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Scarlatescu E, Kim PY, Marchenko SP, Tomescu DR. Validation of the time to attain maximal clot amplitude after reaching maximal clot formation velocity parameter as a measure of fibrinolysis using rotational thromboelastometry and its application in the assessment of fibrinolytic resistance in septic patients: a prospective observational study: communication from the ISTH SSC Subcommittee on Fibrinolysis. J Thromb Haemost 2024; 22:1223-1235. [PMID: 38104723 DOI: 10.1016/j.jtha.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 11/12/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND In sepsis, fibrinolysis resistance correlates with worse outcomes. Practically, rotational thromboelastometry (ROTEM) is used to report residual clot amplitude relative to maximum amplitude at specified times after clot formation clot lysis indices (CLIs). However, healthy individuals can exhibit similar CLIs, thus making it challenging to solely diagnose the low fibrinolytic state. Furthermore, CLI does not include the kinetics of clot formation, which can affect overall fibrinolysis. Therefore, a more nuanced analysis, such as time to attain maximal clot amplitude after reaching maximal clot formation velocity (t-AUCi), is needed to better identify fibrinolysis resistance in sepsis. OBJECTIVES To evaluate the correlation between the degree of fibrinolytic activation and t-AUCi in healthy or septic individuals. METHODS Whole blood (n = 60) from septic or healthy donors was analyzed using tissue factor-activated (EXTEM) and nonactivated (NATEM) ROTEM assays. Lysis was initiated with tissue-type plasminogen activator, and CLI and t-AUCi were calculated. Standard coagulation tests and plasma fibrinolysis markers (D-dimer, plasmin-α2-antiplasmin complex, plasminogen activator inhibitor type 1, and plasminogen) were also measured. RESULTS t-AUCi values decreased with increasing fibrinolytic activity and correlated positively with CLI for different degrees of clot lysis both in EXTEM and NATEM. t-AUCi cutoff value of 1962.0 seconds in EXTEM predicted low fibrinolytic activity with 81.8% sensitivity and 83.7% specificity. In addition, t-AUCi is not influenced by clot retraction. CONCLUSION Whole-blood point-of-care ROTEM analyses with t-AUCi offers a more rapid and parametric evaluation of fibrinolytic potential compared with CLI, which can be used for a more rapid and accurate diagnosis of fibrinolysis resistance in sepsis.
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Affiliation(s)
- Ecaterina Scarlatescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Anesthesia and Intensive Care III, Fundeni Clinical Institute, Bucharest, Romania.
| | - Paul Y Kim
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Thrombosis and Atherosclerosis Research Institute, Hamilton, Ontario, Canada
| | - Sergey P Marchenko
- Department of Cardiac Surgery, Pavlov First St. Petersburg Medical University, St. Petersburg, Russian Federation
| | - Dana R Tomescu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Department of Anesthesia and Intensive Care III, Fundeni Clinical Institute, Bucharest, Romania
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2
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Docampo R. Advances in the cellular biology, biochemistry, and molecular biology of acidocalcisomes. Microbiol Mol Biol Rev 2024; 88:e0004223. [PMID: 38099688 DOI: 10.1128/mmbr.00042-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024] Open
Abstract
SUMMARYAcidocalcisomes are organelles conserved during evolution and closely related to the so-called volutin granules of bacteria and archaea, to the acidocalcisome-like vacuoles of yeasts, and to the lysosome-related organelles of animal species. All these organelles have in common their acidity and high content of polyphosphate and calcium. They are characterized by a variety of functions from storage of phosphorus and calcium to roles in Ca2+ signaling, osmoregulation, blood coagulation, and inflammation. They interact with other organelles through membrane contact sites or by fusion, and have several enzymes, pumps, transporters, and channels.
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Affiliation(s)
- Roberto Docampo
- Department of Cellular Biology, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, USA
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3
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Peshkova AD, Weisel JW, Litvinov RI. A novel technique to quantify the kinetics of blood clot contraction based on the expulsion of fluorescently labeled albumin into serum. J Thromb Haemost 2024:S1538-7836(24)00114-4. [PMID: 38401713 DOI: 10.1016/j.jtha.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND The platelet-driven contraction or retraction of blood clots has been utilized to obtain blood serum for laboratory studies, but now, in vitro clot contraction assays are used in research laboratories and clinics to assess platelet functionality. The static final extent of clot contraction measured using a clot size or expelled serum volume can be supplemented substantially with a dynamic analysis. OBJECTIVES To provide a step-by-step protocol for a relatively simple and affordable new automated methodology to follow the kinetics of blood clot contraction, which allows for simultaneous measurements of various samples at a time and requires only a fluorescence plate reader. METHODS The kinetics of clot contraction in whole blood was assessed by continuously detecting the fluorescence intensity of fluorescein isothiocyanate-albumin added to a blood sample before clotting and expelled into the serum during clot shrinkage. RESULTS The clots are formed and fluorescence is measured in the wells of a black multiwell plate using a standard plate fluorescent reader. The specificity of this technique for clot contraction has been demonstrated by the strong inhibitory effects of blebbistatin, latrunculin A, and abciximab. To validate the new technique, increased fluorescence intensity in the contracting clots was measured in parallel with a visual decrease in clot size performed with the same blood samples. CONCLUSION The resulting clot contraction dynamics based on the expulsion of fluorescein isothiocyanate-albumin can be quantified using a number of kinetic parameters as well as a phase kinetics analysis. The advantages and drawbacks of the new technique are discussed.
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Affiliation(s)
- Alina D Peshkova
- Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - John W Weisel
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Rustem I Litvinov
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
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4
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Kovalenko TA, Panteleev MA, Sveshnikova AN. Different modeling approaches in the simulation of extrinsic coagulation factor X activation: Limitations and areas of applicability. Numer Methods Biomed Eng 2023; 39:e3689. [PMID: 36802118 DOI: 10.1002/cnm.3689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/16/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Proteolytic reactions on the phospholipid membrane surface, so-called "membrane-dependent" reactions, play central role in the process of blood clotting. One particularly important example is FX activation by the extrinsic tenase (VIIa/TF). Here we constructed three mathematical models of FX activation by VIIa/TF: (A) a homogeneous "well-mixed" model, (B) a two-compartment "well-mixed" model, (C) a heterogeneous model with diffusion, to investigate the impact and importance of inclusion of each complexity level. All models provided good description of the reported experimental data and were equivalently applicable for <40 μM of phospholipids. Model C provided better predictions than A, B in the presence of TF-negative phospholipid microparticles. Models predicted that for high TF surface density (STF ) and FX deficiency the FX activation rate was limited by the rate of FX binding to the membrane. For low STF and excess of FX the reaction rate was limited by the tenase formation rate. The analysis of the substrate delivery pathways revealed that FX bound to VIIa/TF predominantly from solution for STF >2.8 × 10-3 nmol/cm2 and from the membrane for lower STF . We proposed the experimental setting to distinguish between the collision-limited and non-collision-limited binding. The analysis of models in flow and non-flow conditions revealed that the model of a vesicle in flow might be substituted by model C in the absence of the substrate depletion. Together, this study was the first which provided the direct comparison of more simple and more complex models. The reaction mechanisms were studied in a wide range of conditions.
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Affiliation(s)
- Tatiana A Kovalenko
- Center for Theoretical Problems of Physico-Chemical Pharmacology, Russian Academy of Sciences, Moscow, Russia
- National Medical Research Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Moscow, Russia
| | - Mikhail A Panteleev
- Center for Theoretical Problems of Physico-Chemical Pharmacology, Russian Academy of Sciences, Moscow, Russia
- National Medical Research Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Moscow, Russia
- Faculty of Physics, Lomonosov Moscow State University, Moscow, Russia
| | - Anastasia N Sveshnikova
- Center for Theoretical Problems of Physico-Chemical Pharmacology, Russian Academy of Sciences, Moscow, Russia
- National Medical Research Centre of Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev, Moscow, Russia
- Faculty of Fundamental Physical and Chemical Engineering, Lomonosov Moscow State University, Moscow, Russia
- Department of Normal Physiology, Sechenov First Moscow State Medical University, Moscow, Russia
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Cheng KJ, De Lio AM, Jain R, Paul D, Morrissey JH, Pogorelov TV. Lactadherin's Multistate Binding Predicts Stable Membrane-Bound Conformations of Factors V and VIII's C Domains. Biochemistry 2023; 62:3020-3032. [PMID: 37747791 PMCID: PMC10903746 DOI: 10.1021/acs.biochem.3c00274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Protein binding to negatively charged lipids is essential for maintaining numerous vital cellular processes where its dysfunction can lead to various diseases. One such protein that plays a crucial role in this process is lactadherin, which competes with coagulation factors for membrane binding sites to regulate blood clotting. Despite identifying key binding regions of these proteins through structural and biochemical studies, models incorporating membrane dynamics are still lacking. In this study, we report on the multimodal binding of lactadherin and use it to gain insight into the binding mechanisms of its C domain homologs, factor V and factor VIII. Molecular dynamics simulations enhanced with the highly mobile mimetic model enabled the determination of lactadherin's multimodal binding on membranes that revealed critical interacting residues consistent with prior NMR and mutagenesis data. The binding occurred primarily via two dynamic structural ensembles: an inserted state and an unreported, highly conserved side-lying state driven by a cationic patch. We utilized these findings to analyze the membrane binding domains of coagulation factors V and VIII and identified their preferred membrane-bound conformations. Specifically, factor V's C domains maintained an inserted state, while factor VIII preferred a tilted, side-lying state that permitted antibody binding. Insight into lactadherin's atomistically resolved membrane interactions from a multistate perspective can guide new therapeutic opportunities in treating diseases related to blood coagulation.
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Affiliation(s)
- Kevin J Cheng
- Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Ashley M De Lio
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States
- National Center for Supercomputer Applications, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Riya Jain
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States
| | - Divyani Paul
- Department of Biological Chemistry, University of Michigan Medical School, Ann Arbor, Michigan 48109, United States
| | - James H Morrissey
- Department of Biological Chemistry, University of Michigan Medical School, Ann Arbor, Michigan 48109, United States
| | - Taras V Pogorelov
- Center for Biophysics and Quantitative Biology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States
- School of Chemical Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801, United States
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Evtugina NG, Peshkova AD, Khabirova AI, Andrianova IA, Abdullayeva S, Ayombil F, Shepeliuk T, Grishchuk EL, Ataullakhanov FI, Litvinov RI, Weisel JW. Activation of Piezo1 channels in compressed red blood cells augments platelet-driven contraction of blood clots. J Thromb Haemost 2023; 21:2418-2429. [PMID: 37268065 PMCID: PMC10949619 DOI: 10.1016/j.jtha.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/04/2023]
Abstract
BACKGROUND Piezo1 is a mechanosensitive cationic channel that boosts intracellular [Ca2+]i. Compression of red blood cells (RBCs) during platelet-driven contraction of blood clots may cause the activation of Piezo1. OBJECTIVES To establish relationships between Piezo1 activity and blood clot contraction. METHODS Effects of a Piezo1 agonist, Yoda1, and antagonist, GsMTx-4, on clot contraction in vitro were studied in human blood containing physiological [Ca2+]. Clot contraction was induced by exogenous thrombin. Activation of Piezo1 was assessed by Ca2+ influx in RBCs and with other functional and morphologic features. RESULTS Piezo1 channels in compressed RBCs are activated naturally during blood clot contraction and induce an upsurge in the intracellular [Ca2+]i, followed by phosphatidylserine exposure. Adding the Piezo1 agonist Yoda1 to whole blood increased the extent of clot contraction due to Ca2+-dependent volumetric shrinkage of RBCs and increased platelet contractility due to their hyperactivation by the enhanced generation of endogenous thrombin on activated RBCs. Addition of rivaroxaban, the inhibitor of thrombin formation, or elimination of Ca2+ from the extracellular space abrogated the stimulating effect of Yoda1 on clot contraction. The Piezo1 antagonist, GsMTx-4, caused a decrease in the extent of clot contraction relative to the control both in whole blood and in platelet-rich plasma. Activated Piezo1 in compressed and deformed RBCs amplified the platelet contractility as a positive feedback mechanism during clot contraction. CONCLUSION The results obtained demonstrate that the Piezo1 channel expressed on RBCs comprises a mechanochemical modulator of blood clotting that may be considered a potential therapeutic target to correct hemostatic disorders.
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Affiliation(s)
- Natalia G Evtugina
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Alina D Peshkova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation; Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Alina I Khabirova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Izabella A Andrianova
- Department of Internal Medicine, Division of Hematology and Program in Molecular Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Shahnoza Abdullayeva
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Republic of Tatarstan, Russian Federation
| | - Francis Ayombil
- Division of Hematology and the Raymond G. Perelman Center for Cellular and Molecular Therapeutics, the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Taisia Shepeliuk
- Department of Physiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Ekaterina L Grishchuk
- Department of Physiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Fazoil I Ataullakhanov
- Department of Physiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Rustem I Litvinov
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - John W Weisel
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
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7
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van Rens MFPT, Hugill K, Francia ALV, Macaraig AV, van Loon FHJ, Spencer TR, Bayoumi MAA. Clotted blood samples in the neonatal intensive care unit: A retrospective, observational study to evaluate interventions to reduce blood sample clotting. Nurs Crit Care 2023. [PMID: 37338149 DOI: 10.1111/nicc.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Blood draws for laboratory investigations are essential for patient management in neonatal intensive care units (NICU). When blood samples clot before analysis, they are rejected, which delays treatment decisions and necessitates repeated sampling. AIMS To decrease the incidence of rejected blood samples taken for laboratory investigation as a result of clotted sample. STUDY DESIGN This retrospective observational study used routine data on blood draws from preterm infants collected between January 2017 and June 2019 in a 112-cot NICU in Qatar. Quality improvement interventions to reduce the rate of clotted blood samples included: awareness raising and safe sampling workshops with NICU staff, involvement of the neonatal vascular access team, development of a complete blood count (CBC) sample collection pathway, review of sample collection equipment, introducing the Tenderfoot® heel lance, establishment of benchmarks and provision of dedicated blood extraction equipment. RESULTS First attempt blood draw occurred in 10 706 cases, representing a 96.2% success rate. In 427 (3.8%) cases, the samples were clotted requiring repeat collection. The overall rate of clotted specimens decreased from 4.8% in 2017 and 2018 to 2.4% in 2019, with odds ratios of 1.42 (95% confidence interval [CI] 1.13-1.78, p = .002), 1.46 (95% CI 1.17-1.81, p < .001) and 0.49 (95% CI 0.39-0.63, p < .001), respectively. The majority (87%-95%) of blood samples were by venepuncture using an intravenous (IV) catheter or the NeoSafe™ blood sampling device. Heel prick sampling was the second (2%-9%) most common method. Clotted samples were most frequently associated with needle use, 228 of 427 (53%), and IV cannula, 162 of 427 (38%), with odds ratios of 4.14 (95% CI 3.34-5.13, p < .001) and 3.11 (95% CI 2.51-3.86, p < .001), respectively. CONCLUSIONS Our interventions over 3 years were associated with reduced rates of sample rejection due to clotting, and this led to improved patient experience through fewer repeated samplings. RELEVANCE TO CLINICAL PRACTICE The insights gained from this project can help to improve patient care. Interventions that reduce the rate of blood sample rejection by clinical laboratories can lead to economic savings, timelier diagnostic and treatment decisions, and contribute to an improved quality care experience for all critical care patients, irrespective of age, by reducing the need for repeated phlebotomy and the risk of related complications.
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Affiliation(s)
- Matheus F P T van Rens
- Neonatal Intensive Care Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Kevin Hugill
- Department of Nursing and Midwifery Education, Hamad Medical Corporation, Doha, Qatar
| | - Airene L V Francia
- Neonatal Intensive Care Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Abraham Victor Macaraig
- Department of Quality Improvement, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Fredericus H J van Loon
- Anaesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, the Netherlands
- PeriOperative Care & Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands
| | | | - Mohammad A A Bayoumi
- Neonatal Intensive Care Unit, Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
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8
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Jayabal P, Kannan Sampathkumar V, Vinothkumar A, Mathapati S, Pannerselvam B, Achiraman S, Venkatasubbu GD. Fabrication of a Chitosan-Based Wound Dressing Patch for Enhanced Antimicrobial, Hemostatic, and Wound Healing Application. ACS Appl Bio Mater 2023; 6:615-627. [PMID: 36723448 DOI: 10.1021/acsabm.2c00903] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Wounds are a serious life threat that occurs in daily life. The complex cascade of synchronized cellular and molecular phases in wound healing is impaired by different means, involving infection, neuropathic complexes, abnormal blood circulation, and cell proliferation at the wound region. Thus, to overcome these problems, a multifunctional wound dressing material is fabricated. In the current research work, we have fabricated a wound dressing polymeric patch, with poly(vinyl alcohol) (PVA) and chitosan (Cs) incorporated with a photocatalytic graphene nanocomposite (GO/TiO2(V-N)) and curcumin by a gel casting method, that focuses on multiple stages of the healing process. The morphology, swelling, degradation, moisture vapor transmission rate (MVTR), porosity, light-induced antibacterial activity, hemolysis, blood clotting, blood abortion, light-induced biocompatibility, migration assay, and drug release were analyzed for the polymeric patches under in vitro conditions. PVA/Cs/GO/TiO2(V-N)/Cur patches have shown enhanced wound healing in in vivo wound healing experiments on Wister rats. They show higher collagen deposition, thicker granulation tissue, and higher fibroblast density than conventional dressing. A histological study shows excellent re-epithelialization ability and dense collagen deposition. In vitro and in vivo analysis confirmed that PVA/Cs/GO/TiO2(V-N) and PVA/Cs/GO/TiO2(V-N)/Cur patches enhance the wound healing process.
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Affiliation(s)
- Prakash Jayabal
- Department of Nanotechnology, SRM Institute of Science and Technology, Kattankulathur603203, Chengalpattu District, Tamil Nadu, India.,Translational Health Science and Technology Institute, Faridabad121001, Haryana, India
| | - Venkataprasanna Kannan Sampathkumar
- Department of Nanotechnology, SRM Institute of Science and Technology, Kattankulathur603203, Chengalpattu District, Tamil Nadu, India.,Department of Physics, University of Tübingen, Geschwister-Scholl-Platz, 72074Tübingen, Germany
| | - Arumagam Vinothkumar
- Department of Environmental Biotechnology, School of Environmental Sciences, Bharathidasan University, Tiruchirappalli620024, Tamil Nadu, India
| | - Santosh Mathapati
- Translational Health Science and Technology Institute, Faridabad121001, Haryana, India
| | | | - Shanmugam Achiraman
- Department of Environmental Biotechnology, School of Environmental Sciences, Bharathidasan University, Tiruchirappalli620024, Tamil Nadu, India
| | - G Devanand Venkatasubbu
- Department of Nanotechnology, SRM Institute of Science and Technology, Kattankulathur603203, Chengalpattu District, Tamil Nadu, India
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9
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Zhang L, Sun Y, Peng L, Fang W, Huang Q, Zhang J, Zhang Z, Li H, Liu Y, Ying Y, Fu Y. Blood-Coagulation-Inspired Dynamic Bridging Strategy for the Fabrication of Multiscale-Assembled Hierarchical Porous Material. Adv Sci (Weinh) 2023; 10:e2204702. [PMID: 36412067 PMCID: PMC9839836 DOI: 10.1002/advs.202204702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Porous materials, from macroscopic bulk materials (MBs) with (sub-)millimeter-scale pores to tiny particles (TPs) with (sub-)nanometer-scale pores, have attracted ever-growing interest in various fields. However, the integration of multi-scale pores in one composite is promising but challenging, owing to the considerable gap in the scale of the pores. Inspired by blood coagulation, a fibrin-based dynamic bridging strategy is developed to fabricate a multiscale-assembled hierarchical porous material (MHPM), in which fibrin formed as the sub-framework for the weaving-narrow of MBs and the enwinding-load of TPs. The bio-polymerization nature makes the fabrication rapid, facile, and universal for the customizable integration of seven kinds of TPs and four kinds of MBs. Besides, the integration is controllable with high load capacity of TPs and is stable against external shock forces. The unique multi-level structure endows the MHPM with large and accessible surface area, and efficient mass transfer pathways, synergistically leading to high adsorption capacity and rapid kinetics in multiple adsorption models. This work suggests a strategy for the rational multi-level design and fabrication of hierarchical porous architectures.
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Affiliation(s)
- Lin Zhang
- College of Biosystems Engineering and Food ScienceZhejiang UniversityHangzhou310058China
- International Research Center for X PolymersDepartment of Polymer Science and EngineeringZhejiang UniversityHangzhou310027China
| | - Yuxin Sun
- College of Biosystems Engineering and Food ScienceZhejiang UniversityHangzhou310058China
| | - Li Peng
- International Research Center for X PolymersDepartment of Polymer Science and EngineeringZhejiang UniversityHangzhou310027China
| | - Wenzhang Fang
- International Research Center for X PolymersDepartment of Polymer Science and EngineeringZhejiang UniversityHangzhou310027China
| | - Qiao Huang
- College of Biosystems Engineering and Food ScienceZhejiang UniversityHangzhou310058China
| | - Jie Zhang
- College of Biosystems Engineering and Food ScienceZhejiang UniversityHangzhou310058China
| | - Ziyan Zhang
- College of Biosystems Engineering and Food ScienceZhejiang UniversityHangzhou310058China
| | - Hang Li
- International Research Center for X PolymersDepartment of Polymer Science and EngineeringZhejiang UniversityHangzhou310027China
| | - Yingjun Liu
- International Research Center for X PolymersDepartment of Polymer Science and EngineeringZhejiang UniversityHangzhou310027China
| | - Yibin Ying
- College of Biosystems Engineering and Food ScienceZhejiang UniversityHangzhou310058China
| | - Yingchun Fu
- College of Biosystems Engineering and Food ScienceZhejiang UniversityHangzhou310058China
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10
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Muacevic A, Adler JR, Kalidoss VK, Polineni S, Jayam C, Kumar C. The Optimal Hemostasis Duration After Tooth Extraction: A Randomized Controlled Trial. Cureus 2023; 15:e33331. [PMID: 36741661 PMCID: PMC9895223 DOI: 10.7759/cureus.33331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/05/2023] Open
Abstract
Background There is a lack of evidence-based practice regarding the duration of pressure pack placement following tooth extraction. This study aimed to compare the incidence of post-extraction bleeding following 60 minutes versus 10 minutes of pressure pack placement. Methodology A randomized controlled trial was conducted at a tertiary care hospital and included patients requiring intra-alveolar tooth extractions. Patients were randomly allocated into the experimental group or control group by a permuted block randomization method. A blinded observer noted the incidence of post-extraction bleeding. Categorical variables were summarized as frequency and percentage. The chi-square test was used for intergroup statistical analysis. P-values <0.05 were considered statistically significant. Results There were 528 participants, 264 of whom were allocated to each group. The incidence of post-extraction bleeding was 8% and 6.8% in the experimental and control groups, respectively. On bivariate analysis, there was no statistically significant difference between the two groups (p = 0.618; relative risk with 95% confidence interval = 1.0). Conclusions In the majority of cases, hemostasis was achieved in 10 minutes. Therefore, removing the pressure pack after 10 minutes may be advised to ensure hemostasis and, ultimately, save chairside time.
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11
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Hochberg JD, Wirth DM, Pokorski JK. Surface-Modified Melt Coextruded Nanofibers Enhance Blood Clotting In Vitro. Macromol Biosci 2022; 22:e2200292. [PMID: 36122179 DOI: 10.1002/mabi.202200292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/28/2022] [Indexed: 01/15/2023]
Abstract
Blood loss causes an estimated 1.9 million deaths per year globally, making new methods to stop bleeding and promote clot formation immediately following injury paramount. The fabrication of functional hemostatic materials has the potential to save countless lives by limiting bleeding and promoting clot formation following an injury. This work describes the melt manufacturing of poly(ε-caprolactone) nanofibers and their chemical functionalization to produce highly scalable materials with enhanced blood clotting properties. The nanofibers are manufactured using a high throughput melt coextrusion method. Once isolated, the nanofibers are functionalized with polymers that promote blood clotting through surface-initiated atom transfer radical polymerization. The functional nanofibers described herein speed up the coagulation cascade and produce more robust blood clots, allowing for the potential use of these functional nonwoven mats as advanced bandages.
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Affiliation(s)
- Justin D Hochberg
- Department of NanoEngineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - David M Wirth
- Department of NanoEngineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jonathan K Pokorski
- Department of NanoEngineering, Jacobs School of Engineering, University of California San Diego, La Jolla, CA, 92093, USA
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12
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Zhao KN, Masci P, Dimeski G, Johnson L, Grant M, de Jersey J, Lavin MF. Potential Application of Recombinant Snake Prothrombin Activator Ecarin in Blood Diagnostics. Biomolecules 2022; 12:1704. [PMID: 36421717 PMCID: PMC9687618 DOI: 10.3390/biom12111704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 08/30/2023] Open
Abstract
We describe here the purification and cloning of a codon-optimized form of the snake prothrombin activator ecarin from the saw scaled viper (Echis carinatus) expressed in mammalian cells. Expression of recombinant ecarin (rEcarin) was carried out in human embryonic kidney cells (HEK) cells under conditions for the development and performance of a novel and scalable recombinant snake ecarin to industry standards. Clotting performance of the rEcarin was established in recalcified citrated whole blood, plasma, and fresh whole blood and found to be comparable to native ecarin (N-Ecarin). Furthermore, hemolysis was observed with N-Ecarin at relatively high doses in both recalcified citrated and fresh whole blood, while clotting was not observed with rEcarin, providing an important advantage for the recombinant form. In addition, rEcarin effectively clotted both recalcified citrated whole blood and fresh whole blood containing different anticoagulants including heparin, warfarin, dabigatran, Fondaparinux, rivaroxaban and apixaban, forming firm clots in the blood collection tubes. These results demonstrate that rEcarin efficiently clots normal blood as well as blood spiked with high concentrations of anticoagulants and has great potential as an additive to blood collection tubes to produce high quality serum for analyte analysis in diagnostic medicine.
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Affiliation(s)
- Kong-Nan Zhao
- Australian Institute of Biotechnology and Nanotechnology, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
- Centre for Kidney Disease Research-Venomics Research, School of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Paul Masci
- Centre for Kidney Disease Research-Venomics Research, School of Medicine, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Goce Dimeski
- Chemical Pathology, Princess Alexandra Hospital, Woolloongabba, Brisbane, QLD 4102, Australia
- School of Chemistry and Molecular Biosciences, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Lambro Johnson
- Australian Institute of Biotechnology and Nanotechnology, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Michael Grant
- Q-Sera Pty Ltd., Level 9, 31 Queen St, Melbourne, VIC 3000, Australia
| | - John de Jersey
- School of Chemistry and Molecular Biosciences, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Martin F. Lavin
- Australian Institute of Biotechnology and Nanotechnology, St Lucia Campus, The University of Queensland, Brisbane, QLD 4072, Australia
- Centre for Clinical Research, RBWH Campus, The University of Queensland, Brisbane, QLD 4029, Australia
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13
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Abstract
Hemorrhage during accidents or surgery is a significant challenge that can contribute to mortality. This is further aggravated due to bacterial infections at the injured site. Therefore, rapid application of a hemostatic and antibacterial material is highly necessary as a pretreatment for patients' survival. Herein, we have developed a hemostatic sponge (Hemobac) through amide crosslinking of gelatin and an N-(2-hydroxy) propyl-3-trimethylammonium chitosan (HTCC)-silver chloride nanocomposite (QAm1-Ag0.1) to mitigate bacterial infections, while aiding hemostasis. This Hemobac sponge completely eradicated (∼4-5 log) a wide range of Gram-positive and Gram-negative bacteria encompassing various clinical isolates within 6 h. The antihemorrhagic ability of Hemobac was ascertained through SEM images, which exhibited the presence of agglomerated blood cells onto the sponge with a significantly low blood-clotting index value (∼23 ± 1). Notably, Hemobac reduced the blood loss by ∼70-80% in the liver puncture model and femoral vein injury model in mice, displaying its improved hemostatic ability over a marketed gelatin-based sponge. Negligible hemolytic activity (∼6%) and retained healthy morphology of mammalian cells were observed upon exposure to the Hemobac sponge. Minimal immune response was noticed at the Hemobac-treated wound in mice through histopathology analysis. Collectively, these findings indicate that this biocompatible Hemobac sponge can stop the bleeding instantaneously and combat bacterial infections.
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Affiliation(s)
- Brinta Bhattacharjee
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru 560064, Karnataka, India
| | - Riya Mukherjee
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru 560064, Karnataka, India
| | - Jayanta Haldar
- Antimicrobial Research Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru 560064, Karnataka, India.,School of Advanced Materials, Jawaharlal Nehru Centre for Advanced Scientific Research (JNCASR), Jakkur, Bengaluru 560064, Karnataka, India
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14
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Yegappan R, Lauko J, Wang Z, Lavin MF, Kijas AW, Rowan AE. Snake Venom Hydrogels as a Rapid Hemostatic Agent for Uncontrolled Bleeding. Adv Healthc Mater 2022; 11:e2200574. [PMID: 35652565 DOI: 10.1002/adhm.202200574] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/09/2022] [Indexed: 11/06/2022]
Abstract
Uncontrolled bleeding from traumatic injury remains the leading cause of preventable death with loss of balance between blood clotting (coagulation) and blood clot breakdown (fibrinolysis). A major limitation of existing hemostatic agents is that they require a functioning clotting system to control the bleeding and are largely based on gauze delivery scaffolds. Herein, a novel rapid wound sealant, composed of two recombinant snake venom proteins, the procoagulant ecarin, to rapidly initiate blood clotting and the antifibrinolytic textilinin, to prevent blood clot breakdown within a synthetic thermoresponsive hydrogel scaffold is developed. In vitro, it is demonstrated that clotting is rapidly initiated with only nanomolar concentrations of venom protein and clot breakdown is effectively inhibited by textilinin. A stable clot is formed within 60 s compared to normal clot formation in 8 min. In vivo studies reveal that the snake venom hydrogel rapidly controls warfarin-induced bleeding, reducing the bleed volume from 48% to 12% and has demonstrated immune compatibility. A new class of hemostatic agents that achieve formation of rapid and stable blood clots even in the presence of blood thinners is demonstrated here.
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Affiliation(s)
- Ramanathan Yegappan
- Australian Institute for Bioengineering and Nanotechnology The University of Queensland St Lucia QLD 4072 Australia
| | - Jan Lauko
- Australian Institute for Bioengineering and Nanotechnology The University of Queensland St Lucia QLD 4072 Australia
| | - Zhao Wang
- Australian Institute for Bioengineering and Nanotechnology The University of Queensland St Lucia QLD 4072 Australia
| | - Martin F. Lavin
- University of Queensland Centre for Clinical Research The University of Queensland Herston QLD 4029 Australia
| | - Amanda W. Kijas
- Australian Institute for Bioengineering and Nanotechnology The University of Queensland St Lucia QLD 4072 Australia
| | - Alan E. Rowan
- Australian Institute for Bioengineering and Nanotechnology The University of Queensland St Lucia QLD 4072 Australia
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15
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Petito E, Colonna E, Falcinelli E, Mezzasoma AM, Cesari E, Giglio E, Fiordi T, Almerigogna F, Villa A, Gresele P. Anti-severe acute respiratory syndrome coronavirus-2 adenoviral-vector vaccines trigger subclinical antiplatelet autoimmunity and increase of soluble platelet activation markers. Br J Haematol 2022; 198:257-266. [PMID: 35577507 DOI: 10.1111/bjh.18245] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/21/2022] [Accepted: 05/01/2022] [Indexed: 12/16/2022]
Abstract
To slow down the coronavirus disease 2019 (COVID-19) pandemic an unequalled vaccination campaign was initiated. Despite proven efficacy and safety, a rare but potentially fatal complication of adenoviral-vector vaccines, called vaccine-induced immune thrombotic thrombocytopenia (VITT), has emerged the pathogenesis of which seems to be related to the development of platelet-activating anti-platelet factor 4 (PF4) antibodies. While a few studies have evaluated the incidence of anti-PF4 positivity in anti-severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine recipients, to date no studies have assessed whether an antiplatelet immunological response develops and if this associates with platelet and blood clotting activation. We carried out a prospective study in healthy subjects who received the first dose of ChAdOx1 or Ad26.COV2.S or BNT162b2 vaccines to evaluate platelet-specific and non-specific immune response and in vivo platelet activation and blood clotting activation. Individuals receiving ChAdOx1 and, less so, Ad26.COV2.S developed with high frequency auto- or alloantiplatelet antibodies, increased circulating platelet-derived microvesicles and soluble P-selectin associated with mild blood clotting activation. Our study shows that an immunological reaction involving platelets is not uncommon in individuals receiving anti-SARS-CoV-2 vaccination, especially after ChAdOx1 and Ad26.COV2.S, and that it associates with in vivo platelet and blood clotting activation.
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Affiliation(s)
- Eleonora Petito
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Elisabetta Colonna
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Emanuela Falcinelli
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Anna Maria Mezzasoma
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Enrica Cesari
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Elisa Giglio
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Tiziana Fiordi
- Section of Occupational Medicine and Toxicology, University of Perugia, Perugia, Italy
| | - Fabio Almerigogna
- Unit of Allergology and Clinical Immunology, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Alfredo Villa
- Central Clinical Chemistry Laboratory, S.M. della Misericordia Hospital, Perugia, Italy
| | - Paolo Gresele
- Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
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16
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Ramberg C, Hindberg K, Biedermann JS, Cannegieter SC, van der Meer FJ, Snir O, Leebeek FWG, Kruip MJHA, Hansen JB, Lijfering WM. Rosuvastatin treatment decreases plasma procoagulant phospholipid activity after a VTE: A randomized controlled trial. J Thromb Haemost 2022; 20:877-887. [PMID: 34953155 DOI: 10.1111/jth.15626] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Venous thromboembolism (VTE) is a frequent cardiovascular disease with severe complications, including recurrence and death. There is a great need for alternative prophylactic treatment options as anticoagulation is accompanied by increased bleeding risk. Statins are reported to reduce the risk of incident and recurrent VTE, but the mechanisms are elusive. Procoagulant phospholipids (PPL), and phosphatidylserine in particular, are crucial for efficient coagulation activation, but no studies have investigated the effect of statin treatment on plasma PPL activity. OBJECTIVES To investigate the impact of rosuvastatin treatment on plasma PPL activity and levels of extracellular vesicles (EVs). PATIENTS/METHODS Patients with a history of VTE (≥18 years) allowed to stop anticoagulant treatment were randomized to either 20 mg/day of rosuvastatin treatment or no treatment for 28 days in the Statins Reduce Thrombophilia (NCT01613794) trial. Plasma samples were collected at baseline and study end. PPL activity was measured in samples from 245 participants using a factor Xa-dependent clotting assay and EV levels by flow cytometry. RESULTS Rosuvastatin treatment yielded an overall 22% (95% confidence interval [CI] -38.2 to -5.8) reduction in PPL activity, and 37% (95% CI -62.9 to -11.2) reduction in PPL activity in participants with a history of pulmonary embolism. The effect of rosuvastatin on plasma PPL activity was not explained by changes in total cholesterol nor change in levels of total- or platelet-derived EVs. CONCLUSIONS Rosuvastatin treatment caused a substantial decrease in plasma PPL activity, suggesting that a PPL-dependent attenuation of coagulation activation may contribute to a reduced VTE risk following statin treatment.
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Affiliation(s)
- Cathrine Ramberg
- Department of Clinical Medicine, Thrombosis Research Center (TREC), UiT-The Arctic University of Norway, Tromsø, Norway
| | - Kristian Hindberg
- Department of Clinical Medicine, Thrombosis Research Center (TREC), UiT-The Arctic University of Norway, Tromsø, Norway
| | - Joseph S Biedermann
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
- Star-shl Anticoagulation Clinic, Rotterdam, The Netherlands
| | - Suzanne C Cannegieter
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, the Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Felix J van der Meer
- Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - Omri Snir
- Department of Clinical Medicine, Thrombosis Research Center (TREC), UiT-The Arctic University of Norway, Tromsø, Norway
| | - Frank W G Leebeek
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marieke J H A Kruip
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
- Star-shl Anticoagulation Clinic, Rotterdam, The Netherlands
| | - John-Bjarne Hansen
- Department of Clinical Medicine, Thrombosis Research Center (TREC), UiT-The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Willem M Lijfering
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
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17
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Baron MV, dos Santos MP, Werle TM, Scherer GD, Santos MMD, Dominguez LML, Brandenburg C, Feltez G, Sampaio AR, de Mello Pinto MV, Carvalho S, Meyer PF, Picariello F, Pacheco EF, Reinheimer IC, Sancho AG, da Costa BEP. Does COVID-19 infection increase the risk of pressure injury in critically ill patients?: A narrative review. Medicine (Baltimore) 2022; 101:e29058. [PMID: 35356924 PMCID: PMC10513310 DOI: 10.1097/md.0000000000029058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 02/24/2022] [Indexed: 02/02/2023] Open
Abstract
ABSTRACT Patients with severe COVID-19 may have endothelial dysfunction and a hypercoagulable state that can cause skin damage. In the presence of external pressure on the tissues, the local inflammatory process regulated by inflammatory cytokines can increase and prolong itself, contributing to the formation of pressure injury (PI). PI is defined as localized damage to the skin or underlying tissues. It usually occurs as a result of intense and/or prolonged pressure in combination with shear. The aim of the study is to perform a narrative review on the physiological evidence of increased risk in the development of PI in critically ill patients with COVID-19.In patients with severe COVID-19 a pattern of tissue damage consistent with complement-mediated microvascular injury was found in the lungs and skin of critically ill COVID-19 patients, suggesting sustained systemic activation of complement pathways. Theoretically, the same thrombogenic vascular changes related to COVID-19 that occur in the skin also occur in the underlying tissues, making patients less tolerant to the harmful effects of pressure and shear. Unlike the syndromes typical of acute respiratory illnesses and other pathologies that commonly lead to intensive care unit admission, COVID-19 and systemic viral spread show that local and systemic factors overlap. This fact may be justified by current epidemiological data showing that the prevalence of PI among intensive care unit patients with COVID-19 was 3 times higher than in those without COVID-19. This narrative review presents physiological evidence to suggesting an increased risk of developing PI in critically ill patients with COVID-19.
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Affiliation(s)
- Miriam Viviane Baron
- Correspondence: Miriam Viviane Baron, Graduate Program in Medicine and Health Sciences of the Pontifical Catholic University of Rio Grande do Sul (PUC/RS), Porto Alegre, Rio Grande do Sul 90619-900, Brazil (e-mail: ).
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18
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Abstract
In [Fogelson and Keener, Phys. Rev. E, 81 (2010), 051922], we introduced a kinetic model of fibrin polymerization during blood clotting that captured salient experimental observations about how the gel branching structure depends on the conditions under which the polymerization occurs. Our analysis there used a moment-based approach that is valid only before the finite time blow-up that indicates formation of a gel. Here, we extend our analyses of the model to include both pre-gel and post-gel dynamics using the PDE-based framework we introduced in [Fogelson and Keener, SIAM J. Appl. Math., 75 (2015), pp. 1346-1368]. We also extend the model to include spatial heterogeneity and spatial transport processes. Studies of the behavior of the model reveal different spatial-temporal dynamics as the time scales of the key processes of branch formation, monomer introduction, and diffusion are varied.
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Affiliation(s)
- Aaron L Fogelson
- Departments of Mathematics and Biomedical Engineering, University of Utah, Salt Lake City, UT (http://www.math.utah.edu/~fogelson)
| | - Anna C Nelson
- Department of Mathematics, University of Utah, Salt Lake City, UT
| | | | - James P Keener
- Departments of Mathematics and Biomedical Engineering, University of Utah, Salt Lake City, UT (http://www.math.utah.edu/~keener)
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19
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Ripoll-Rozada J, Maxwell JWC, Payne RJ, Barbosa Pereira PJ. Tyrosine-O-sulfation is a widespread affinity enhancer among thrombin interactors. Biochem Soc Trans 2022:BST20210600. [PMID: 34994377 DOI: 10.1042/BST20210600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 12/24/2022]
Abstract
Tyrosine-O-sulfation is a common post-translational modification (PTM) of proteins following the cellular secretory pathway. First described in human fibrinogen, tyrosine-O-sulfation has long been associated with the modulation of protein-protein interactions in several physiological processes. A number of relevant interactions for hemostasis are largely dictated by this PTM, many of which involving the serine proteinase thrombin (FIIa), a central player in the blood-clotting cascade. Tyrosine sulfation is not limited to endogenous FIIa ligands and has also been found in hirudin, a well-known and potent thrombin inhibitor from the medicinal leech, Hirudo medicinalis. The discovery of hirudin led to successful clinical application of analogs of leech-inspired molecules, but also unveiled several other natural thrombin-directed anticoagulant molecules, many of which undergo tyrosine-O-sulfation. The presence of this PTM has been shown to enhance the anticoagulant properties of these peptides from a range of blood-feeding organisms, including ticks, mosquitos and flies. Interestingly, some of these molecules display mechanisms of action that mimic those of thrombin's bona fide substrates.
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20
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Yu H, Wan Y, Zhang G, Huang X, Lin L, Zhou C, Jiao Y, Li H. Blood compatibility evaluations of two-dimensional Ti 3C 2T xnanosheets. Biomed Mater 2021; 17. [PMID: 34937009 DOI: 10.1088/1748-605x/ac45ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/22/2021] [Indexed: 11/11/2022]
Abstract
Two-dimensional (2D) nanomaterial Ti3C2Tx is a novel biomaterial used for medical apparatus. For its application, biosafety serves as a prerequisite for their use in vivo. So far, no research has systematically reported how Ti3C2Tx interacts with various components in the blood. In this work, we evaluated the hemocompatibility of Ti3C2Tx nanosheets which we prepared by HF etching. Effects of the concentration and size of Ti3C2Tx on the morphology and hemolysis rate of human red blood cells (RBCs), the structure and conformation of plasma proteins, the complement activation, as well as in vitro blood coagulation were studied. In general, Ti3C2Tx takes on good blood compatibility, but in the case of high concentration (>30 μg/mL) and "Small size" (about 100 nm), it led to the rupture of RBCs membrane and a higher rate of hemolysis. Meanwhile, platelets and complement were inclined to be activated with the increased concentration, accompanying the changed configuration of plasma proteins dependent on concentration. Surprisingly, the presence of Ti3C2Tx did not significantly disrupt the coagulation. In vitro cell culture, the results prove that when the Ti3C2Tx concentration is as high as 60μg/mL and still has good biological safety. By establishing a fuzzy mathematical model, it was proved that the hemocompatibility of Ti3C2Tx is more concentration-dependent than size-dependent, and the hemolysis rate is the most sensitive to the size and concentration of the Ti3C2Tx. These findings provide insight into the potential use of Ti3C2Tx as biofriendly nanocontainers for biomaterials in vivo.
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Affiliation(s)
- Hongbo Yu
- Jinan University, Jinan University, Guangzhou, 510632, CHINA
| | - Yi Wan
- Department of Materials Science and Engineering, Jinan University, Jinan University, Guangzhou, 510632, CHINA
| | - Guiyin Zhang
- Department of Materials Science and Engineering, Jinan University, Jinan University, Guangzhou, 510632, CHINA
| | - Xiuhong Huang
- Department of Materials Science and Engineering, Jinan University, Jinan University, Guangzhou, 510632, CHINA
| | - Lichen Lin
- Department of Materials Science and Engineering, Jinan University, Jinan University, Guangzhou, 510632, CHINA
| | - Changren Zhou
- Jinan University, Guangzhou 510632, PR China, Guangzhou, Guangdong, 510632, CHINA
| | - Yanpeng Jiao
- Department of Materials Science and Engineering, Jinan University, Guangzhou, Guangzhou, Guangdong, 510632, CHINA
| | - Hong Li
- Department of Materials Science and Engineering, Jinan University, Jinan University, Guangzhou, 510632, CHINA
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21
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Laubscher GJ, Lourens PJ, Venter C, Kell DB, Pretorius E. TEG ®, Microclot and Platelet Mapping for Guiding Early Management of Severe COVID-19 Coagulopathy. J Clin Med 2021; 10:jcm10225381. [PMID: 34830660 PMCID: PMC8621180 DOI: 10.3390/jcm10225381] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 02/08/2023] Open
Abstract
An important component of severe COVID-19 disease is virus-induced endothelilitis. This leads to disruption of normal endothelial function, initiating a state of failing normal clotting physiology. Massively increased levels of von Willebrand Factor (VWF) lead to overwhelming platelet activation, as well as activation of the enzymatic (intrinsic) clotting pathway. In addition, there is an impaired fibrinolysis, caused by, amongst others, increased levels of alpha-(2) antiplasmin. The end result is hypercoagulation (proven by thromboelastography® (TEG®)) and reduced fibrinolysis, inevitably leading to a difficult-to-overcome hypercoagulated physiological state. Platelets in circulation also plays a significant role in clot formation, but they themselves may also drive hypercoagulation when they are overactivated due to the interactions of their receptors with the endothelium, immune cells or circulating inflammatory molecules. From the literature it is clear that the role of platelets in severely ill COVID-19 patients has been markedly underestimated or even ignored. We here highlight the value of early management of severe COVID-19 coagulopathy as guided by TEG®, microclot and platelet mapping. We also argue that the failure of clinical trials, where the efficacy of prophylactic versus therapeutic clexane (low molecular weight heparin (LMWH)) were not always successful, which may be because the significant role of platelet activation was not taken into account during the planning of the trial. We conclude that, because of the overwhelming alteration of clotting, the outcome of any trial evaluating an any single anticoagulant, including thrombolytic, would be negative. Here we suggest the use of the degree of platelet dysfunction and presence of microclots in circulation, together with TEG®, might be used as a guideline for disease severity. A multi-pronged approach, guided by TEG® and platelet mapping, would be required to maintain normal clotting physiology in severe COVID-19 disease.
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Affiliation(s)
| | | | - Chantelle Venter
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch 7602, South Africa;
| | - Douglas B Kell
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch 7602, South Africa;
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool L69 7ZB, UK
- The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark
- Correspondence: (D.B.K.); (E.P.)
| | - Etheresia Pretorius
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch 7602, South Africa;
- Correspondence: (D.B.K.); (E.P.)
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22
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Tutwiler V, Litvinov RI, Protopopova A, Nagaswami C, Villa C, Woods E, Abdulmalik O, Siegel DL, Russell JE, Muzykantov VR, Lam WA, Myers DR, Weisel JW. Pathologically stiff erythrocytes impede contraction of blood clots: Reply to comment. J Thromb Haemost 2021; 19:2894-2895. [PMID: 34668295 PMCID: PMC10031937 DOI: 10.1111/jth.15511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Valerie Tutwiler
- Department of Cell and Developmental Biology, University of
Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Biomedical Engineering, Rutgers – The
State University of New Jersey, Piscataway, New Jersey, USA
| | - Rustem I. Litvinov
- Department of Cell and Developmental Biology, University of
Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Institute of Fundamental Medicine and Biology, Kazan
Federal University, Kazan, Russia
| | - Anna Protopopova
- Department of Cell and Developmental Biology, University of
Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Chandrasekaran Nagaswami
- Department of Cell and Developmental Biology, University of
Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Carlos Villa
- Department of Pathology and Laboratory Medicine, University
of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Eric Woods
- Max- Planck- Institut für Eisenforschung GmbH
Düsseldorf, Düsseldorf, Germany
| | | | - Don L. Siegel
- Department of Pathology and Laboratory Medicine, University
of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - J. Eric Russell
- Department of Medicine, University of Pennsylvania Perelman
School of Medicine, Philadelphia, Pennsylvania, USA
| | - Vladimir R. Muzykantov
- Department of Pharmacology, University of Pennsylvania
Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Wilbur A. Lam
- The Wallace H. Coulter Department of Biomedical
Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia,
USA
| | - David R. Myers
- The Wallace H. Coulter Department of Biomedical
Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia,
USA
| | - John W. Weisel
- Department of Cell and Developmental Biology, University of
Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Tutwiler V, Litvinov RI, Protopopova A, Nagaswami C, Villa C, Woods E, Abdulmalik O, Siegel DL, Russell JE, Muzykantov VR, Lam WA, Myers DR, Weisel JW. Pathologically stiff erythrocytes impede contraction of blood clots. J Thromb Haemost 2021; 19:1990-2001. [PMID: 34233380 PMCID: PMC10066851 DOI: 10.1111/jth.15407] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/27/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Blood clot contraction, volume shrinkage of the clot, is driven by platelet contraction and accompanied by compaction of the erythrocytes and their gradual shape change from biconcave to polyhedral, with the resulting cells named polyhedrocytes. OBJECTIVES Here, we examined the role of erythrocyte rigidity on clot contraction and erythrocyte shape transformation. METHODS We used an optical tracking methodology that allowed us to quantify changes in contracting clot size over time. RESULTS AND CONCLUSIONS Erythrocyte rigidity has been shown to be increased in sickle cell disease (SCD), and in our experiments erythrocytes from SCD patients were 4-fold stiffer than those from healthy subjects. On average, the final extent of clot contraction was reduced by 53% in the clots from the blood of patients with SCD compared to healthy individuals, and there was significantly less polyhedrocyte formation. To test if this reduction in clot contraction was due to the increase in erythrocyte rigidity, we used stiffening of erythrocytes via chemical cross-linking (glutaraldehyde), rigidifying Wrightb antibodies (Wrb ), and naturally more rigid llama ovalocytes. Results revealed that stiffening erythrocytes result in impaired clot contraction and fewer polyhedrocytes. These results demonstrate the role of erythrocyte rigidity in the contraction of blood clots and suggest that the impaired clot contraction/shrinkage in SCD is due to the reduced erythrocyte deformability, which may be an underappreciated mechanism that aggravates obstructiveness of erythrocyte-rich (micro)thrombi in SCD.
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Affiliation(s)
- Valerie Tutwiler
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Rustem I. Litvinov
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Anna Protopopova
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Chandrasekaran Nagaswami
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Carlos Villa
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Eric Woods
- Max-Planck-Institut für Eisenforschung GmbH Düsseldorf, Düsseldorf, Germany
| | | | - Don L. Siegel
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - J. Eric Russell
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Vladimir R. Muzykantov
- Department of Pharmacology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Wilbur A. Lam
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, USA
| | - David R. Myers
- The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, Georgia, USA
| | - John W. Weisel
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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24
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Litvinov RI, Peshkova AD, Le Minh G, Khaertdinov NN, Evtugina NG, Sitdikova GF, Weisel JW. Effects of Hyperhomocysteinemia on the Platelet-Driven Contraction of Blood Clots. Metabolites 2021; 11:354. [PMID: 34205914 DOI: 10.3390/metabo11060354] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/21/2021] [Accepted: 05/30/2021] [Indexed: 12/17/2022] Open
Abstract
Hyperhomocysteinemia (HHcy) is associated with thrombosis, but the mechanistic links between them are not understood. We studied effects of homocysteine (Hcy) on clot contraction in vitro and in a rat model of HHcy. Incubation of blood with exogenous Hcy for 1 min enhanced clot contraction, while 15-min incubation led to a dose-dependent suppression of contraction. These effects were likely due to direct Hcy-induced platelet activation followed by exhaustion, as revealed by an increase in fibrinogen-binding capacity and P-selectin expression determined by flow cytometry. In the blood of rats with HHcy, clot contraction was enhanced at moderately elevated Hcy levels (10–50 μM), while at higher Hcy levels (>50 μM), the onset of clot contraction was delayed. HHcy was associated with thrombocytosis combined with a reduced erythrocyte count and hypofibrinogenemia. These data suggest that in HHcy, platelets get activated directly and indirectly, leading to enhanced clot contraction that is facilitated by the reduced content and resilience of fibrin and erythrocytes in the clot. The excessive platelet activation can lead to exhaustion and impaired contractility, which makes clots larger and more obstructive. In conclusion, HHcy modulates blood clot contraction, which may comprise an underappreciated pro- or antithrombotic mechanism.
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25
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Miglio A, Falcinelli E, Mezzasoma AM, Cappelli K, Mecocci S, Gresele P, Antognoni MT. Effect of First Long-Term Training on Whole Blood Count and Blood Clotting Parameters in Thoroughbreds. Animals (Basel) 2021; 11:447. [PMID: 33572086 PMCID: PMC7915801 DOI: 10.3390/ani11020447] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/02/2021] [Accepted: 02/04/2021] [Indexed: 02/08/2023] Open
Abstract
Training has a strong effect on the physiology of hematological parameters and blood coagulation, both in humans and in horses. Several blood changes have been reported after exercise in horses but available data differ. We aimed to investigate modifications in complete blood count and some hemostatic parameters induced by the first training period in young untrained Thoroughbred racehorses to detect a possible labile blood coagulability in racehorses. Twenty-nine untrained 2-year-old Thoroughbreds were followed during their incremental 4-month sprint exercise schedule. Blood collection was performed once a month, five times (T-30, T0, T30, T60 and T90), before and during the training period for measurement of complete blood count (CBC) and blood clotting parameters (prothrombin time-PT, activated partial prothrombin time-APTT, thrombin clotting time-TCT, fibrinogen-Fb, thrombin-antithrombin complex-TAT). Differences among the time points for each parameter were analyzed (ANOVA, Kruskal-Wallis one-way analysis of variance, p < 0.05). In Thoroughbreds, the first long-term exercise workout period was found to induce a statistical increase in red blood cell indexes and lymphocytes, eosinophils and platelet counts, as well as a hypercoagulability state evident at 30 days of training, which returned to basal levels after 90 days. Regular physical exercise seems to blunt the negative effects of acute efforts on hematological and clotting parameters, an effect that may be attributed to the training condition.
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Affiliation(s)
- Arianna Miglio
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (K.C.); (S.M.); (M.T.A.)
| | - Emanuela Falcinelli
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (A.M.M.); (P.G.)
| | - Anna Maria Mezzasoma
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (A.M.M.); (P.G.)
| | - Katia Cappelli
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (K.C.); (S.M.); (M.T.A.)
| | - Samanta Mecocci
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (K.C.); (S.M.); (M.T.A.)
| | - Paolo Gresele
- Department of Medicine and Surgery, Section of Internal and Cardiovascular Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (A.M.M.); (P.G.)
| | - Maria Teresa Antognoni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy; (K.C.); (S.M.); (M.T.A.)
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26
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Buccione E, Guzzi F, Colosimo D, Tedesco B, Romagnoli S, Ricci Z, L'Erario M, Villa G. Continuous Renal Replacement Therapy in Critically Ill Children in the Pediatric Intensive Care Unit: A Retrospective Analysis of Real-Life Prescriptions, Complications, and Outcomes. Front Pediatr 2021; 9:696798. [PMID: 34195164 PMCID: PMC8236631 DOI: 10.3389/fped.2021.696798] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 05/19/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction: Severe acute kidney injury is a common finding in the Pediatric Intensive Care Unit (PICU), however, Continuous Renal Replacement Therapy (CRRT) is rarely applied in this setting. This study aims to describe our experience in the rate of application of CRRT, patients' clinical characteristics at admission and CRRT initiation, CRRT prescription, predictors of circuit clotting, short- and long-term outcomes. Methods: A 6-year single center retrospective study in a tertiary PICU. Results: Twenty-eight critically ill patients aged 0 to 18 years received CRRT between January 2012 and December 2017 (1.4% of all patients admitted to PICU). Complete clinical and CRRT technical information were available for 23/28 patients for a total of 101 CRRT sessions. CRRT was started, on average, 40 h (20-160) after PICU admission, mostly because of fluid overload. Continuous veno-venous hemodiafiltration and systemic heparinization were applied in 83.2 and 71.3% of sessions, respectively. Fifty-nine sessions (58.4%) were complicated by circuit clotting. At multivariate Cox-regression analysis, vascular access caliber larger than 8 Fr [HR 0.37 (0.19-0.72), p = 0.004] and regional citrate anticoagulation strategy [HR 0.14 (0.03-0.60), p = 0.008] were independent protective factors for clotting. PICU mortality rate was 42.8%, and six survivors developed chronic kidney disease (CKD), within an average follow up of 3.5 years. Conclusions: CRRT is uncommonly applied in our PICU, mostly within 2 days after admission and because of fluid overload. Larger vascular access and citrate anticoagulation are independent protective factors for circuit clotting. Patients' PICU mortality rate is high and survival often complicated by CKD development.
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Affiliation(s)
- Emanuele Buccione
- Pediatric Intensive Care Unit, Meyer Children's University Hospital, Florence, Italy.,Neonatal Intensive Care Unit, AUSL Pescara, Pescara, Italy
| | - Francesco Guzzi
- Nephrology and Dialysis Unit, Meyer Children's University Hospital, Florence, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Denise Colosimo
- Pediatric Intensive Care Unit, Meyer Children's University Hospital, Florence, Italy
| | - Brigida Tedesco
- Pediatric Intensive Care Unit, Meyer Children's University Hospital, Florence, Italy
| | - Stefano Romagnoli
- Section of Anesthesiology and Intensive Care, Department of Health Sciences, University of Florence, Florence, Italy.,Department of Anesthesia and Intensive Care, AOU Careggi, Florence, Italy
| | - Zaccaria Ricci
- Pediatric Intensive Care Unit, Meyer Children's University Hospital, Florence, Italy.,Section of Anesthesiology and Intensive Care, Department of Health Sciences, University of Florence, Florence, Italy
| | - Manuela L'Erario
- Pediatric Intensive Care Unit, Meyer Children's University Hospital, Florence, Italy
| | - Gianluca Villa
- Section of Anesthesiology and Intensive Care, Department of Health Sciences, University of Florence, Florence, Italy.,Department of Anesthesia and Intensive Care, AOU Careggi, Florence, Italy
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Savage SA, Zarzaur BL, Gaski GE, McCarroll T, Zamora R, Namas RA, Vodovotz Y, Callcut RA, Billiar TR, McKinley TO. Insights into the association between coagulopathy and inflammation: abnormal clot mechanics are a warning of immunologic dysregulation following major injury. Ann Transl Med 2020; 8:1576. [PMID: 33437775 PMCID: PMC7791215 DOI: 10.21037/atm-20-3651] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background Severe injury initiates a complex physiologic response encompassing multiple systems and varies phenotypically between patients. Trauma-induced coagulopathy may be an early warning of a poorly coordinated response at the molecular level, including a deleterious immunologic response and worsening of shock states. The onset of trauma-induced coagulopathy (TIC) may be subtle however. In previous work, we identified an early warning sign of coagulopathy from the admission thromboelastogram, called the MAR ratio. We hypothesized that a low MAR ratio would be associated with specific derangements in the inflammatory response. Methods In this prospective, observational study, 88 blunt trauma patients admitted to the intensive care unit (ICU) were identified. Concentrations of inflammatory mediators were recorded serially over the course of a week and the MAR ratio was calculated from the admission thromboelastogram. Correlation analysis was used to assess the relationship between MAR and inflammatory mediators. Dynamic network analysis was used to assess coordination of immunologic response. Results Seventy-nine percent of patients were male and mean age was 37 years (SD 12). The mean ISS was 30.2 (SD 12) and mortality was 7.2%. CRITICAL patients (MAR ratio ≤14.2) had statistically higher shock volumes at three time points in the first day compared to NORMAL patients (MAR ratio >14.2). CRITICAL patients had significant differences in IL-6 (P=0.0065), IL-8 (P=0.0115), IL-10 (P=0.0316) and MCP-1 (P=0.0039) concentrations compared to NORMAL. Differences in degree of expression and discoordination of immune response continued in CRITICAL patients throughout the first day. Conclusions The admission MAR ratio may be the earliest warning signal of a pathologic inflammatory response associated with hypoperfusion and TIC. A low MAR ratio is an early indication of complicated dysfunction of multiple molecular processes following trauma.
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Affiliation(s)
- Stephanie A Savage
- Department of Surgery, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Ben L Zarzaur
- Department of Surgery, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
| | - Greg E Gaski
- Department of Orthopedics, Inova Fairfax Medical Campus, Fairfax, Virginia, USA
| | - Tyler McCarroll
- Department of Orthopedics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ruben Zamora
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rami A Namas
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Yoram Vodovotz
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rachael A Callcut
- Department of Surgery, University of California Davis School of Medicine, Davis, California, USA
| | - Timothy R Billiar
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Todd O McKinley
- Department of Orthopedics, Indiana University School of Medicine, Indianapolis, Indiana, USA
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28
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Link KG, Sorrells MG, Danes NA, Neeves KB, Leiderman K, Fogelson AL. A MATHEMATICAL MODEL OF PLATELET AGGREGATION IN AN EXTRAVASCULAR INJURY UNDER FLOW. Multiscale Model Simul 2020; 18:1489-1524. [PMID: 33867873 PMCID: PMC8051825 DOI: 10.1137/20m1317785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
We present the first mathematical model of flow-mediated primary hemostasis in an extravascular injury which can track the process from initial deposition to occlusion. The model consists of a system of ordinary differential equations (ODEs) that describe platelet aggregation (adhesion and cohesion), soluble-agonist-dependent platelet activation, and the flow of blood through the injury. The formation of platelet aggregates increases resistance to flow through the injury, which is modeled using the Stokes-Brinkman equations. Data from analogous experimental (microfluidic flow) and partial differential equation models informed parameter values used in the ODE model description of platelet adhesion, cohesion, and activation. This model predicts injury occlusion under a range of flow and platelet activation conditions. Simulations testing the effects of shear and activation rates resulted in delayed occlusion and aggregate heterogeneity. These results validate our hypothesis that flow-mediated dilution of activating chemical adenosine diphosphate hinders aggregate development. This novel modeling framework can be extended to include more mechanisms of platelet activation as well as the addition of the biochemical reactions of coagulation, resulting in a computationally efficient high throughput screening tool of primary and secondary hemostasis.
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Affiliation(s)
- Kathryn G Link
- Department of Mathematics, University of California, Davis, Davis, CA 95616 USA
| | - Matthew G Sorrells
- Department of Chemical and Biological Engineering, Colorado School of Mines, Golden, CO 80401 USA
| | - Nicholas A Danes
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, CO 80401 USA
| | - Keith B Neeves
- Departments of Bioengineering and Pediatrics, Hemophilia and Thrombosis Center, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO 80401 USA
| | - Karin Leiderman
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, CO 80401 USA
| | - Aaron L Fogelson
- Department of Mathematics, University of California, Davis, Davis, CA 95616 USA
- Department of Biomedical Engineering University of Utah, Salt Lake City, UT 84112 USA
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Abstract
Further complications associated with infection by severe acute respiratory syndrome coronavirus 2 (a.k.a. SARS-CoV-2) continue to be reported. Very recent findings reveal that 20-30% of patients at high risk of mortality from COVID-19 infection experience blood clotting that leads to stroke and sudden death. Timely assessment of the severity of blood clotting will be of enormous help to clinicians in determining the right blood-thinning medications to prevent stroke or other life-threatening consequences. Therefore, rapid identification of blood-clotting-related proteins in the plasma of COVID-19 patients would save many lives. Several nanotechnology-based approaches are being developed to diagnose patients at high risk of death due to complications from COVID-19 infections, including blood clots. This Perspective outlines (i) the significant potential of nanomedicine in assessing the risk of blood clotting and its severity in SARS-CoV-2 infected patients and (ii) its synergistic roles with advanced mass-spectrometry-based proteomics approaches in identifying the important protein patterns that are involved in the occurrence and progression of this disease. The combination of such powerful tools might help us understand the clotting phenomenon and pave the way for development of new diagnostics and therapeutics in the fight against COVID-19.
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Affiliation(s)
- Amir Ata Saei
- Division
of Physiological Chemistry I, Department of Medical Biochemistry and
Biophysics, Karolinska Institutet, 171 65 Stockholm, Sweden
| | - Shahriar Sharifi
- Precision
Health Program and Department of Radiology, Michigan State University, East Lansing, Michigan 48824, United States
| | - Morteza Mahmoudi
- Precision
Health Program and Department of Radiology, Michigan State University, East Lansing, Michigan 48824, United States
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30
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Edwards JV, Graves E, Prevost N, Condon B, Yager D, Dacorta J, Bopp A. Development of a Nonwoven Hemostatic Dressing Based on Unbleached Cotton: A De Novo Design Approach. Pharmaceutics 2020; 12:pharmaceutics12070609. [PMID: 32629845 PMCID: PMC7407894 DOI: 10.3390/pharmaceutics12070609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023] Open
Abstract
Minimally processed greige (unbleached) cotton fibers demonstrate enhanced clotting relative to highly processed United States Pharmacopeia (USP) type 7 bleached cotton gauze. This effect is thought to be due to the material surface polarity. We hypothesized that a textile could be constructed, conserving the hemostasis-accelerating properties of greige cotton, while maintaining structural integrity and improving absorbance. Spun bond nonwovens of varying surface polarity were designed and prepared based on ratios of greige cotton/bleached cotton/polypropylene fibers. A thromboelastographic analysis was performed on fibrous samples in citrated blood to evaluate the rate of fibrin and clot formation. Lee White clotting times were obtained to assess the material’s clotting activity in platelet fresh blood. An electrokinetic analysis of samples was performed to analyze for material surface polarity. Hemostatic properties varied with composition ratios, fiber density, and fabric fenestration. The determinations of the surface polarity of cotton fabrics with electrokinetic analysis uncovered a range of surface polarities implicated in fabric-initiated clotting; a three-point design approach was employed with the combined use of thromboelastography, thrombin velocity index, Lee White clotting, and absorption capacity determinations applied to fabric structure versus function analysis. The resulting analysis demonstrates that greige cotton may be utilized, along with hydrophilic and hydrophobic fibers, to improve the initiation of fibrin formation and a decrease in clotting time in hemostatic dressings suitable to be commercially developed. Hydroentanglement is an efficient and effective process for imparting structural integrity to cotton-based textiles, while conserving hemostatic function.
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Affiliation(s)
- J. Vincent Edwards
- Southern Regional Research Center, New Orleans, LA 70124, USA; (E.G.); (N.P.); (B.C.)
- Correspondence: ; Tel.: +1-504-284-4360
| | - Elena Graves
- Southern Regional Research Center, New Orleans, LA 70124, USA; (E.G.); (N.P.); (B.C.)
| | - Nicolette Prevost
- Southern Regional Research Center, New Orleans, LA 70124, USA; (E.G.); (N.P.); (B.C.)
| | - Brian Condon
- Southern Regional Research Center, New Orleans, LA 70124, USA; (E.G.); (N.P.); (B.C.)
| | - Dorne Yager
- Plastic and Reconstructive Surgery, Virginia Commonwealth University, Richmond, VA 23111, USA;
| | | | - Alvin Bopp
- Department of Natural Sciences, Southern University at New Orleans, New Orleans, LA 70126, USA;
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31
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Fu Y, An Q, Cheng Y, Yang Y, Wang L, Zhang H, Ge Y, Li D, Zhang Y. A Textile Pile Debridement Material Consisting of Polyester Fibers for in Vitro Removal of Biofilm. Polymers (Basel) 2020; 12:polym12061360. [PMID: 32560399 PMCID: PMC7362169 DOI: 10.3390/polym12061360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022] Open
Abstract
Biofilms formed on skin wound lead to inflammation and a delay of healing. In the present work, a novel textile pile debridement material was prepared and treated by plasma. Samples before and after plasma treatment were characterized by a series of methods, including scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), and water uptake capacity. Besides, mechanical, coagulation, and in vitro biofilm removal performances of the textile pile debridement material were evaluated, with a medical gauze as a control. The results demonstrate that the plasma treatment produced corrosions and oxygen-containing polar groups on the fiber surface, offering an enhanced water uptake capacity of the textile pile debridement material. In addition, compressive tests certify the mechanical performances of the textile pile debridement material in both dry and wet conditions. The results from a kinetic clotting time test suggest a favorable ability to promote blood coagulation. Furthermore, the results of an MTT cell viability assay, SEM, and confocal laser scanning microscopy (CLSM) illustrate that the textile pile debridement material demonstrates a more superior in vitro biofilm removal performance than medical gauze. All of these characterizations suggest that the textile pile debridement material can offer a feasible application for clinical wound debridement.
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Affiliation(s)
- Yijun Fu
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- National & Local Joint Engineering Research Center of Technical Fiber Composites for Safety and Health, College of Textile and Clothing, Nantong University, Nantong 226019, China
| | - Qi An
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
| | - Yue Cheng
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
| | - Yumin Yang
- Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education and Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226019, China;
| | - Lu Wang
- Key Laboratory of Textile Science and Technology of Ministry of Education and College of Textiles, Donghua University, Shanghai 201620, China;
| | - Haifeng Zhang
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- National & Local Joint Engineering Research Center of Technical Fiber Composites for Safety and Health, College of Textile and Clothing, Nantong University, Nantong 226019, China
| | - Yan Ge
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- National & Local Joint Engineering Research Center of Technical Fiber Composites for Safety and Health, College of Textile and Clothing, Nantong University, Nantong 226019, China
| | - Dawei Li
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- Correspondence: (D.L.); (Y.Z.); Tel.: +86-513-8501-2837 (D.L.); +86-513-8501-2871 (Y.Z.)
| | - Yu Zhang
- College of Textile and Clothing, Nantong University, Nantong 226019, China; (Y.F.); (Q.A.); (Y.C.); (H.Z.); (Y.G.)
- National & Local Joint Engineering Research Center of Technical Fiber Composites for Safety and Health, College of Textile and Clothing, Nantong University, Nantong 226019, China
- Correspondence: (D.L.); (Y.Z.); Tel.: +86-513-8501-2837 (D.L.); +86-513-8501-2871 (Y.Z.)
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32
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Shimohata N, Echigo R, Karatsu K, Uchikawa S, Suzuki S, Chung UI, Sasaki N, Mochizuki M. Trehalose decreases blood clotting in the cerebral space after experimental subarachnoid hemorrhage. J Vet Med Sci 2020; 82:566-570. [PMID: 32173691 PMCID: PMC7273599 DOI: 10.1292/jvms.19-0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Subarachnoid hemorrhage (SAH) frequently results in several serious complications, such as cerebral vasospasm. We previously reported the effect of trehalose on vasospasm, inflammatory
responses, and lipid peroxidation induced by blood exposure. Herein, to further elucidate the mechanism of action of trehalose, we investigated whether or not post-administration of
trehalose can directly influence blood clotting in the cistern. As a result of trehalose injection after the onset of experimental SAH, blood clotting around the basilar artery was clearly
inhibited. We also found that trehalose positively impacted coagulation and fibrinolysis parameters in rat, rabbit and human plasma in vitro. These findings suggest that
trehalose has suppressive effects on blood clotting in addition to vasospasm, inflammatory responses, and lipid peroxidation after SAH.
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Affiliation(s)
- Nobuyuki Shimohata
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Ryosuke Echigo
- Department of Veterinary Surgery, Graduate School of Agriculture and Life Science, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan.,Faculty of Veterinary Medicine, Hokkaido University, Kita 18, Nishi 9, Kita-ku, Sapporo, Hokkaido 080-0818, Japan
| | - Kensuke Karatsu
- Department of Veterinary Surgery, Graduate School of Agriculture and Life Science, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Saori Uchikawa
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Nojihigashi, Kusatsu, Shiga 525-8577, Japan
| | - Shigeki Suzuki
- NEXT21 K.K., 3-38-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ung-Il Chung
- Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, 2-11-16 Yayoi, Bunkyo-ku, Tokyo 113-8656, Japan.,Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Nobuo Sasaki
- Department of Veterinary Surgery, Graduate School of Agriculture and Life Science, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Manabu Mochizuki
- Department of Veterinary Surgery, Graduate School of Agriculture and Life Science, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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Rizwan M, Yao Y, Gorbet MB, Tse J, Anderson DEJ, Hinds MT, Yim EKF. One-Pot Covalent Grafting of Gelatin on Poly(Vinyl Alcohol) Hydrogel to Enhance Endothelialization and Hemocompatibility for Synthetic Vascular Graft Applications. ACS Appl Bio Mater 2020; 3:693-703. [PMID: 32656504 PMCID: PMC7351135 DOI: 10.1021/acsabm.9b01026] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cardiovascular diseases remain the leading cause of death worldwide. Patency rates of clinically-utilized small diameter synthetic vascular grafts such as Dacron® and expanded polytetrafluoroethylene (ePTFE) to treat cardiovascular disease are inadequate due to lack of endothelialization. Sodium trimetaphosphate (STMP) crosslinked PVA could be potentially employed as blood-compatible small diameter vascular graft for the treatment of cardiovascular disease. However, PVA severely lacks cell adhesion properties, and the efforts to endothelialize STMP-PVA have been insufficient to produce a functioning endothelium. To this end, we developed a one-pot method to conjugate cell-adhesive protein via hydroxyl-to-amine coupling using carbonyldiimidazole by targeting residual hydroxyl groups on crosslinked STMP-PVA hydrogel. Primary human umbilical vascular endothelial cells (HUVECs) demonstrated significantly improved cells adhesion, viability and spreading on modified PVA. Cells formed a confluent endothelial monolayer, and expressed vinculin focal adhesions, cell-cell junction protein zonula occludens 1 (ZO1), and vascular endothelial cadherin (VE-Cadherin). Extensive characterization of the blood-compatibility was performed on modified PVA hydrogel by examining platelet activation, platelet microparticle formation, platelet CD61 and CD62P expression, and thrombin generation, which showed that the modified PVA was blood-compatible. Additionally, grafts were tested under whole, flowing blood without any anticoagulants in a non-human primate, arteriovenous shunt model. No differences were seen in platelet or fibrin accumulation between the modified-PVA, unmodified PVA or clinical, ePTFE controls. This study presents a significant step in the modification of PVA for the development of next generation in situ endothelialized synthetic vascular grafts.
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Affiliation(s)
- Muhammad Rizwan
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - Yuan Yao
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - Maud B. Gorbet
- Systems Design Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
- Centre for Bioengineering and Biotechnology, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - John Tse
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
| | - Deirdre E. J. Anderson
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Monica T. Hinds
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - Evelyn K. F. Yim
- Department of Chemical Engineering, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1
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Sorensen AB, Tuneew I, Svensson LA, Persson E, Østergaard H, Overgaard MT, Olsen OH, Gandhi PS. Beating tissue factor at its own game: Design and properties of a soluble tissue factor-independent coagulation factor VIIa. J Biol Chem 2019; 295:517-528. [PMID: 31801825 DOI: 10.1074/jbc.ra119.009183] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/29/2019] [Indexed: 11/06/2022] Open
Abstract
Two decades of research have uncovered the mechanism by which the complex of tissue factor (TF) and the plasma serine protease factor VIIa (FVIIa) mediates the initiation of blood coagulation. Membrane-anchored TF directly interacts with substrates and induces allosteric effects in the protease domain of FVIIa. These properties are also recapitulated by the soluble ectodomain of TF (sTF). At least two interdependent allosteric activation pathways originate at the FVIIa:sTF interface are proposed to enhance FVIIa activity upon sTF binding. Here, we sought to engineer an sTF-independent FVIIa variant by stabilizing both proposed pathways, with one pathway terminating at segment 215-217 in the activation domain and the other pathway terminating at the N terminus insertion site. To stabilize segment 215-217, we replaced the flexible 170 loop of FVIIa with the more rigid 170 loop from trypsin and combined it with an L163V substitution (FVIIa-VYT). The FVIIa-VYT variant exhibited 60-fold higher amidolytic activity than FVIIa, and displayed similar FX activation and antithrombin inhibition kinetics to the FVIIa.sTF complex. The sTF-independent activity of FVIIa-VYT was partly mediated by an increase in the N terminus insertion and, as shown by X-ray crystallography, partly by Tyr-172 inserting into a cavity in the activation domain stabilizing the S1 substrate-binding pocket. The combination with L163V likely drove additional changes in a delicate hydrogen-bonding network that further stabilized S1-S3 sites. In summary, we report the first FVIIa variant that is catalytically independent of sTF and provide evidence supporting the existence of two TF-mediated allosteric activation pathways.
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Affiliation(s)
- Anders B Sorensen
- Global Research, Novo Nordisk A/S, DK-2760 Måløv, Denmark; Department of Chemistry and Bioscience, Aalborg University, DK-9220 Aalborg, Denmark.
| | - Inga Tuneew
- Global Research, Novo Nordisk A/S, DK-2760 Måløv, Denmark
| | | | - Egon Persson
- Global Research, Novo Nordisk A/S, DK-2760 Måløv, Denmark
| | | | | | - Ole H Olsen
- Global Research, Novo Nordisk A/S, DK-2760 Måløv, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Section for Metabolic Receptology, University of Copenhagen, Blegdamsvej 3b, DK-2200 Copenhagen N, Denmark
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35
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Danes N, Leiderman K. A density-dependent FEM-FCT algorithm with application to modeling platelet aggregation. Int J Numer Method Biomed Eng 2019; 35:e3212. [PMID: 31117155 PMCID: PMC6718345 DOI: 10.1002/cnm.3212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/05/2019] [Accepted: 05/02/2019] [Indexed: 05/17/2023]
Abstract
Upon injury to a blood vessel, flowing platelets will aggregate at the injury site, forming a plug to prevent blood loss. Through a complex system of biochemical reactions, a stabilizing mesh forms around the platelet aggregate forming a blood clot that further seals the injury. Computational models of clot formation have been developed to a study intravascular thrombosis, where a vessel injury does not cause blood leakage outside the blood vessel but blocks blood flow. To model scenarios in which blood leaks from a main vessel out into the extravascular space, new computational tools need to be developed to handle the complex geometries that represent the injury. We have previously modeled intravascular clot formation under flow using a continuum approach wherein the transport of platelet densities into some spatial location is limited by the platelet fraction that already reside in that location, i.e., the densities satisfy a maximum packing constraint through the use of a hindered transport coefficient. To extend this notion to extravascular injury geometries, we have modified a finite element method flux-corrected transport (FEM-FCT) scheme by prelimiting antidiffusive nodal fluxes. We show that our modified scheme, under a variety of test problems, including mesh refinement, structured vs unstructured meshes, and for a range of reaction rates, produces numerical results that satisfy a maximum platelet-density packing constraint.
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Wilson AC, Chou SF, Lozano R, Chen JY, Neuenschwander PF. Thermal and Physico-Mechanical Characterizations of Thromboresistant Polyurethane Films. Bioengineering (Basel) 2019; 6:bioengineering6030069. [PMID: 31416139 PMCID: PMC6783839 DOI: 10.3390/bioengineering6030069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/19/2019] [Accepted: 08/07/2019] [Indexed: 01/27/2023] Open
Abstract
Hemocompatibility remains a challenge for injectable and/or implantable medical devices, and thromboresistant coatings appear to be one of the most attractive methods to down-regulate the unwanted enzymatic reactions that promote the formation of blood clots. Among all polymeric materials, polyurethanes (PUs) are a class of biomaterials with excellent biocompatibility and bioinertness that are suitable for the use of thromboresistant coatings. In this work, we investigated the thermal and physico-mechanical behaviors of ester-based and ether-based PU films for potential uses in thromboresistant coatings. Our results show that poly(ester urethane) and poly(ether urethane) films exhibited characteristic peaks corresponding to their molecular configurations. Thermal characterizations suggest a two-step decomposition process for the poly(ether urethane) films. Physico-mechanical characterizations show that the surfaces of the PU films were hydrophobic with minimal weight changes in physiological conditions over 14 days. All PU films exhibited high tensile strength and large elongation to failure, attributed to their semi-crystalline structure. Finally, the in vitro clotting assays confirmed their thromboresistance with approximately 1000-fold increase in contact time with human blood plasma as compared to the glass control. Our work correlates the structure-property relationships of PU films with their excellent thromboresistant ability.
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Affiliation(s)
- Aaron C Wilson
- Department of Mechanical Engineering, College of Engineering, The University of Texas at Tyler, 3900 University Blvd, Tyler, TX 75799, USA
| | - Shih-Feng Chou
- Department of Mechanical Engineering, College of Engineering, The University of Texas at Tyler, 3900 University Blvd, Tyler, TX 75799, USA.
| | - Roberto Lozano
- School of Human Ecology, College of Natural Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Jonathan Y Chen
- School of Human Ecology, College of Natural Sciences, The University of Texas at Austin, Austin, TX 78712, USA
| | - Pierre F Neuenschwander
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, Tyler, TX 75708, USA
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Watson EE, Ripoll-Rozada J, Lee AC, Wu MCL, Franck C, Pasch T, Premdjee B, Sayers J, Pinto MF, Martins PM, Jackson SP, Pereira PJB, Payne RJ. Rapid assembly and profiling of an anticoagulant sulfoprotein library. Proc Natl Acad Sci U S A 2019; 116:13873-8. [PMID: 31221752 DOI: 10.1073/pnas.1905177116] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Hematophagous organisms produce a suite of salivary proteins which interact with the host's coagulation machinery to facilitate the acquisition and digestion of a bloodmeal. Many of these biomolecules inhibit the central blood-clotting serine proteinase thrombin that is also the target of several clinically approved anticoagulants. Here a bioinformatics approach is used to identify seven tick proteins with putative thrombin inhibitory activity that we predict to be posttranslationally sulfated at two conserved tyrosine residues. To corroborate the biological role of these molecules and investigate the effects of amino acid sequence and sulfation modifications on thrombin inhibition and anticoagulant activity, a library of 34 homogeneously sulfated protein variants were rapidly assembled using one-pot diselenide-selenoester ligation (DSL)-deselenization chemistry. Downstream functional characterization validated the thrombin-directed activity of all target molecules and revealed that posttranslational sulfation of specific tyrosine residues crucially modulates potency. Importantly, access to this homogeneously modified protein library not only enabled the determination of key structure-activity relationships and the identification of potent anticoagulant leads, but also revealed subtleties in the mechanism of thrombin inhibition, between and within the families, that would be impossible to predict from the amino acid sequence alone. The synthetic platform described here therefore serves as a highly valuable tool for the generation and thorough characterization of libraries of related peptide and/or protein molecules (with or without modifications) for the identification of lead candidates for medicinal chemistry programs.
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38
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Bradford HN, Krishnaswamy S. Occlusion of anion-binding exosite 2 in meizothrombin explains its impaired ability to activate factor V. J Biol Chem 2019; 294:2422-2435. [PMID: 30578302 DOI: 10.1074/jbc.ra118.006510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/12/2018] [Indexed: 11/06/2022] Open
Abstract
The proteolytic conversion of factor V to factor Va is central for amplified flux through the blood coagulation cascade. Heterodimeric factor Va is produced by cleavage at three sites in the middle of factor V by thrombin, yielding an N terminus-derived heavy chain and a C terminus-derived light chain. Here, we show that light chain formation resulting from the C-terminal cleavage is the rate-limiting step in the formation of fully cleaved Va. This rate-limiting step also corresponded to and was sufficient for the ability of cleaved factor V to bind Xa and assemble into the prothrombinase complex. Meizothrombin, the proteinase intermediate in thrombin formation, cleaves factor V more slowly than does thrombin, resulting in a pronounced defect in the formation of the light chain. A ∼100-fold reduced rate of meizothrombin-mediated light chain formation by meizothrombin corresponded to equally slow production of active cofactor and an impaired ability to amplify flux through the coagulation cascade initiated in plasma. We show that this defect arises from the occlusion of anion-binding exosite 2 in the catalytic domain by the covalently retained propiece in meizothrombin. Our findings provide structural insights into the prominent role played by exosite 2 in the rate-limiting step of factor V activation. They also bear on how factor V is converted into a cofactor capable of assembling into prothrombinase.
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Affiliation(s)
- Harlan N Bradford
- From the Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104 and
| | - Sriram Krishnaswamy
- From the Research Institute, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104 and .,the Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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Seo D, Cha SK, Kim G, Shin H, Hong S, Cho YH, Chun H, Choi Y. Flexible and Stable Omniphobic Surfaces Based on Biomimetic Repulsive Air-Spring Structures. ACS Appl Mater Interfaces 2019; 11:5877-5884. [PMID: 30648844 DOI: 10.1021/acsami.8b20521] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In artificial biological circulation systems such as extracorporeal membrane oxygenation, surface wettability is a critical factor in blood clotting problems. Therefore, to prevent blood from clotting, omniphobic surfaces are required to repel both hydrophilic and oleophilic liquids and reduce surface friction. However, most omniphobic surfaces have been fabricated by combining chemical reagent coating and physical structures and/or using rigid materials such as silicon and metal. It is almost impossible for chemicals to be used in the omniphobic surface for biomedical devices due to durability and toxicity. Moreover, a flexible and stable omniphobic surface is difficult to be fabricated by using conventional rigid materials. This study demonstrates a flexible and stable omniphobic surface by mimicking the re-entrant structure of springtail's skin. Our surface consists of a thin nanohole membrane on supporting microstructures. This structure traps air under the membrane, which can repel the liquid on the surface like a spring and increase the contact angle regardless of liquid type. By theoretical wetting model and simulation, we confirm that the omniphobic property is derived from air trapped in the structure. Also, our surface well maintains the omniphobicity under a highly pressurized condition. As a proof of our concept and one of the real-life applications, blood experiments are performed with our flat and curved surfaces and the results including contact angle, advancing/receding angles, and residuals show significant omniphobicity. We hope that our omniphobic surface has a significant impact on blood-contacting biomedical applications.
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Affiliation(s)
| | | | | | | | | | - Yang Hyun Cho
- Department of Thoracic and Cardiovascular Surgery , Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul 06351 , Republic of Korea
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Tutwiler V, Peshkova AD, Le Minh G, Zaitsev S, Litvinov RI, Cines DB, Weisel JW. Blood clot contraction differentially modulates internal and external fibrinolysis. J Thromb Haemost 2019; 17:361-370. [PMID: 30582674 DOI: 10.1111/jth.14370] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Indexed: 01/16/2023]
Abstract
Essentials Clot contraction influences the rate of fibrinolysis in vitro. Internal fibrinolysis is enhanced ∼2-fold in contracted vs. uncontracted blood clots. External fibrinolysis is ∼4-fold slower in contracted vs. uncontracted blood clots. Contraction can modulate lytic resistance and potentially the clinical outcome of thrombosis. SUMMARY: Background Fibrinolysis involves dissolution of polymeric fibrin networks that is required to restore blood flow through vessels obstructed by thrombi. The efficiency of lysis depends in part on the susceptibility of fibrin to enzymatic digestion, which is governed by the structure and spatial organization of fibrin fibers. How platelet-driven clot contraction affects the efficacy of fibrinolysis has received relatively little study. Objective Here, we examined the effects of clot contraction on the rate of internal fibrinolysis emanating from within the clot to simulate (patho)physiological conditions and external fibrinolysis initiated from the clot exterior to simulate therapeutic thrombolysis. Methods Clot contraction was prevented by inhibiting platelet myosin IIa activity, actin polymerization or platelet-fibrin(ogen) binding. Internal fibrinolysis was measured by optical tracking of clot size. External fibrinolysis was determined by the release of radioactive fibrin degradation products. Results and Conclusions Clot contraction enhanced the rate of internal fibrinolysis ∼2-fold. In contrast, external fibrinolysis was ~4-fold slower in contracted clots. This dichotomy in the susceptibility of contracted and uncontracted clots to internal vs. external lysis suggests that the rate of lysis is dependent upon the interplay between accessibility of fibrin fibers to fibrinolytic agents, including clot permeability, and the spatial proximity of the fibrin fibers that modulate the effects of the fibrinolytic enzymes. Understanding how compaction of blood clots influences clot lysis might have important implications for prevention and treatment of thrombotic disorders.
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Affiliation(s)
- Valerie Tutwiler
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Alina D Peshkova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Giang Le Minh
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Sergei Zaitsev
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Rustem I Litvinov
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Douglas B Cines
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - John W Weisel
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Abstract
New evidence has stirred up a long-standing but undeservedly forgotten interest in the role of erythrocytes, or red blood cells (RBCs), in blood clotting and its disorders. This review summarizes the most recent research that describes the involvement of RBCs in hemostasis and thrombosis. There are both quantitative and qualitative changes in RBCs that affect bleeding and thrombosis, as well as interactions of RBCs with cellular and molecular components of the hemostatic system. The changes in RBCs that affect hemostasis and thrombosis include RBC counts or hematocrit (modulating blood rheology through viscosity) and qualitative changes, such as deformability, aggregation, expression of adhesive proteins and phosphatidylserine, release of extracellular microvesicles, and hemolysis. The pathogenic mechanisms implicated in thrombotic and hemorrhagic risk include variable adherence of RBCs to the vessel wall, which depends on the functional state of RBCs and/or endothelium, modulation of platelet reactivity and platelet margination, alterations of fibrin structure and reduced susceptibility to fibrinolysis, modulation of nitric oxide availability, and the levels of von Willebrand factor and factor VIII in blood related to the ABO blood group system. RBCs are involved in platelet-driven contraction of clots and thrombi that results in formation of a tightly packed array of polyhedral erythrocytes, or polyhedrocytes, which comprises a nearly impermeable barrier that is important for hemostasis and wound healing. The revisited notion of the importance of RBCs is largely based on clinical and experimental associations between RBCs and thrombosis or bleeding, implying that RBCs are a prospective therapeutic target in hemostatic and thrombotic disorders.
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Affiliation(s)
- J. W. WEISEL
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - R. I. LITVINOV
- Department of Cell and Developmental Biology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
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42
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Kell DB, Pretorius E. No effects without causes: the Iron Dysregulation and Dormant Microbes hypothesis for chronic, inflammatory diseases. Biol Rev Camb Philos Soc 2018; 93:1518-1557. [PMID: 29575574 PMCID: PMC6055827 DOI: 10.1111/brv.12407] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/12/2018] [Accepted: 02/15/2018] [Indexed: 12/11/2022]
Abstract
Since the successful conquest of many acute, communicable (infectious) diseases through the use of vaccines and antibiotics, the currently most prevalent diseases are chronic and progressive in nature, and are all accompanied by inflammation. These diseases include neurodegenerative (e.g. Alzheimer's, Parkinson's), vascular (e.g. atherosclerosis, pre-eclampsia, type 2 diabetes) and autoimmune (e.g. rheumatoid arthritis and multiple sclerosis) diseases that may appear to have little in common. In fact they all share significant features, in particular chronic inflammation and its attendant inflammatory cytokines. Such effects do not happen without underlying and initially 'external' causes, and it is of interest to seek these causes. Taking a systems approach, we argue that these causes include (i) stress-induced iron dysregulation, and (ii) its ability to awaken dormant, non-replicating microbes with which the host has become infected. Other external causes may be dietary. Such microbes are capable of shedding small, but functionally significant amounts of highly inflammagenic molecules such as lipopolysaccharide and lipoteichoic acid. Sequelae include significant coagulopathies, not least the recently discovered amyloidogenic clotting of blood, leading to cell death and the release of further inflammagens. The extensive evidence discussed here implies, as was found with ulcers, that almost all chronic, infectious diseases do in fact harbour a microbial component. What differs is simply the microbes and the anatomical location from and at which they exert damage. This analysis offers novel avenues for diagnosis and treatment.
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Affiliation(s)
- Douglas B. Kell
- School of ChemistryThe University of Manchester, 131 Princess StreetManchesterLancsM1 7DNU.K.
- The Manchester Institute of BiotechnologyThe University of Manchester, 131 Princess StreetManchesterLancsM1 7DNU.K.
- Department of Physiological SciencesStellenbosch University, Stellenbosch Private Bag X1Matieland7602South Africa
| | - Etheresia Pretorius
- Department of Physiological SciencesStellenbosch University, Stellenbosch Private Bag X1Matieland7602South Africa
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Chérifi F, Saoud S, Laraba-Djebari F. Molecular modeling, biochemical characterization, and pharmacological properties of Cc 3 -SPase: A platelet-aggregating thrombin-like enzyme purified from Cerastes cerastes venom. J Biochem Mol Toxicol 2018; 32:e22165. [PMID: 29979475 DOI: 10.1002/jbt.22165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 05/23/2018] [Accepted: 06/15/2018] [Indexed: 01/25/2023]
Abstract
Cc3 -SPase (30 kDa-proteinase; pI 5.98) was isolated from Cerastes cerastes venom. Its sequence of 271 residues yielded from LC-MALDI-TOF showed high degrees of homology when aligned with other proteinases. Cc3 -SPase cleaved natural and synthetic proteins such as casein and fibrinogen leaving fibrin clots unaffected. Cc3 -SPase was fully abolished by ion chelators, whereas aprotinin, antithrombin III (Sigma Aldrich, Saint-Louis, Missouri, USA), and heparin were ineffective. Affinity of Cc3 -SPase to benzamidine indicated the presence of an aspartate residue in the catalytic site as confirmed by three-dimensional structure consisting of 14 β-strands and four α-helices. Molecular mechanisms revealed that Cc3 -SPase is capable of promoting dysfunctional platelet aggregation via two signaling pathways mediated by the G-coupled protein receptors and αIIbβ3 integrin. Cc3 -SPase is involved in both extrinsic/intrinsic coagulation pathways in deficient plasmas by replacing defective/lacking factors FII, FVII, and FVIII but not FX. Cc3 -SPase could substitute missing factors in blood diseases related to plasma factor deficiencies.
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Affiliation(s)
- Fatah Chérifi
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, Bab Ezzouar, Algiers, Algeria
| | - Samah Saoud
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, Bab Ezzouar, Algiers, Algeria
| | - Fatima Laraba-Djebari
- USTHB, Faculty of Biological Sciences, Laboratory of Cellular and Molecular Biology, Bab Ezzouar, Algiers, Algeria
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Schneider TM, Nagel AM, Zorn M, Wetscherek A, Bendszus M, Ladd ME, Straub S. Quantitative susceptibility mapping and 23 Na imaging-based in vitro characterization of blood clotting kinetics. NMR Biomed 2018; 31:e3926. [PMID: 29694688 DOI: 10.1002/nbm.3926] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/16/2018] [Accepted: 03/04/2018] [Indexed: 06/08/2023]
Abstract
Blood clotting is a fundamental biochemical process in post-hemorrhagic hemostasis. Although the varying appearance of coagulating blood in T1 - and T2 -weighted images is widely used to qualitatively determine bleeding age, the technique permits only a rough discrimination of coagulation stages, and it remains difficult to distinguish acute and chronic hemorrhagic stages because of low T1 - and T2 -weighted signal intensities in both instances. To investigate new biomedical parameters for magnetic resonance imaging-based characterization of blood clotting kinetics, sodium imaging and quantitative susceptibility mapping (QSM) were compared with conventional T1 - and T2 -weighted imaging, as well as with biochemical hemolysis parameters. For this purpose, a blood-filled spherical agar phantom was investigated daily for 14 days, as well as after 24 days at 7 T after initial preparation with fresh blood. T1 - and T2 -weighted sequences, a three-dimensional (3D) gradient echo sequence and a density-adapted 3D radial projection reconstruction pulse sequence for 23 Na imaging were applied. For hemolysis estimations, free hemoglobin and free potassium concentrations were measured photometrically and with the direct ion-selective electrode method, respectively, in separate heparinized whole-blood samples along the same timeline. Initial mean susceptibility was low (0.154 ± 0.020 ppm) and increased steadily during the course of coagulation to reach up to 0.570 ± 0.165 ppm. The highest total sodium (NaT) values (1.02 ± 0.06 arbitrary units) in the clot were observed initially, dropped to 0.69 ± 0.13 arbitrary units after one day and increased again to initial values. Compartmentalized sodium (NaS) showed a similar signal evolution, and the NaS/NaT ratio steadily increased over clot evolution. QSM depicts clot evolution in vitro as a process associated with hemoglobin accumulation and transformation, and enables the differentiation of the acute and chronic coagulation stages. Sodium imaging visualizes clotting independent of susceptibility and seems to correspond to clot integrity. A combination of QSM and sodium imaging may enhance the characterization of hemorrhage.
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Affiliation(s)
- Till M Schneider
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Markus Zorn
- Department of Medical Chemistry, University of Heidelberg, Heidelberg, Germany
| | - Andreas Wetscherek
- Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Martin Bendszus
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Mark E Ladd
- Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Sina Straub
- Medical Physics in Radiology, German Cancer Research Center, Heidelberg, Germany
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Khan I, Vishwakarma SK, Khan AA, Ramakrishnan G, Dutta JR. In vitro hemocompatability evaluation of gold nanoparticles capped with Lactobacillus plantarum derived lipase1. Clin Hemorheol Microcirc 2018; 69:197-205. [PMID: 29630542 DOI: 10.3233/ch-189117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Gold nanoparticles (GNPs) are key diagnostic and therapeutic agents in biomedical sciences. Several studies have been carried out in different therapeutic areas such as in cancer treatment, antibacterial topical agents, imaging agents etc. There is a necessity to evaluate the gold nanoparticles cytotoxicity at all fronts. Since blood is the first point of contact in any therapy, it is required to have a thorough in vitro investigation of gold nanoparticles to avoid any adverse effects. OBJECTIVE The objective of the current study is to evaluate the effect of gold nanoparticles capped with lipase on blood clotting factors, platelets, coagulation time and blood clotting strength. METHODS Whole blood samples were drawn from healthy volunteers. Plasma and plasma with platelets were isolated from the blood and all the samples were treated with lipase capped gold nanoparticles, except control. Plasma fibrinogen formed in the blood coagulation process after contacting with nanoparticles was quantitatively evaluated. In addition, platelet aggregation, blood clotting kinetics, strength of the blood clot and time were evaluated post nanoparticle treatment. RESULTS The work primarily explores the effect of GNPs on blood with changing concentrations of lipase capping. Plasma fibrinogen levels of plasma samples were found to be moderately elevated, however, there is no significant effect on blood clotting kinetics, strength, and platelet aggregation. Also, the study showed that lipase capped GNPs did not result in aggregation upon interaction with plasma components and remained stable for 1 hour after incubation. CONCLUSIONS Our study revealed that lipase capped GNPs synthesized using NaBH4 approach were stable and hemocompatible. There is an increase in fibrinogen levels after the exposure to nanoparticles, an observation which is consistent with other studies. However, the functional consequences of such increase are unknown. The results of no significant platelet aggregation, change in blood clotting time, kinetics, and clot strength revealed the non-toxic effect of lipase capped GNPs towards blood components, which is essential for any in vivo applications.
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Affiliation(s)
- Imran Khan
- Department of Biological Sciences, BITS Pilani, Hyderabad Campus, Jawahar Nagar, Shameerpet Mandal, Hyderabad, Telangana, India
| | - Sandeep Kumar Vishwakarma
- Central Laboratory for Stem Cell Research and Translational Medicine, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, Telangana, India
| | - Aleem Ahmed Khan
- Central Laboratory for Stem Cell Research and Translational Medicine, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, Telangana, India
| | - Ganesan Ramakrishnan
- Department of Chemistry, BITS Pilani, Hyderabad Campus, Jawahar Nagar, Shameerpet Mandal, Hyderabad, Telangana, India
| | - Jayati Ray Dutta
- Department of Biological Sciences, BITS Pilani, Hyderabad Campus, Jawahar Nagar, Shameerpet Mandal, Hyderabad, Telangana, India
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Peshkova AD, Malyasyov DV, Bredikhin RA, Le Minh G, Andrianova IA, Tutwiler V, Nagaswami C, Weisel JW, Litvinov RI. Reduced Contraction of Blood Clots in Venous Thromboembolism Is a Potential Thrombogenic and Embologenic Mechanism. TH Open 2018; 2:e104-e115. [PMID: 31249934 PMCID: PMC6524864 DOI: 10.1055/s-0038-1635572] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 02/08/2018] [Indexed: 12/12/2022] Open
Abstract
Contraction (retraction) of the blood clot is a part of the clotting process driven by activated platelets attached to fibrin that can potentially modulate the obstructiveness and integrity of thrombi. The aim of this work was to reveal the pathogenic importance of contraction of clots and thrombi in venous thromboembolism (VTE). We investigated the kinetics of clot contraction in the blood of 55 patients with VTE. In addition, we studied the ultrastructure of ex vivo venous thrombi as well as the morphology and functionality of isolated platelets. Thrombi from VTE patients contained compressed polyhedral erythrocytes, a marker for clot contraction in vivo. The extent and rate of contraction were reduced by twofold in clots from the blood of VTE patients compared with healthy controls. The contraction of clots from the blood of patients with pulmonary embolism was significantly impaired compared with that of those with isolated venous thrombosis, suggesting that less compacted thrombi are prone to embolization. The reduced ability of clots to contract correlated with continuous platelet activation followed by their partial refractoriness. Morphologically, 75% of platelets from VTE patients were spontaneously activated (with filopodia) compared with only 21% from healthy controls. At the same time, platelets from VTE patients showed a 1.4-fold reduction in activation markers expressed in response to chemical activation when compared with healthy individuals. The results obtained suggest that the impaired contraction of thrombi is an underappreciated pathogenic mechanism in VTE that may regulate the obstructiveness and embologenicity of venous thrombi.
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Affiliation(s)
- Alina D Peshkova
- Department of Biochemistry and Biotechnology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Dmitry V Malyasyov
- Department of Vascular Surgery, Inter-Regional Clinical Diagnostic Center, Kazan, Russian Federation
| | - Roman A Bredikhin
- Department of Vascular Surgery, Inter-Regional Clinical Diagnostic Center, Kazan, Russian Federation
| | - Giang Le Minh
- Department of Biochemistry and Biotechnology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Izabella A Andrianova
- Department of Biochemistry and Biotechnology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation
| | - Valerie Tutwiler
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| | - Chandrasekaran Nagaswami
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| | - John W Weisel
- Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| | - Rustem I Litvinov
- Department of Biochemistry and Biotechnology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russian Federation.,Department of Cell and Developmental Biology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
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Pich J. Plasma transfusions prior to insertion of central lines for people with abnormal coagulation. Nurs Stand 2018; 32:41-43. [PMID: 29411952 DOI: 10.7748/ns.2018.e11098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 11/09/2022]
Abstract
The mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes through increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and healthcare professionals who deliver, lead or research nursing care. The CNCF produces Cochrane Corner columns, summaries of recent nursing-care-relevant Cochrane Reviews that are regularly published in collaborating nursing-related journals. Information on the processes CNCF has developed can be accessed at: cncf.cochrane.org/evidence-transfer-program-review-summaries. This is a Cochrane review summary of: Hall DP, Estcourt LJ, Doree C et al ( 2016 ) Plasma transfusions prior to insertion of central lines for people with abnormal coagulation. Cochrane Database of Systematic Reviews. Issue 9. CD011756. doi: 10.1002/14651858.CD011756.pub2.
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Affiliation(s)
- Jacqueline Pich
- Faculty of Health, University of Technology Sydney, New South Wales, Australia, and member of the Cochrane Nursing Care Field
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Abstract
Anticoagulant drugs are widely used in hospital and community settings. Anticoagulation is the first-line treatment for venous thromboembolism, and anticoagulant drugs have an important role in the treatment and prevention of blood clots. However, maintaining the equilibrium between clotting and bleeding can be challenging and anticoagulants have been identified as a class of drug associated with preventable patient harm. Direct oral anticoagulants (DOACs) have become the first-line treatment for many patients requiring an anticoagulant, removing the burden of frequent tests and the many food and drug interactions associated with vitamin K antagonists such as warfarin sodium. However, DOACs have increased the complexity of decision-making regarding treatment, which also increases the risk of drug errors. This article discusses the uses, modes of action and potential side effects of anticoagulants, to improve nurses' understanding and enable them to have an active role in limiting the risk of harm from these drugs.
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Affiliation(s)
- Emma Gee
- Thrombosis and coagulation, King's College Hospital NHS Foundation Trust, London, England
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Le Minh G, Peshkova AD, Andrianova IA, Sibgatullin TB, Maksudova AN, Weisel JW, Litvinov RI. Impaired contraction of blood clots as a novel prothrombotic mechanism in systemic lupus erythematosus. Clin Sci (Lond) 2018; 132:243-54. [PMID: 29295895 DOI: 10.1042/CS20171510] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 12/13/2017] [Accepted: 01/01/2018] [Indexed: 11/17/2022]
Abstract
The aim of this work was to examine a possible role of clot contraction/retraction in thrombotic complications of systemic lupus erythematosus (SLE). Using a novel automated method, we investigated kinetics of clot contraction in the blood of 51 SLE patients and 60 healthy donors. The functionality of platelets in the SLE patients was assessed using flow cytometry by expression of P-selectin and fibrinogen-binding capacity. The rate and degree of clot contraction were significantly reduced in SLE patients compared with healthy subjects, especially in the patients with higher blood levels of anti-dsDNA antibodies. The reduced platelet contractility correlated with partial refractoriness of platelets isolated from the blood of SLE patients to stimulation induced by the thrombin receptor activating peptide. To test if the anti-dsDNA autoantibodies cause continuous platelet activation, followed by exhaustion and dysfunction of the cells, we added purified exogenous anti-dsDNA autoantibodies from SLE patients to normal blood before clotting. In support of this hypothesis, the antibodies first enhanced clot contraction and then suppressed it in a time-dependent manner. Importantly, a direct correlation of clot contraction parameters with the disease severity suggests that the reduced compactness of intravascular clots and thrombi could be a pathogenic factor in SLE that may exaggerate the impaired blood flow at the site of thrombosis. In conclusion, autoantibodies in SLE can affect platelet contractility, resulting in reduced ability of clots and thrombi to shrink in volume, which increases vessel obstruction and may aggravate the course and outcomes of thrombotic complications in SLE.
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Ramachandran R, Maani N, Rayz VL, Nosonovsky M. Vibrations and spatial patterns in biomimetic surfaces: using the shark-skin effect to control blood clotting. Philos Trans A Math Phys Eng Sci 2016; 374:rsta.2016.0133. [PMID: 27354733 DOI: 10.1098/rsta.2016.0133] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/19/2016] [Indexed: 05/08/2023]
Abstract
We study the effect of small-amplitude fast vibrations and small-amplitude spatial patterns on various systems involving wetting and liquid flow, such as superhydrophobic surfaces, membranes and flow pipes. First, we introduce a mathematical method of averaging the effect of small spatial and temporal patterns and substituting them with an effective force. Such an effective force can change the equilibrium state of a system as well as a phase state, leading to surface texture-induced and vibration-induced phase control. Vibration and patterns can effectively jam holes in vessels with liquid, separate multi-phase flow, change membrane properties, result in propulsion and locomotion and lead to many other multi-scale, nonlinear effects including the shark-skin effect. We discuss the application of such effects to blood flow for novel biomedical 'haemophobic' applications which can prevent blood clotting and thrombosis by controlling the surface pattern at a wall of a vessel (e.g. a catheter or stent).This article is part of the themed issue 'Bioinspired hierarchically structured surfaces for green science'.
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Affiliation(s)
- Rahul Ramachandran
- College of Engineering and Applied Science, University of Wisconsin, Milwaukee, WI 53201, USA
| | - Nazanin Maani
- College of Engineering and Applied Science, University of Wisconsin, Milwaukee, WI 53201, USA
| | - Vitaliy L Rayz
- College of Engineering and Applied Science, University of Wisconsin, Milwaukee, WI 53201, USA Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA
| | - Michael Nosonovsky
- College of Engineering and Applied Science, University of Wisconsin, Milwaukee, WI 53201, USA
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