We have adapted the corn-trypsin inhibitor whole-blood model to include EA.hy926 as an endothelium surrogate to evaluate the vascular modulation of blood coagulation initiated by relipidated recombinant tissue factor (rTf) and a cellular Tf surrogate, lipopolysaccharide (LPS)-stimulated THP1 cells (LPS-THP-1). Compared with bare tubes, EA.hy926 with rTf decreased the rate of thrombin formation, ITS accumulation, and the production of fibrinopeptide A. These phenomena occurred with increased rates of factor Va (fVa) inactivation by cleavages at R 506 and R 306 . Thus, EA.hy926 provides thrombin-dependent protein C activation and APC fVa inactivation. Comparisons of rTf with LPS-THP-1 showed that the latter gave reduced rates for TAT formation but equivalent fibrinopeptide A, and fV activation/inactivation. In the presence of EA.hy926, the reverse was obtained; with the surrogate endothelium and LPS-THP-1 the rates of TAT generation, fibrinopeptide release, and fV activation were almost doubled, whereas cleavage at R 306 was equivalent. These observations suggest cooperativity between the 2 cell surrogates. These data suggest that the use of these 2 cell lines provides a reproducible quasiendothelial quasi-inflammatory cytokinestimulated monocyte system that provides a method to evaluate the variations in blood phenotype against the background of stable inflammatory cell activator and a stable vascular endothelial surrogate.(Blood. 2010; 116(26):6082-6091)
IntroductionVirchow postulated 3 phenomena that lead to venous thrombosis: (1) the components contained within the blood itself lead to systemic hypercoagulability; (2) alteration of the endothelium from injury or dysfunction; and (3) alterations of blood flow. 1 These postulates are the foundation for the physiologic understanding of blood coagulation and the maintenance of the hemostatic balance in the venous circulation.The maintenance of blood fluidity and vascular integrity is actively maintained by collaborations between the vascular wall and the procoagulant and anticoagulant functions in blood. Cellbound and soluble constituents cooperate to maintain this quasiequilibrium fluid state. Upon vascular perforation, multiple interactions initiate a local coagulant response, promoting platelet adhesion/ aggregation, the generation of membrane-bound catalysts, thrombin generation, and fibrin deposition that overcome local anticoagulants. These processes arrest blood loss with dimensions relevant to the injury. Subsequently, fibrinolysis and cellular proliferation repair 2 the injured tissue.The coagulation processes have been studied in vitro using anticoagulated phlebotomy blood, 3 derived plasma, 4,5 isolated component systems, [6][7][8] and numerical simulations. 9,10 We have used corn-trypsin inhibitor (CTI) stabilized whole blood to study the tissue factor (Tf)-initiated process in the absence of chelating anticoagulants. 11,12 Several hundred of these experiments have been performed to characterize the temporal dynamics of various blood clotting reactions...