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Zdenek CN, Rodrigues CFB, Bourke LA, Tanaka-Azevedo AM, Monagle P, Fry BG. Children and Snakebite: Snake Venom Effects on Adult and Paediatric Plasma. Toxins (Basel) 2023; 15:158. [PMID: 36828472 PMCID: PMC9961128 DOI: 10.3390/toxins15020158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/26/2023] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
Snakebite is a globally neglected tropical disease, with coagulation disturbances being the primary pathology of many deadly snake venoms. Age-related differences in human plasma have been abundantly reported, yet the effect that these differences pose regarding snakebite is largely unknown. We tested for differences in coagulotoxic effects (via clotting time) of multiple snake venoms upon healthy human adult (18+) and paediatric (median 3.3 years old) plasma in vivo and compared these effects to the time it takes the plasmas to clot without the addition of venom (the spontaneous clotting time). We tested venoms from 15 medically significant snake species (from 13 genera) from around the world with various mechanisms of coagulotoxic actions, across the three broad categories of procoagulant, pseudo-procoagulant, and anticoagulant, to identify any differences between the two plasmas in their relative pathophysiological vulnerability to snakebite. One procoagulant venom (Daboia russelii, Russell's Viper) produced significantly greater potency on paediatric plasma compared with adult plasma. In contrast, the two anticoagulant venoms (Pseudechis australis, Mulga Snake; and Bitis cornuta, Many-horned Adder) were significantly more potent on adult plasma. All other procoagulant venoms and all pseudo-procoagulant venoms displayed similar potency across both plasmas. Our preliminary results may inform future studies on the effect of snake venoms upon plasmas from different age demographics and hope to reduce the burden of snakebite upon society.
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Affiliation(s)
- Christina N. Zdenek
- Venom Evolution Lab, School of Biological Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | | | - Lachlan A. Bourke
- Venom Evolution Lab, School of Biological Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Anita Mitico Tanaka-Azevedo
- Laboratório de Herpetologia, Instituto Butantan, São Paulo 05508-040, SP, Brazil
- Programa de Pós-Graduação Interunidades Em Biotecnologia, USP, IPT e Instituto Butantan, São Paulo 05508-040, SP, Brazil
| | - Paul Monagle
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3010, Australia
- Haematology Research, Murdoch children’s Research Institute, Flemington Rd., Parkville, VIC 3052, Australia
- Department of Clinical Haematology, Royal Children’s Hospital, Flemington Rd., Parkville, VIC 3052, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, High St., Randwick, NSW 2031, Australia
| | - Bryan G. Fry
- Venom Evolution Lab, School of Biological Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
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Chen Z, Dai X, Cao J, Tan X, Chen S, Yu M. Reference intervals for coagulation tests in adults with different ABO blood types. J Clin Lab Anal 2022; 36:e24269. [PMID: 35119133 PMCID: PMC8906010 DOI: 10.1002/jcla.24269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/15/2022] [Accepted: 01/21/2022] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Coagulation tests are affected by many factors, such as age, race, and gestation. Although coagulation test results vary by ABO blood type, reference intervals of different ABO blood groups remain to be determined. This study aims to investigate the reference ranges of coagulation tests for different ABO blood groups in the Han population in South China. METHODS A retrospective study was conducted in the First Affiliated Hospital of Shantou University Medical College. In all, 9600 individuals aged between 20 and 79 years were included. Coagulation tests, including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), thrombin time, and fibrinogen, were performed. RESULTS There was a significant difference in PT, INR, and aPTT among ABO blood groups. PT and INR varied slightly between ABO blood groups. There was a higher aPTT value in individuals in the O blood group than in those in non-O blood groups, in both males and females across the included age range. No differences were found in thrombin time and fibrinogen between the ABO blood groups. CONCLUSION The study provides reference data on coagulation tests from ABO blood groups in South China. The established reference intervals specific to ABO blood type, sex, and age may improve clinical decisions based on coagulation tests.
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Affiliation(s)
- Zeliang Chen
- Department of CardiologyThe First Affiliated HospitalShantou University Medical CollegeShantouChina
| | - Xiaoqing Dai
- Department of CardiologyThe First Affiliated HospitalShantou University Medical CollegeShantouChina
| | - Jing Cao
- Department of CardiologyThe First Affiliated HospitalShantou University Medical CollegeShantouChina
| | - Xuerui Tan
- Department of CardiologyThe First Affiliated HospitalShantou University Medical CollegeShantouChina
| | - Shuying Chen
- Department of CardiologyThe First Affiliated HospitalShantou University Medical CollegeShantouChina
| | - Min Yu
- Department of CardiologyThe First Affiliated HospitalShantou University Medical CollegeShantouChina
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Association of ABO blood group with bleeding severity in patients with bleeding of unknown cause. Blood Adv 2021; 4:5157-5164. [PMID: 33095871 DOI: 10.1182/bloodadvances.2020002452] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 09/08/2020] [Indexed: 12/22/2022] Open
Abstract
Blood group O has been associated with an increased bleeding tendency due to lower von Willebrand factor (VWF) and factor VIII (FVIII) levels. We explored whether blood group O is independently associated with bleeding severity in patients with mild-to-moderate bleeding of unknown cause (BUC) in the Vienna Bleeding Biobank cohort. Bleeding severity was recorded with the Vicenza bleeding score (BS). Blood group O was overrepresented in 422 patients with BUC compared with its presence in 23 145 healthy blood donors (47.2% vs 37.6%; odds ratio, 1.48; 95% confidence interval [CI], 1.22-1.79). The BS and the number of bleeding symptoms were significantly higher in patients with blood group O than in patients with non-O after adjustment for VWF and FVIII levels and sex (least-square [LS] means of BSs: 6.2; 95% CI, 5.8-6.6 vs 5.3; 4.9-5.7; and of number of symptoms: LS, 3.5; 95% CI, 3.2-3.7 vs 3.0; 2.8-3.2, respectively). Oral mucosal bleeding was more frequent in those with blood group O than in those with other blood types (group non-O; 26.1% vs 14.3%), independent of sex and VWF and FVIII levels, whereas other bleeding symptoms did not differ. Patients with blood group O had increased clot density in comparison with those with blood group non-O, as determined by rotational thromboelastometry and turbidimetric measurement of plasma clot formation. There were no differences in thrombin generation, clot lysis, or platelet function. Our data indicate that blood group O is a risk factor for increased bleeding and bleeding severity in patients with BUC, independent of VWF and FVIII levels.
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Ravanat C, Dupuis A, Marpaux N, Naegelen C, Mourey G, Isola H, Laforêt M, Morel P, Gachet C. In vitro
quality of amotosalen‐
UVA
pathogen‐inactivated mini‐pool plasma prepared from whole blood stored overnight. Vox Sang 2018; 113:622-631. [DOI: 10.1111/vox.12697] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Catherine Ravanat
- Université de Strasbourg INSERM EFS Grand‐Est BPPS UMR‐S1255 FMTS Strasbourg France
| | - Arnaud Dupuis
- Université de Strasbourg INSERM EFS Grand‐Est BPPS UMR‐S1255 FMTS Strasbourg France
| | | | | | - Guillaume Mourey
- EFS Bourgogne‐Franche‐Comté UMR1098 Besançon France
- Université Bourgogne Franche Comté INSERM EFS Bourgogne‐Franche‐Comté UMR1098 Besançon France
| | - Herve Isola
- Université de Strasbourg INSERM EFS Grand‐Est BPPS UMR‐S1255 FMTS Strasbourg France
| | - Michel Laforêt
- Université de Strasbourg INSERM EFS Grand‐Est BPPS UMR‐S1255 FMTS Strasbourg France
| | - Pascal Morel
- EFS Bourgogne‐Franche‐Comté UMR1098 Besançon France
- Université Bourgogne Franche Comté INSERM EFS Bourgogne‐Franche‐Comté UMR1098 Besançon France
| | - Christian Gachet
- Université de Strasbourg INSERM EFS Grand‐Est BPPS UMR‐S1255 FMTS Strasbourg France
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Sinegre T, Duron C, Lecompte T, Pereira B, Massoulier S, Lamblin G, Abergel A, Lebreton A. Increased factor VIII plays a significant role in plasma hypercoagulability phenotype of patients with cirrhosis. J Thromb Haemost 2018; 16:1132-1140. [PMID: 29577605 DOI: 10.1111/jth.14011] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Indexed: 12/14/2022]
Abstract
Essentials The role of increased factor VIII in cirrhosis-induced hypercoagulability has never been demonstrated. Factor VIII and protein C effects were characterized by thrombin generation with thrombomodulin. Factor VIII elevation plays a significant role in cirrhosis-induced plasma hypercoagulability. Only protein C and factor VIII normalization led to thrombin generation similar to controls. SUMMARY Background In cirrhosis, thrombin generation (TG) studied in the presence of thrombomodulin (TM) indicates plasma hypercoagulability. Although the role of protein C (PC) deficiency has been investigated, the influence of an increase in the factor VIII level has never been addressed. Objectives We investigated the roles of high FVIII and low PC levels in increased TG in the presence of TM. Methods Blood samples were prospectively collected from 35 healthy controls and 93 patients with cirrhosis (Child-Turcotte-Pugh [CTP]-A, n = 61; CTP-B, n = 19; and CTP-C, n = 13) and FVIII levels > 150% (n = 48) and/or PC levels < 70% (n = 88). TG was performed with tissue factor (5 pm), phospholipids, and TM (4 nm). FVIII and PC levels were normalized by adding an inhibitory anti-FVIII antibody and exogenous PC, respectively. Results The endogenous thrombin potential (ETP) in the presence of TM was higher in patients than in controls. After FVIII normalization, the ETP (median) decreased from 929 nm min to 621 nm min (CTP-A), 1122 nm min to 1082 nm min (CTP-B), and 1221 nm min to 1143 nm min (CTP-C); after PC normalization, it decreased from 776 nm min to 566 nm min (CTP-A), 1120 nm min to 790 nm min (CTP-B), and 995 nm min to 790 nm min (CTP-C). The ETP was reduced by 17% and 30%, respectively, but normal TG was not restored. When both FVIII and PC levels were normalized, the ETP decreased from 929 nm min to 340 nm min (CTP-A), 1122 nm min to 506 nm min (CTP-B), and 1226 nm min to 586 nm min (CTP-C), becoming similar to control levels. Conclusion Cirrhosis-induced plasma hypercoagulability, as demonstrated in these experimental conditions, can be partly explained by opposite changes in two factors: PC level (decrease) and FVIII level (increase).
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Affiliation(s)
- T Sinegre
- Service d'Hématologie Biologique, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Université Clermont Auvergne, INRA, UMR 1019, Clermont-Ferrand, France
| | - C Duron
- Service d'Hépato-Gastro-Entérologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Université Clermont Auvergne, CNRS, UMR 6284, Clermont-Ferrand, France
| | - T Lecompte
- Hôpitaux Universitaires de Genève, Unité d'hémostase, Département des spécialités de médecine, Geneva, Switzerland
- Université de Genève, GpG, Geneva, Switzerland
| | - B Pereira
- CHU Clermont-Ferrand, Unité de Biostatistiques (Direction de la recherche clinique et de l'innovation), Clermont-Ferrand, France
| | - S Massoulier
- Service d'Hépato-Gastro-Entérologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - G Lamblin
- Service d'Hépato-Gastro-Entérologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - A Abergel
- Service d'Hépato-Gastro-Entérologie, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Université Clermont Auvergne, CNRS, UMR 6284, Clermont-Ferrand, France
| | - A Lebreton
- Service d'Hématologie Biologique, CHU Clermont-Ferrand, Clermont-Ferrand, France
- Université Clermont Auvergne, INRA, UMR 1019, Clermont-Ferrand, France
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Liu X, Chen X, Yang J, Guo R. Association of ABO blood groups with von Willebrand factor, factor VIII and ADAMTS-13 in patients with lung cancer. Oncol Lett 2017; 14:3787-3794. [PMID: 28927148 DOI: 10.3892/ol.2017.6619] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/31/2017] [Indexed: 02/05/2023] Open
Abstract
Coagulative and fibrinolytic disorders appear to be associated with the development of lung cancer. The aim of the present study was to determine plasma levels of von Willebrand factor (VWF) and a disintegrin and metalloproteinase with a thrombospondin type 1 motif 13 (ADAMTS-13), and factor VIII (FVIII) activity, in association with O and non-O blood groups in patients with lung cancer. Plasma levels of VWF and ADAMTS-13, and FVIII activity were measured in 115 patients with lung cancer and 98 healthy subjects. Phenotyping of the ABO blood groups was also performed for the two groups. Significantly increased VWF levels and FVIII activity, as well as significantly decreased ADAMTS-13 levels, were observed in patients with distant metastasis as compared with those without distant metastasis and the healthy controls. Plasma VWF levels and FVIII activity were significantly increased in subjects with non-O type blood compared with those with type O blood in the two groups. However, a significant decrease in ADAMTS-13 levels was observed only in the control group among those with non-O type blood, compared with those with type O blood. The results of the present study indicate that increased VWF and decreased ADAMTS-13 levels facilitate the invasiveness and metastasis of lung cancer. Non-O blood groups constitute a risk factor for increased VWF and FVIII in plasma. Continued monitoring of VWF and ADAMTS-13 levels, and of FVIII activity in patients with lung cancer with distinct blood groups may help to minimize the incidence of thrombotic events and improve assessment of disease progression.
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Affiliation(s)
- Xia Liu
- Department of Intensive Care Unit, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiaogang Chen
- Department of Laboratory Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Jiezuan Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Renyong Guo
- Department of Laboratory Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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Vojacek JF. Should We Replace the Terms Intrinsic and Extrinsic Coagulation Pathways With Tissue Factor Pathway? Clin Appl Thromb Hemost 2016; 23:922-927. [PMID: 28301900 DOI: 10.1177/1076029616673733] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Present review highlights some new aspects of the role of individual components of blood coagulation process and proposes a modified concept of hemocoagulation cascade. The role of FXII in the initiation of the so-called intrinsic coagulation system is currently questioned. Its role has been recently demonstrated mainly in the thrombus propagation and final stabilization together with factors XI and XIII. The edited concept underlines the common part of the tissue factor (TF) in the initiation of both the intrinsic and extrinsic pathways of the coagulation system and therefore may make it not improperly be called the TF coagulation pathway. The search for new antithrombotic agents shows that the level of the coagulation system blockade depends on which step in the coagulation cascade is targeted and results in different degrees of the antithrombotic efficiency and the risk of bleeding complications.
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Affiliation(s)
- Jan F Vojacek
- 1 Department of Cardiovascular Medicine I, Charles University Prague, School of Medicine and University Hospital, Hradec Kralove, Czech Republic
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Kremers RMW, Mohamed ABO, Pelkmans L, Hindawi S, Hemker HC, de Laat HB, Huskens D, Al Dieri R. Thrombin Generating Capacity and Phenotypic Association in ABO Blood Groups. PLoS One 2015; 10:e0141491. [PMID: 26509437 PMCID: PMC4624869 DOI: 10.1371/journal.pone.0141491] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/07/2015] [Indexed: 01/28/2023] Open
Abstract
Individuals with blood group O have a higher bleeding risk than non-O blood groups. This could be explained by the lower levels of FVIII and von Willebrand Factor (VWF) levels in O individuals. We investigated the relationship between blood groups, thrombin generation (TG), prothrombin activation and thrombin inactivation. Plasma levels of VWF, FVIII, antithrombin, fibrinogen, prothrombin and α2Macroglobulin (α2M) levels were determined. TG was measured in platelet rich (PRP) and platelet poor plasma (PPP) of 217 healthy donors and prothrombin conversion and thrombin inactivation were calculated. VWF and FVIII levels were lower (75% and 78%) and α2M levels were higher (125%) in the O group. TG is 10% lower in the O group in PPP and PRP. Less prothrombin was converted in the O group (86%) and the thrombin decay capacity was lower as well. In the O group, α2M plays a significantly larger role in the inhibition of thrombin (126%). In conclusion, TG is lower in the O group due to lower prothrombin conversion, and a larger contribution of α2M to thrombin inactivation. The former is unrelated to platelet function because it is similar in PRP and PPP, but can be explained by the lower levels of FVIII.
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Affiliation(s)
- Romy M. W. Kremers
- Synapse, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- * E-mail:
| | - Abdulrahman B. O. Mohamed
- Synapse, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- Department of Pharmacology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Leonie Pelkmans
- Synapse, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Salwa Hindawi
- Department of Haematology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - H. Coenraad Hemker
- Synapse, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - H. Bas de Laat
- Synapse, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Dana Huskens
- Synapse, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Raed Al Dieri
- Synapse, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, the Netherlands
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