Rautou Pierre-Emmanuel, Tatsumi Kohei, Antoniak Silvio, Owens A Phillip, Sparkenbaugh Erica, Holle Lori A, Wolberg Alisa S, Kopec Anna K, Pawlinski Rafal, Luyendyk James P, Mackman Nigel
Department of Medicine, Division of Hematology and Oncology, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; Service d'Hépatologie, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Clichy, France.
Department of Medicine, Division of Hematology and Oncology, McAllister Heart Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
J Hepatol. 2016 Jan;64(1):53-9. doi: 10.1016/j.jhep.2015.08.017. Epub 2015 Aug 29.
BACKGROUND & AIMS: Patients with chronic liver disease and cirrhosis have a dysregulated coagulation system and are prone to thrombosis. The basis for this hypercoagulable state is not completely understood. Tissue factor (TF) is the primary initiator of coagulation in vivo. Patients with cirrhosis have increased TF activity in white blood cells and circulating microparticles. The aim of our study was to determine the contribution of TF to the hypercoagulable state in a mouse model of chronic liver injury.
We measured levels of TF activity in the liver, white blood cells and circulating microparticles, and a marker of activation of coagulation (thrombin-antithrombin complexes (TATc)) in the plasma of mice subjected to bile duct ligation for 12days. We used wild-type mice, mice with a global TF deficiency (low TF mice), and mice deficient for TF in either myeloid cells (TF(flox/flox),LysMCre mice) or in hepatocytes (TF(flox/flox),AlbCre).
Wild-type mice with liver injury had increased levels of white blood cell, microparticle TF activity and TATc compared to sham mice. Low TF mice and mice lacking TF in hepatocytes had reduced levels of TF in the liver and in microparticles and exhibited reduced activation of coagulation without a change in liver fibrosis. In contrast, mice lacking TF in myeloid cells had reduced white blood cell TF but no change in microparticle TF activity or TATc.
Hepatocyte TF activates coagulation in a mouse model of chronic liver injury. TF may contribute to the hypercoagulable state associated with chronic liver diseases in patients.
慢性肝病和肝硬化患者存在凝血系统失调,且易于发生血栓形成。这种高凝状态的基础尚未完全明确。组织因子(TF)是体内凝血的主要启动因子。肝硬化患者白细胞和循环微粒中的TF活性增加。我们研究的目的是在慢性肝损伤小鼠模型中确定TF对高凝状态的作用。
我们测量了胆管结扎12天的小鼠肝脏、白细胞和循环微粒中TF活性水平,以及血浆中凝血激活标志物(凝血酶 - 抗凝血酶复合物(TATc))。我们使用野生型小鼠、全身性TF缺乏小鼠(低TF小鼠),以及髓系细胞中缺乏TF的小鼠(TF(flox/flox),LysMCre小鼠)或肝细胞中缺乏TF的小鼠(TF(flox/flox),AlbCre)。
与假手术小鼠相比,肝损伤的野生型小鼠白细胞、微粒TF活性和TATc水平升高。低TF小鼠和肝细胞中缺乏TF的小鼠肝脏和微粒中的TF水平降低,凝血激活减少,但肝纤维化无变化。相比之下,髓系细胞中缺乏TF的小鼠白细胞TF降低,但微粒TF活性或TATc无变化。
在慢性肝损伤小鼠模型中,肝细胞TF激活凝血。TF可能导致患者慢性肝病相关的高凝状态。