, Guo X, Sattar N, Tenesa A, Cushman M, Slagboom PE, Visscher PM, Spector TD, Illig T, Rudan I, Bovill EG, Wright AF, McArdle WL, Tofler G, Hofman A, Westendorp RGJ, Starr JM, Grant PJ, Karakas M, Hastie ND, Psaty BM, Wilson JF, Lowe GDO, O'Donnell CJ, Witteman JCM, Jukema JW, Deary IJ, Soranzo N, Koenig W, Hayward C. Genetic predictors of fibrin D-dimer levels in healthy adults. Circulation 2011; 123:1864-72. [PMID: 21502573 DOI: 10.1161/circulationaha.110.009480] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Fibrin fragment D-dimer, one of several peptides produced when crosslinked fibrin is degraded by plasmin, is the most widely used clinical marker of activated blood coagulation. To identity genetic loci influencing D-dimer levels, we performed the first large-scale, genome-wide association search. METHODS AND RESULTS A genome-wide investigation of the genomic correlates of plasma D-dimer levels was conducted among 21 052 European-ancestry adults. Plasma levels of D-dimer were measured independently in each of 13 cohorts. Each study analyzed the association between ≈2.6 million genotyped and imputed variants across the 22 autosomal chromosomes and natural-log–transformed D-dimer levels using linear regression in additive genetic models adjusted for age and sex. Among all variants, 74 exceeded the genome-wide significance threshold and marked 3 regions. At 1p22, rs12029080 (P=6.4×10(-52)) was 46.0 kb upstream from F3, coagulation factor III (tissue factor). At 1q24, rs6687813 (P=2.4×10(-14)) was 79.7 kb downstream of F5, coagulation factor V. At 4q32, rs13109457 (P=2.9×10(-18)) was located between 2 fibrinogen genes: 10.4 kb downstream from FGG and 3.0 kb upstream from FGA. Variants were associated with a 0.099-, 0.096-, and 0.061-unit difference, respectively, in natural-log–transformed D-dimer and together accounted for 1.8% of the total variance. When adjusted for nonsynonymous substitutions in F5 and FGA loci known to be associated with D-dimer levels, there was no evidence of an additional association at either locus. CONCLUSIONS Three genes were associated with fibrin D-dimer levels. Of these 3, the F3 association was the strongest, and has not been previously reported.
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Affiliation(s)
- Nicholas L Smith
- Department of Epidemiology, University of Washington, Seattle 98101, USA.
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Alexander KS, Madden TE, Farrell DH. Association between γ' fibrinogen levels and inflammation. Thromb Haemost 2010; 105:605-9. [PMID: 21174007 DOI: 10.1160/th10-09-0626] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 12/11/2010] [Indexed: 11/05/2022]
Abstract
The γ' fibrinogen isoform produces clots that are stiffer and more resistant to breakdown than the more common fibrinogen isoform, γA. Increased levels of γ' fibrinogen are associated with several forms of cardiovascular disease. The purpose of this cross-sectional study was to investigate the relationship between γ' fibrinogen, an emerging risk factor for cardiovascular disease, and inflammatory markers in subjects with a chronic inflammatory state. The 284 subjects for this study came from the Periodontitis And Vascular Events (PAVE) study, and γ' fibrinogen and total fibrinogen in plasma were measured by ELISA. Information on patient demographics and health status, as well as levels of C-reactive protein (CRP), an inflammatory marker, have previously been collected for this study. The mean (SE) γ' fibrinogen level in the subjects was 0.622 (0.017) mg/ml. Levels of γ' fibrinogen were correlated with CRP (p = 0.006), with a one unit increase in CRP associated with a 1.9% increase in γ' fibrinogen, after adjustment for potential confounders. Total fibrinogen was not correlated with γ' fibrinogen in these subjects. The number of dental sites with evidence of tissue inflammation was also significantly associated with γ' fibrinogen levels. These results provide an important step in the evolution of γ' fibrinogen not only as a general risk factor for cardiovascular disease, but as a potentially useful biomarker for assessing a patient's inflammatory state and associated cardiovascular disease risk.
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Affiliation(s)
- Kristine S Alexander
- Department of Molecular and Medical Genetics, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
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