University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Kazan Federal University, Kazan, Russian Federation.
Sci Rep. 2020 Mar 20;10(1):5112. doi: 10.1038/s41598-020-59526-x.
Although arterial and venous thromboembolic disorders are among the most frequent causes of mortality and morbidity, there has been little description of how the composition of thrombi and emboli depends on their vascular origin and age. We quantified the structure and composition of arterial and venous thrombi and pulmonary emboli using high-resolution scanning electron microscopy. Arterial thrombi contained a surprisingly large amount of fibrin, in addition to platelets. The composition of pulmonary emboli mirrored the most distal part of venous thrombi from which they originated, which differed from the structure of the body and head of the same thrombi. All thrombi and emboli contained few biconcave red blood cells but many polyhedrocytes or related forms of compressed red blood cells, demonstrating that these structures are a signature of clot contraction in vivo. Polyhedrocytes and intermediate forms comprised the major constituents of venous thrombi and pulmonary emboli. The structures within all of the thrombi and emboli were very tightly packed, in contrast to clots formed in vitro. There are distinctive, reproducible differences among arterial and venous thrombi and emboli related to their origin, destination and duration, which may have clinical implications for the understanding and treatment of thrombotic disorders.
尽管动脉和静脉血栓栓塞性疾病是最常见的死亡和发病原因之一，但对于血栓和栓子的组成如何取决于其血管起源和年龄，几乎没有描述。我们使用高分辨率扫描电子显微镜定量分析了动脉和静脉血栓及肺栓塞的结构和组成。动脉血栓除了血小板外，还含有大量出人意料的纤维蛋白。肺栓塞的组成反映了它们起源的静脉血栓的最远端部分，这与同一血栓的体部和头部结构不同。所有血栓和栓子内都只有少量双凹形红细胞，而有许多多角形细胞或相关形式的压缩红细胞，表明这些结构是体内血栓收缩的特征。多角形细胞和中间形式构成了静脉血栓和肺栓塞的主要成分。与体外形成的血栓相比，所有血栓和栓子内的结构都非常紧密。动脉和静脉血栓及栓子之间存在明显的、可重复的差异，这与它们的起源、目的地和持续时间有关，这可能对理解和治疗血栓性疾病具有临床意义。
