Rognes, Ingrid Nygren; Hellum, Marit; Ottestad, William; Bache, Kristi Grønvold; Eken, Torsten & Henriksson, Carola Elisabeth
Extracellular vesicle-associated procoagulant activity is highest the first 3 hours after trauma and thereafter declines substantially: A prospective observational pilot study.
Journal of Trauma and Acute Care Surgery.
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Background: Trauma patients have high concentrations of circulating extracellular vesicles (EVs) following injury, but the functional role of EVs in this setting is only partly deciphered. We aimed to describe in detail EV-associated procoagulant activity in individual trauma patients during the first 12 hours after injury to explore their putative function and relate findings to relevant trauma characteristics and outcome.
Methods: In a prospective observational study of 33 convenience recruited trauma patients, citrated plasma samples were obtained at trauma center admission and 2, 4, 6, and 8 hours thereafter. We measured thrombin generation from isolated EVs and the procoagulant activity of phosphatidylserine (PS)-exposing EVs. Correlation and multivariable linear regression analyses were used to explore associations between EV-associated procoagulant activity and trauma characteristics as well as outcome measures.
Results: EV-associated procoagulant activity was highest in the first 3 hours after injury. EV-associated thrombin generation normalized within 7 to 12 hours of injury, whereas the procoagulant activity of PS-exposing EVs declined to a level right above that of healthy volunteers. Increased EV-associated procoagulant activity at admission was associated with higher New Injury Severity Score, lower admission base excess, higher admission international normalized ratio, prolonged admission activated partial thromboplastin time, higher Sequential Organ Failure Assessment score at day 0, and fewer ventilator-free days.
Conclusion: Our data suggest that EVs have a transient hypercoagulable function and may play a role in the early phase of hemostasis after injury. The role of EVs in trauma-induced coagulopathy and posttraumatic thrombosis should be studied bearing in mind this novel temporal pattern.
Level of evidence: Prognostic/epidemiologic, level V.
Garabet, Lamya Samir Noori; Ghanima, Waleed Khalid; Hellum, Marit Synnøve; Sandset, Per Morten; Bussel, James B. & Tran, Hoa Thi Tuyet
[Vis alle 7 forfattere av denne artikkelen](2019).
Increased microvesicle-associated thrombin generation in patients with immune thrombocytopenia after initiation of thrombopoietin receptor agonists.
Hellum, Marit Synnøve; Lie, Maria Isabel Lopes Romao Franc; Øvstebø, Reidun; Hauge, Truls & Henriksson, Carola
The effect of corn trypsin inhibitor, anti-tissue factor pathway inhibitor antibodies and phospholipids on microvesicle-associated thrombin generation in patients with pancreatic cancer and healthy controls.
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Hellum, Marit Synnøve; Siebke, Anne-Marie; Berg, Jens Petter; Brandtzæg, Petter; Øvstebø, Reidun & Henriksson, Carola
The Neisseria meningitidis lpxL1 mutant induces less tissue factor expression and activity in primary human monocytes and
monocyte-derived microvesicles than the wild type meningococcus.
Iversen, Nina; Sletten, Marit; Hellum, Marit Synnøve; Skogstad, Marie Jeanette; Chollet, Maria Eugenia & Skarpen, Ellen
[Vis alle 11 forfattere av denne artikkelen](2019).
Functional characterization of FV deficiency in Norway: Effects of F5 mutations on secretion, endoplasmic reticulum stress, apoptosis, and activated protein C sensitivity.