Institute of Immunology and Immunotherapy and.
Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
Blood. 2019 Feb 7;133(6):600-604. doi: 10.1182/blood-2018-08-867267. Epub 2018 Nov 6.
Thrombosis is a frequent, life-threatening complication of systemic infection associated with multiple organ damage. We have previously described a novel mechanism of inflammation-driven thrombosis induced by Typhimurium infection of mice. Thrombosis in the liver develops 7 days after infection, persisting after the infection resolves, and is monocytic cell dependent. Unexpectedly, thrombosis was not prominent in the spleen at this time, despite carrying a similar bacterial burden as the liver. In this study, we show that thrombosis does occur in the spleen but with strikingly accelerated kinetics compared with the liver, being evident by 24 hours and resolving rapidly thereafter. The distinct kinetics of thrombosis and bacterial burden provides a test of the hypothesis that thrombi form in healthy vessels to trap or remove bacteria from the circulation, often termed immunothrombosis. Remarkably, despite bacteria being detected throughout infected spleens and livers in the early days of infection, immunohistological analysis of tissue sections show that thrombi contain very low numbers of bacteria. In contrast, bacteria are present throughout platelet aggregates induced by in vitro. Therefore, we show that thrombosis develops with organ-specific kinetics and challenge the universality of immunothrombosis as a mechanism to capture bacteria in vivo.
血栓形成是系统性感染的一种常见且危及生命的并发症,与多器官损伤有关。我们之前描述了一种由鼠伤寒沙门氏菌感染引起的新型炎症驱动性血栓形成机制。感染后 7 天肝脏发生血栓形成,在感染消退后持续存在,并且依赖单核细胞。出乎意料的是,此时脾脏的血栓形成并不明显,尽管其细菌负荷与肝脏相似。在这项研究中,我们发现脾脏确实会发生血栓形成,但与肝脏相比,其动力学明显加快,在 24 小时内即可观察到,并迅速消退。血栓形成和细菌负荷的不同动力学为血栓形成形成于健康血管以捕获或从循环中清除细菌的假说提供了一个检验,通常称为免疫血栓形成。值得注意的是,尽管在感染早期的感染脾脏和肝脏中都检测到细菌,但组织切片的免疫组织化学分析显示血栓中细菌数量非常少。相比之下,在体外诱导的血小板聚集中细菌则广泛存在。因此,我们表明血栓形成具有器官特异性动力学,并对免疫血栓形成作为体内捕获细菌的机制的普遍性提出了挑战。