Plasma phospholipid fatty acids are associated with altered fibrin clot properties in a population-based setting

Lange, Zelda de; Kahler, B.; Smuts, Cornelius M.; Pieters, Marlien

doi:10.1016/j.plefa.2019.02.001

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…12 Not only do these changes in fatty acids have implications in neurotrauma, but fatty acids are also associated with prothrombotic effects. 43 In addition to increased lipolysis metabolites, our data revealed decreases in citrulline, arginine, and proline metabolites, which has been described in previous TBI metabolomic investigations. 44 These same changes have been observed in critically injured patients and those in hemorrhagic shock 37 and linked to adverse clinical outcomes.…”

Section: Discussionsupporting

confidence: 82%

“…Fatty acids have been established as important potential metabolite markers of severity of TBI, with medium-chain fatty acids, octanoic and decanoic acids, being highly associated with severity of injury 12 . Not only do these changes in fatty acids have implications in neurotrauma, but fatty acids are also associated with prothrombotic effects 43 …”

Section: Discussionmentioning

confidence: 99%

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A metabolomic and proteomic analysis of pathologic hypercoagulability in traumatic brain injury patients after dura violation

Coleman

D’Alessandro

LaCroix

et al. 2023

J Trauma Acute Care Surg

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BACKGROUND The coagulopathy of traumatic brain injury (TBI) remains poorly understood. Contradictory descriptions highlight the distinction between systemic and local coagulation, with descriptions of systemic hypercoagulability despite intracranial hypocoagulopathy. This perplexing coagulation profile has been hypothesized to be due to tissue factor release. The objective of this study was to assess the coagulation profile of TBI patients undergoing neurosurgical procedures. We hypothesize that dura violation is associated with higher tissue factor and conversion to a hypercoagulable profile and unique metabolomic and proteomic phenotype. METHODS This is a prospective, observational cohort study of all adult TBI patients at an urban, Level I trauma center who underwent a neurosurgical procedure from 2019 to 2021. Whole blood samples were collected before and then 1 hour following dura violation. Citrated rapid and tissue plasminogen activator (tPA) thrombelastography (TEG) were performed, in addition to measurement of tissue factory activity, metabolomics, and proteomics. RESULTS Overall, 57 patients were included. The majority (61%) were male, the median age was 52 years, 70% presented after blunt trauma, and the median Glasgow Coma Score was 7. Compared with pre-dura violation, post-dura violation blood demonstrated systemic hypercoagulability, with a significant increase in clot strength (maximum amplitude of 74.4 mm vs. 63.5 mm; p < 0.0001) and a significant decrease in fibrinolysis (LY30 on tPAchallenged TEG of 1.4% vs. 2.6%; p = 0.04). There were no statistically significant differences in tissue factor. Metabolomics revealed notable increases in metabolites involved in late glycolysis, cysteine, and one-carbon metabolites, and metabolites involved in endothelial dysfunction/arginine metabolism/responses to hypoxia. Proteomics revealed notable increase in proteins related to platelet activation and fibrinolysis inhibition. CONCLUSION A systemic hypercoagulability is observed in TBI patients, characterized by increased clot strength and decreased fibrinolysis and a unique metabolomic and proteomics phenotype independent of tissue factor levels.

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