Einthoven Laboratory for Vascular and Regenerative Medicine and.
Department of Internal Medicine, Division of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, The Netherlands.
Blood. 2019 May 9;133(19):2090-2099. doi: 10.1182/blood-2018-06-853762. Epub 2019 Mar 21.
Tissue factor, coagulation factor XII, platelets, and neutrophils are implicated as important players in the pathophysiology of (experimental) venous thrombosis (VT). Their role became evident in mouse models in which surgical handlings were required to provoke VT. Combined inhibition of the natural anticoagulants antithrombin () and protein C () using small interfering RNA without additional triggers also results in a venous thrombotic phenotype in mice, most notably with vessel occlusion in large veins of the head. VT is fatal but is fully rescued by thrombin inhibition. In the present study, we used this VT mouse model to investigate the involvement of tissue factor, coagulation factor XII, platelets, and neutrophils. Antibody-mediated inhibition of tissue factor reduced the clinical features of VT, the coagulopathy in the head, and fibrin deposition in the liver. In contrast, genetic deficiency in, and small interfering RNA-mediated depletion of, coagulation factor XII did not alter VT onset, severity, or thrombus morphology. Antibody-mediated depletion of platelets fully abrogated coagulopathy in the head and liver fibrin deposition. Although neutrophils were abundant in thrombotic lesions, depletion of circulating Ly6G-positive neutrophils did not affect onset, severity, thrombus morphology, or liver fibrin deposition. In conclusion, VT after inhibition of antithrombin and protein C is dependent on the presence of tissue factor and platelets but not on coagulation factor XII and circulating neutrophils. This study shows that distinct procoagulant pathways operate in mouse VT, dependent on the triggering stimulus.
组织因子、凝血因子 XII、血小板和中性粒细胞被认为是(实验性)静脉血栓形成(VT)病理生理学中的重要参与者。在需要手术处理来引发 VT 的小鼠模型中,它们的作用变得明显。使用小干扰 RNA 联合抑制天然抗凝剂抗凝血酶()和蛋白 C(),而不使用其他触发因素,也会导致小鼠出现静脉血栓形成表型,尤其是头部大静脉的血管闭塞。VT 是致命的,但可通过抑制凝血酶完全挽救。在本研究中,我们使用这种 VT 小鼠模型来研究组织因子、凝血因子 XII、血小板和中性粒细胞的参与情况。组织因子的抗体抑制减少了 VT 的临床特征、头部的凝血异常和肝脏中的纤维蛋白沉积。相比之下,凝血因子 XII 的基因缺失和小干扰 RNA 介导的耗竭并未改变 VT 的发作、严重程度或血栓形态。血小板的抗体耗竭完全消除了头部和肝脏的凝血异常和纤维蛋白沉积。尽管中性粒细胞在血栓病变中大量存在,但循环 Ly6G 阳性中性粒细胞的耗竭并未影响发作、严重程度、血栓形态或肝脏纤维蛋白沉积。总之,抗凝血酶和蛋白 C 抑制后的 VT 依赖于组织因子和血小板的存在,但不依赖于凝血因子 XII 和循环中性粒细胞。本研究表明,在依赖于触发刺激的小鼠 VT 中,存在不同的促凝途径。