Whole blood thromboelastometry profiles in women with preeclampsia

Spiezia, Luca; Bogana, G.; Campello, Elena; Maggiolo, Sara; Pelizzaro, Elena; Carbonare, Cristina Dalle; Gervasi, Maria Teresa; Simioni, Paolo

doi:10.1515/cclm-2014-1128

Cited by 20 publications

(28 citation statements)

References 6 publications

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“…143,145 Patients with PE had a higher plasma TAT complex, F1 þ 2, and D-dimer concentration than normal pregnant women, 126,128,136,140,144,146,147 but other work has shown that the TAT level in PE was not significantly higher compared with normotensive pregnancy. 148 TEG does not demonstrate any changes in PE compared with normotensive pregnancy, 135,137,[149][150][151] except for a maximal amplitude decrease with the platelet count. 135 Clot lysis time in TEG is shortened in PE.…”

Section: Assays Of Hemostasis During Normal Pregnancymentioning

confidence: 99%

“…135 Clot lysis time in TEG is shortened in PE. 149,150 Only in women with severe PE, "r" and "k" are slightly increased and "α" is decreased. 151 Preliminary data obtained with thrombodynamics assay in Kazan State Medical University (Kazan, Russia) show that women with PE that developed in the third trimester (n ¼ 20) had clot growth rate increased by 20% compared with the group of healthy pregnant women (n ¼ 94) at the similar gestational age.…”

Section: Assays Of Hemostasis During Normal Pregnancymentioning

confidence: 99%

See 1 more Smart Citation

Classic and Global Hemostasis Testing in Pregnancy and during Pregnancy Complications

Ataullakhanov

Koltsova

Баландина³

et al. 2016

Semin Thromb Hemost

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Pregnancy is associated with a significant procoagulant shift in the hemostatic system balance as well as other metabolic changes. Pregnancy can thereby provoke manifestation of otherwise dormant disorders of hemostasis (e.g., thrombophilia), or even cause new, pregnancy-specific disorders (e.g., HELLP syndrome). Application and interpretation of laboratory assays of hemostasis in pregnancy is particularly challenging, because normal physiological ranges are no longer applicable, and because the most dangerous and complex changes are not detected by classic routine coagulation/platelet assays. New global assays of coagulation and of platelet-dependent hemostasis appear to be promising in this respect, but are still far from clinical practice and rarely appear in current patient management guidelines. These global assays require a high level of research to identify their relationship to clinically significant outcomes. Here, we review the state-of-the-art knowledge of the molecular changes in the hemostatic system in normal pregnancy and during pregnancy-related complications (preeclampsia, thrombotic microangiopathies, antiphospholipid syndrome, etc.). We also discuss the sensitivity of various classic and innovative assays to these pregnancy-associated changes, and describe current and potential future applications of these assays in meeting specific clinical needs.

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Section: Assays Of Hemostasis During Normal Pregnancymentioning

confidence: 99%

Section: Assays Of Hemostasis During Normal Pregnancymentioning

confidence: 99%

Classic and Global Hemostasis Testing in Pregnancy and during Pregnancy Complications

Ataullakhanov

Koltsova

Баландина³

et al. 2016

Semin Thromb Hemost

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show abstract

“…b Control * 30 g/ml 300 g/ml 3000 g/ml Adj. b p-value p-value of MCF increase we observed is small, a recent study demonstrated significant differences when comparing the activated INTEM (ellagic acid) and EXTEM (tissue factor) MCF parameters of healthy pregnant vs. preeclamptic women [25]. Based on our in vitro hypercoagulability findings alone, it is unclear if preeclamptic women have additional risk for thromboembolism in the setting of antifibrinolytic therapy.…”

Section: Discussionmentioning

confidence: 62%

Using antifibrinolytics in the peripartum period – concern for a hypercoagulable effect?

Ahmadzia

Lockhart

Thomas

et al. 2017

NPM

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“…During normal pregnancy, plasma fibrinogen is increased and fibrinolysis activity is suppressed, ostensibly to promote coagulability of blood (Thornton and Douglas, 2010). There are conflicting data regarding fibrinogen levels in PE, with some studies, including ours, demonstrating increased (Al-ofi et al, 2014, Kawada, 2015, whilst others demonstrate reduced, circulating levels (Spiezia et al, 2015). Moreover, immunofluorescence microscopy has revealed fibrin deposition in the vascular compartments 4 of the placenta, kidney and liver in severe PE (Arias and Mancilla-Jimenez, 1976, Roberts and Post, 2008, Al-ofi et al, 2014 We recently showed that fibrinogen activates monocytes from women with PE (Al-ofi et al, 2014).…”

Section: Introductionmentioning

confidence: 72%

Ligands of toll-like receptors 2/4 differentially alter markers of inflammation, adhesion and angiogenesis by monocytes from women with pre-eclampsia in co-culture with endothelial cells

Al-ofi

Anumba

2017

Journal of Reproductive Immunology

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Pre-eclampsia (PE) is characterized by an exaggerated systemic inflammatory response and generalized endothelial dysfunction. We have recently demonstrated that fibrinogen, an endogenous ligand of Toll-like receptor (TLR) 4, activates monocytes from women with pre-eclampsia (Al-ofi et al., 2014). Using an experimental co-culture model of primary human monocytes (derived from 9 women with PE (GA=33.18±5.8) and 9 normotensive pregnant women, NP (GA=33.15±4.0)) and human umbilical venous endothelial cells (HUVECs), we compared the effects of fibrinogen and lipopolysaccharide (LPS, bacterial ligand to TLR4) on the expression levels of inflammatory cytokines (IL-6 and IL-1β), chemokines (IL-8 and MCP-1), and anti-angiogenic factor (soluble fms-like tyrosine kinase-1,sFLT-1), as well as the soluble vascular cell adhesion molecule-1 (sVCAM-1). Cytokines, VEGF and sVCAM-1 were measured in the supernatant media by cytometric array. The levels of sFLT-1 were measured by ELISA. Fibrinogen induced greater expression levels of IL-1β and VCAM-1 from PE HUVEC-monocyte co-culture than from NP HUVEC-monocyte co-culture (P<0.05), similar to the effects of LPS. In contrast, unlike LPS, fibrinogen suppressed IL-6, IL-8, MCP-1 and sFLT-1 production by co-cultures that included PE monocytes compared to those with NP monocytes (P<0.05). In conclusion, fibrinogen promotes monocyte-endothelial cell adhesion and angiogenesis and suppresses the expression of some inflammatory markers in pre-eclampsia. Although the physiological implications of these intriguing observations are unclear our findings suggest that fibrinogen contributes to the regulation of cell adhesion, angiogenesis and inflammation by mechanisms not wholly dependent on TLR4 stimulation.

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Whole blood thromboelastometry profiles in women with preeclampsia

Cited by 20 publications

References 6 publications

Classic and Global Hemostasis Testing in Pregnancy and during Pregnancy Complications

Classic and Global Hemostasis Testing in Pregnancy and during Pregnancy Complications

Using antifibrinolytics in the peripartum period – concern for a hypercoagulable effect?

Ligands of toll-like receptors 2/4 differentially alter markers of inflammation, adhesion and angiogenesis by monocytes from women with pre-eclampsia in co-culture with endothelial cells

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