Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands.
Hamostaseologie. 2024 Oct;44(5):377-385. doi: 10.1055/a-2374-2903. Epub 2024 Oct 23.
Current blood coagulation models consider the interactions between blood, the vessel wall, and other tissues that expose tissue factor (TF), the main initiator of coagulation. A potential role of body fluids other than blood is generally not considered. In this review, we summarize the evidence that body fluids such as mother's milk saliva, urine, semen, and amniotic fluid trigger coagulation. The ability of these body fluids to trigger coagulation is explained by the presence of extracellular vesicles (EVs). These EVs expose extrinsic tenase complexes (i.e., complexes of TF and activated factor VII) that can trigger coagulation. Why these body fluids share this activity, however, is unknown. Possible explanations are that these body fluids contribute to hemostatic protection and/or to the regulation of the epithelial barrier function. Further investigations may help understand the underlying cellular and biochemical pathways regulating or contributing to coagulation and innate immunity, which may be directly relevant to medical conditions such as gastrointestinal bleeding and chronic inflammatory bowel disease.
目前的凝血模型考虑了血液、血管壁和其他暴露组织因子 (TF) 的组织之间的相互作用，TF 是凝血的主要启动子。一般不考虑血液以外的体液的潜在作用。在这篇综述中，我们总结了证据表明，母乳、唾液、尿液、精液和羊水等体液会引发凝血。这些体液引发凝血的能力是由细胞外囊泡 (EVs) 的存在所解释的。这些 EVs 暴露了外在的 tenase 复合物（即 TF 和激活的因子 VII 复合物），可以引发凝血。然而，这些体液为什么会有这种活性还不清楚。可能的解释是这些体液有助于止血保护和/或调节上皮屏障功能。进一步的研究可能有助于了解调节或有助于凝血和先天免疫的细胞和生化途径，这可能与胃肠道出血和慢性炎症性肠病等医学状况直接相关。
