Clinical relevance of fibrin fiber diameter during different phases of pregnancy

Swanepoel, Albe C.

doi:10.1002/jemt.22727

Cited by 6 publications

(6 citation statements)

References 43 publications

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“…We simulated the concentrations of each individual hormone that the human body would be exposed to when taking a single dose of an oral contraceptive pill. We added DRSP and EE ex vivo to whole blood and PPP collected from male and female participants, at concentrations equal to that found in COCs, that is, DRSP at 3 mg and EE at 20 and 50 μ g (Swanepoel et al, 2016). Our current results regarding the impact of DRSP/EE formulations on the viscoelastic parameters are comparable with our results from the ex vivo exposure of whole blood and PPP from female participants to DRSP and EE, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…From three images, 50 fibrin fibers were measured for each participant, thus a total of 1,250 per group. Fibrin network branching was determined with fractal dimension analysis of three images for each participant using the Fractal Analysis system supplied by the National Agricultural and Food Research Organization (NARO), Japan as previously described (Swanepoel, 2016); thus, a total of 75 micrographs per group were analyzed.…”

Section: Methodsmentioning

confidence: 99%

“…For SEM analysis, 10 μL of PPP along with 5 μL of 20 U/mL human thrombin provided by the South African National Blood Services (SANBS) were pipetted onto a round glass coverslip to prepare duplicate fibrin clot smears for each sample as previously described (Swanepoel, 2016;Swanepoel et al, 2014bSwanepoel et al, , 2016aSwanepoel et al, , 2016b.…”

Section: Scanning Electron Microscopymentioning

confidence: 99%

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Mechanical and Physical Behavior of Fibrin Clot Formation and Lysis in Combined Oral Contraceptive Users

2020

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Scanning Electron Microscopymentioning

confidence: 99%

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Mechanical and Physical Behavior of Fibrin Clot Formation and Lysis in Combined Oral Contraceptive Users

2020

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“…SEM micrographs were used to determine biophysical characteristics of the fibrin fiber network, fibrin fiber diameter (using ImageJ) as well as fibrin fiber network fractal dimension analysis also referred to as the fibrin network branching (using the Fractal analysis system supplied by the National Agricultural and Food Research Organization [NARO], Japan) as previously described (Swanepoel, ). A total of 50 fibrin fibers per subject were analyzed to determine the fibrin diameter, therefore 1,000 fibers per group.…”

Section: Methodsmentioning

confidence: 99%

Hemorheological mechanisms for increased thrombosis in subjects using gestodene

Swanepoel

Roberts

Soma

et al. 2018

Microscopy Res & Technique

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There are several possible mechanisms by which combined oral contraceptives (COC) use increase venous thromboembolism (VTE) risk. Melodene ® is a monophasic COC containing the third-generation progestin Gestodene (GSD), which is associated with increased risk of VTE.Therefore, the aim of this study was to investigate the possible alterations in viscoelastic parameters of whole blood and plasma clots along with the biophysical characteristics of erythrocytes and specifically fibrin fibers in females using a COC containing GSD. GSD appeared to have a significant impact on the biophysical characteristics of fibrin fiber networks. When GSD is combined with ethinylestradiol the viscoelastic properties of whole blood clots tend to become more prothrombotic. The alterations to and aggregation of erythrocytes accompanied with spontaneous formation of a fibrin "blanket" provides a possible mechanism for the increased occurrence of "red" clots, which can lead to occlusions in the vascular system. Thus, the increased risk of VTE associated with these COCs can be attributed to these erythrocyte-andfibrin-rich-clots occluding venous vessels. However, our findings also propose that these changes to the biophysical properties of both erythrocytes and fibrin, specifically spontaneous expansion of deformed fibrin networks, can also occlude vessels in the microcirculation, which could have lasting, subclinical complications for female users. We recommend that a thorough risk assessment, with specific focus on coagulation and other factors affecting fibrin formation, be done for each female before prescribing a GSD-containing COC. Females that "qualify" then need to be monitored on a regular basis to lower the risk of thrombotic events. K E Y W O R D S erythrocytes, fibrin, gestodene, hypercoagulability, viscoelasticity

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“…The fractal analysis system (P6065‐1: 19 May 2016,) supplied by NARO, Japan, and previously described by the program developers (Sasaki, Shibata, & Hatanaka, 1994) was used to evaluate the SEM micrographs from the control group as well as different concentrations of E 1 and E 3 . This fractal analysis software has previously been used by the authors to specifically evaluate fibrin fiber network geometry (Swanepoel, ). The image size of the micrographs of 1024 × 690 pixels was all factorials of 2.…”

Section: Methodsmentioning

confidence: 99%

Clinical relevance of hypercoagulability and possible hypofibrinolysis associated with estrone and estriol

Swanepoel

Naidoo

Nielsen

et al. 2017

Microscopy Res & Technique

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Estrone (E ) and Estriol (E ) are endogenous female hormones, present in increased concentrations during female specific physiological processes (menopause and pregnancy respectively) that are associated with increased venous thrombotic risk. These hormones are also used as hormone therapies that are also associated with increased thromboembolism risk. Viscoelastic analysis revealed no significant difference to clot formation after hormone addition, however morphological analysis showed that the addition of both E and E result in fibrin clots composed of thinner fibrin fibers arranged in dense matted networks. These changes to the fibrin network ultrastructure are indicative of a prothrombotic state but may also indicate hypofibrinolysis. We therefore conclude that the increased risk of venous thrombosis during pregnancy and menopause may originate from a combination of hypercoagulation and a possible hypofibrinolytic mechanism of these hormones. Therefore females with a hypercoagulable tendency that fall pregnant or enter menopause need to be monitored to prevent venous thrombotic events. The decision to use hormone therapies during and after menopause should not be taken lightly and the risk-reward scale should be closely examined to ensure it does not tip towards thrombosis and subsequent thrombotic events that ultimately could have been prevented.

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Clinical relevance of fibrin fiber diameter during different phases of pregnancy

Cited by 6 publications

References 43 publications

Mechanical and Physical Behavior of Fibrin Clot Formation and Lysis in Combined Oral Contraceptive Users

Mechanical and Physical Behavior of Fibrin Clot Formation and Lysis in Combined Oral Contraceptive Users

Hemorheological mechanisms for increased thrombosis in subjects using gestodene

Clinical relevance of hypercoagulability and possible hypofibrinolysis associated with estrone and estriol

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