Saliva-Induced Clotting Captures Streptococci: Novel Roles for Coagulation and Fibrinolysis in Host Defense and Immune Evasion

Waldetoft, Kristofer Wollein; Mohanty, Tirthankar; Karlsson, Christofer; Mörgelin, Matthias; Frick, Inga-Maria; Malmström, Johan; Björck, Lars

doi:10.1128/iai.00307-16

Cited by 13 publications

(16 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subsequently, Streptococci of groups A, C and G may shift the balance in the clotting cascade towards fibrinolysis, which may increase the probability of bleeding in the oral mucosa. This phenomenon has been repeatedly described in chronic inflammatory disease of the oral cavity . As response to fibrous deposits at wounded and inflamed sites in the oral mucosa, higher PFLs were found in patients with chronic inflammation in the oral cavity when compared to healthy subjects .…”

Section: Discussionmentioning

confidence: 57%

“…Even the microbiome in the oral cavity impacts on the delicate balance between fibrinogenesis and fibrinolysis. Wollein Waldetoft et al described that saliva activates the plasma clotting system via the extrinsic and intrinsic pathways of coagulation. Bacterial colonies are entrapped in the clots, but are able to escape by inducing fibrinolysis via secretion of streptokinase and activation of host plasminogen.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Preoperative plasma fibrinogen as a predictive factor for post‐tonsillectomy haemorrhage

Grasl

Janik

Vyskocil

et al. 2019

Clinical Otolaryngology

View full text Add to dashboard Cite

Objectives To assess whether preoperative plasma fibrinogen is able to predict severe post‐tonsillectomy haemorrhage. Study design Retrospective chart review. Methods We included 456 patients who underwent tonsillectomy between 2008 and 2013. Preoperative plasma fibrinogen levels (PFL) were assessed in patients who developed severe bleeding requiring surgical revision under general anesthesia compared to those with uneventful postoperative courses. Results 414 (90.8%) had no severe post‐tonsillectomy haemorrhage. In contrast, 42 (9.2%) patients needed surgical hemostasis. PFL were significantly higher (P = .023) in patients with a severe bleeding. Univariate Cox‐regression analysis revealed that elevated preoperative fibrinogen represents a significant worse (P = .003; HR 2.66; 95% CI 1.38‐5.10) prognostic factor for postoperative bleeding. Even at multivariable analysis, increased PFLs were a significantly worse prognostic factor for post‐tonsillectomy haemorrhage (P = .016; HR 15.4; 95% CI 0.01‐0.6). High preoperative PFL was associated with significantly higher risk for post‐tonsillectomy haemorrhage within the first 31 days after surgery (65% vs 90%; P = .002). Moreover, accurate negative predictive value (NPV) of 95.1% pointed out that PFL could be used as a reliable preoperative screening marker. Conclusions Elevated PFL represents an independent worse prognostic factor for severe bleeding after tonsillectomy and could be helpful to identify patients at higher risk for PTH.

show abstract

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Preoperative plasma fibrinogen as a predictive factor for post‐tonsillectomy haemorrhage

Grasl

Janik

Vyskocil

et al. 2019

Clinical Otolaryngology

View full text Add to dashboard Cite

show abstract

“…In a recent publication, Wollein Woldetoft et al . have put forth a novel role for streptokinase in allowing colonization of the nasopharynx [76]. They first observed that human saliva was capable of activating both the extrinsic and intrinsic clotting cascades in human plasma, an exudate secreted in response to bacterial infection.…”

Section: Newly Discovered Roles For Virulence Factorsmentioning

confidence: 99%

“…ska Δ GAS mixed with saliva and plasma were quickly and permanently trapped in fibrin clots, while cells capable of secreting streptokinase could escape. They propose that this clotting reaction may be a mechanism to trap GAS on the mucosal surface to promote bacterial clearance, with streptokinase primarily acting to allow GAS to escape this immune mechanism [76]. The efficacy of these proposed mechanisms remains to be evaluated in vivo .…”

Section: Newly Discovered Roles For Virulence Factorsmentioning

confidence: 99%

Evolutionary Constraints Shaping Streptococcus pyogenes –Host Interactions

Wilkening

Federle

2017

Trends in Microbiology

View full text Add to dashboard Cite

Research on the Gram-positive human-restricted pathogen Streptococcus pyogenes (Group A Streptococcus, GAS) has long focused on invasive illness, the most severe manifestations of GAS infection. Recent advances in descriptions of molecular mechanisms of GAS virulence, coupled with massive sequencing efforts of isolate genomes, have allowed the field to better understand the molecular and evolutionary changes leading to pandemic strains. These findings suggest it necessary to rethink the dogma involving GAS pathogenesis, and that the most productive avenues for research going forward may be investigations into GAS in its normal habitat, the nasopharynx, and its ability to either live with its host in an asymptomatic lifestyle or as an agent of superficial infections. This review will consider these advances, focusing on the natural history of GAS, the evolution of pandemic strains and novel roles for several key virulence factors that may allow the field to better understand their physiological role.

show abstract

“…Besides reducing blood loss, this would also contribute to the non‐specific host defence by reducing the risk of pathogens entering the blood. Wollein Waldetoft et al . reported that saliva may induce clotting of plasma through both extrinsic and intrinsic pathways of coagulation.…”

Section: Introductionmentioning

confidence: 99%

Influence of saliva on the results of global laboratory coagulation tests

Špiljak

Šimunović

Lapić

et al. 2020

Australian Dental Journal

View full text Add to dashboard Cite

Background Oral wounds inevitably come into contact with saliva which can affect the time needed for bleeding to stop. The influence of saliva can be non‐specific, related to dilution of blood, and/or mediated by salivary factors that affect haemostasis directly. The aim of this study was to assess if mixing blood with an individual's saliva would affect the rate of its coagulation measured by global coagulation tests, prothrombin time (PT) and activated partial thromboplastin time (APTT). Methods The study included 30 healthy non‐smoking volunteers. Paired blood and unstimulated saliva samples were obtained from each participant and PT and APTT were determined in blood, blood + saliva and blood + water mixtures. Coagulation tests were performed using the mechanical clot detection method. Results PT was significantly longer in both blood + saliva and blood + water mixtures compared to blood alone. APTT was significantly longer only in blood + water mixture compared to blood. Conclusions Similarly prolonged PT in both mixtures suggests that both saliva and water prolong coagulation evenly due to their non‐specific effect of blood dilution. The finding that APTT was significantly prolonged only when blood was mixed with water could indicate presence of tissue factor in saliva, however, in a concentration too low to influence the results of PT.

show abstract

Saliva-Induced Clotting Captures Streptococci: Novel Roles for Coagulation and Fibrinolysis in Host Defense and Immune Evasion

Cited by 13 publications

References 50 publications

Preoperative plasma fibrinogen as a predictive factor for post‐tonsillectomy haemorrhage

Preoperative plasma fibrinogen as a predictive factor for post‐tonsillectomy haemorrhage

Evolutionary Constraints Shaping Streptococcus pyogenes –Host Interactions

Influence of saliva on the results of global laboratory coagulation tests

Contact Info

Product

Resources

About