scholarly journals Clot Retraction: Cellular Mechanisms and Inhibitors, Measuring Methods, and Clinical Implications

Biomedicines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1064
Author(s):  
Ellen E. Jansen ◽  
Matthias Hartmann

Platelets have important functions in hemostasis. Best investigated is the aggregation of platelets for primary hemostasis and their role as the surface for coagulation leading to fibrin- and clot-formation. Importantly, the function of platelets does not end with clot formation. Instead, platelets are responsible for clot retraction through the concerted action of the activated αIIbβ3 receptors on the surface of filopodia and the platelet’s contractile apparatus binding and pulling at the fibrin strands. Meanwhile, the signal transduction events leading to clot retraction have been investigated thoroughly, and several targets to inhibit clot retraction have been demonstrated. Clot retraction is a physiologically important mechanism allowing: (1) the close contact of platelets in primary hemostasis, easing platelet aggregation and intercellular communication, (2) the reduction of wound size, (3) the compaction of red blood cells to a polyhedrocyte infection-barrier, and (4) reperfusion in case of thrombosis. Several methods have been developed to measure clot retraction that have been based on either the measurement of clot volume or platelet forces. Concerning the importance of clot retraction in inborn diseases, the failure of clot retraction in Glanzmann thrombasthenia is characterized by a bleeding phenotype. Concerning acquired diseases, altered clot retraction has been demonstrated in patients with coronary heart disease, stroke, bronchial asthma, uremia, lupus erythematodes, and other diseases. However, more studies on the diagnostic and prognostic value of clot retraction with methods that have to be standardized are necessary.

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2202-2202
Author(s):  
David R Myers ◽  
Todd Sulchek ◽  
Wilbur Lam

Abstract Abstract 2202 Background: Blood clots are composed of fibrin, platelets, and other blood cells and proteins, which interact to prevent hemorrhage. Previous studies on clot formation have shown that the mechanical properties of clots have direct effects on hemostasis and thrombosis, and alterations of those clot mechanics are associated with disease. For example, clots are 50% stiffer and more resistant to dissolution in young patients with post-myocardial infarction (Collet, et al., Arterioscler Thromb Vasc Biol, 2006) than clots from healthy controls. Conversely, clots are softer and more prone to dissolution in patients with bleeding disorders (Hvas, et al., J. Thrombosis and Haemostasis, 2007). As such, understanding the mechanical properties of clots is vital to understand hemostasis and thrombosis. As platelets drive this contraction phenomenon, single platelet measurements are required to obtain a mechanistic understanding of the retraction process and to identify specific therapeutic targets for disease states in which platelet/clot retraction is pathologically altered. In addition, as fibrin has recently been shown to have extremely complex material and mechanical properties (Brown, et al., Science, 2009), single platelet studies would decouple the effects of fibrin from platelets when examining clot mechanics. However, few studies have focused on the biomechanical role of platelets in clot formation and clot mechanics, especially at the single cell level. The key barrier which has prevented the study of single platelets has been the lack of technology with the sufficient precision and sensitivity to both manipulate and measure individual platelets. To that end, we recently published the first study investigating platelet contractility at the single cell level using an atomic force microscope (AFM) (Lam, et al., Nat Mater, 2011) Results: An AFM enables precise measurements of force down to the pico-newton level. A mechanically well-defined, fibrinogen-coated cantilever is brought into contact with a platelet and then brought to a fibrinogen-coated surface as shown in Figure 1A. The platelet will contract and the resulting deflection of the cantilever is measured with high accuracy to determine the force applied by the platelet. From AFM studies, it was found that both the loading rate (Fig 1B) and maximum contraction force exerted by single platelets (Fig 1C) were a function of the mechanical stiffness of the cantilever. Furthermore, preliminary data using the same techniques is indicating that there may be a unique subpopulation of platelets which exhibit high-amplitude, oscillatory contraction as shown in Figure 1D. Conclusions and Ongoing Effort: Ours is the first reported data measuring platelet contraction at the single cell level and reveals that platelets are extremely “strong” contractile machines, especially when taking account their small size. In addition, we discovered that platelets can “sense” their mechanical microenvironment, adjusting their contractility accordingly. Based on this research, the overall theme of this proposed work is to quantitatively investigate how the biophysics interacts with the molecular biology of platelet contraction. However, our initial work and past research have shown that platelets within a given population exhibit varied behavior, and to truly obtain meaningful data, studies on large populations are necessary. We are developing a high-throughput device that is capable of individually measuring the contractility of thousands of platelets using the same principles as AFM. As this “biomechanical flow cytometer” leverages microfabrication techniques, it offers new capabilities to manipulate the platelet microenvironment while making contractility measurements. This device will use massively parallel sets of polymer cantilevers to measure individual platelet contractility with an integrated microfluidic delivery system (Figure 2). Platelets flowing in the microfluidic channel will be captured by a set of fibrinogen-coated cantilevers. As the platelet contracts, the deflection of the cantilever tip can be measured optically, which is correlated to the force with the cantilever spring constant. Leveraging the capabilities of this system to test multiple conditions simultaneously, we will vary shear stresses and expose platelet to different doses of different agonists and determine how these parameters affect contraction. Disclosures: No relevant conflicts of interest to declare.


Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2478-2478
Author(s):  
Camille Faes ◽  
Anton Ilich ◽  
Erica M Sparkenbaugh ◽  
Alisa S. Wolberg ◽  
Brian C. Cooley ◽  
...  

Abstract Sickle cell disease (SCD) is associated with chronic activation of coagulation and an increased risk of venous thromboembolism. Traditionally, it is believed that during venous thrombosis, red blood cells (RBC) are simply trapped within fibrin-rich thrombi and do not actively affect thrombosis. However, a study from our group showed that factor XIII (FXIII) activity is critical for the retention of RBC within clots and directly affects thrombus size. Others reported that during clot contraction polyhedral shaped RBC formed a densely packed core and that SCD alters the formation of polyhedrocytes which may affect clot stability (Strauss et al, 2015, ASH abstract). We further investigated if SCD affects the structure and the dynamics of clot formation. Ex vivo clot retraction was performed using blood from sickle cell patients and Townes mice (a model of SCD). Citrated blood was added to siliconized wells of 96-well plates containing CaCl2 (10mM) and tissue factor (1pM) and incubated for 2 hours at 37°C. The number of RBC extruded from the clot was counted in serum by Hemavet™ and expressed as a percentage of initial RBC number in the anticoagulated blood. Morphology of the clots was evaluated using scanning and transmission electron microscopy (EM). Thrombosis in Townes SS (sickle) and AA (control) mice was studied using femoral vein thrombosis induced by electrolytic injury and inferior vena cava stenosis models. The number of mouse SS RBC in the serum extruded during clot contraction was dramatically reduced compared to the number of AA RBC (0.8±0.8% vs. 19.4±0.8%, n=3, p<0.0001, Fig. A). A similar result was observed for human RBC. Since SS mice and sickle patients have a lower hematocrit (HCT), we investigated if the number of RBC affects the extrusion of these cells during clot retraction. Indeed, lowering HCT in AA mouse blood reduced RBC extrusion from the clots. However, increasing HCT in SS mouse blood to that of AA blood did not increase the number of SS RBC extruded from the clot. Furthermore, inhibition of FXIIIa activity with T101 (10µM) increased the release of AA (by 64%, n=6, p<0.05) but not SS RBC from mouse clots. These data indicate that the entrapment of SS RBCs within the clot is not simply caused by lower RBC number, and is FXIII-independent. Mixing the platelet poor plasma (PPP) and cellular fraction of AA and SS mouse blood revealed that the entrapment of SS RBC is not mediated by PPP (AA blood recombined = 6.9±3.6%; SS blood recombined = 0.4±0.4%; AA cells/SS PPP = 6.7±6.4%; SS cells/AA PPP = 0.1±0.2%, n=3 per group). Clots formed ex vivo from AA blood had a gel-like, soft structure, whereas SS clots were more firm and stiff. EM demonstrated that RBC within AA clots had polyhedral shapes and were tightly packed in the central part of the clot. In contrast, most of the mouse SS RBC did not have polyhedral shapes, underwent sickling and were not compacted within the clot. They also formed long "spicule-like" processes that intertwined with fibrin fibers (Fig. C). Similar results were observed in blood of sickle patients; however, the sickled RBC phenotype was less prominent. Importantly, sickling of RBC was observed in clots formed in the inferior vena cava of SS mice, 2 hours after vessel stenosis (Fig. D). We also performed a tPA challenge assay on clots formed ex vivo from human blood and showed that SS clots challenged with low tPA concentration (0.6nM) were more resistant to fibrinolysis compared to AA clots (clot lysis time, 714±6 vs. 388.3±120.7 minutes, n=6, p=0.08). The electrolytic injury model of venous thrombosis was used to investigate the dynamics of clot formation in SS mice in vivo. Mice were infused with fluorescently labeled antibodies for fibrin (green) and platelets (red). Electrolytic injury was applied to the femoral vein; a relative intensity of fibrin and platelet accumulation was assessed by fluorescence microscopy for one hour at 10-minute intervals. SS mice have increased platelet and fibrin accumulation compared to AA mice (~ 2 fold, n=5-7, p<0.05 for 40, 50 and 60 minute time points). Interestingly, in the AA clots, platelets were mostly localized on the surface, in contrast to their widespread distribution throughout the clot in SS mice (Fig. E, yellow color). Our data demonstrated that SCD alters the structure and dynamics of venous clot formation. Experiments investigating the consequence of these observations in mouse models of stroke and pulmonary embolism are currently ongoing. Figure Figure. Disclosures No relevant conflicts of interest to declare.


1981 ◽  
Author(s):  
Jawed Fareed ◽  
Harry L Messmore ◽  
Daniel A Walz

We have reported on the antiserine protease actions of low molecular weight peptides with arginine and lysine at the carboxyl terminus and their derivatives. In order to investigate the action of these peptides and their analogues on other components of hemostasis we studied their effects on platelet function; aggregation and release reactions, clot retraction and serotonin uptake by platelets. D-Phe-Pro-Arg-NH-heptyl, D-Phe-Pro-Arg-O-heptyl, D-Phe-Pro-Arg-thiobenzyl, D-Phe-Pro-Arg-COOH, D-Phe-Pro-Arg-NH2, D-Phe-Pro-Arginal and similar derivatives of D-Pro-Phe-Arg, D-Phe-Phe-Arg and Val-leu-lys- were screened None of these peptides produced aggregation and release reactions in concentration >10 mM. D-Phe-Pro-Arg-thiobenzyl and D-Phe-Pro-Arginal produced a strong inhibition of thrombin induced aggregation and release reactions at sub ymolar levels. Both of these peptides also inhibited thrombin’s action in amidolytic and coagulant assays. D-Phe-Pro-Arg-thiobenzyl ester also produced a complete inhibition of arachidonic acid induced aggregation of platelets and showed varying inhibitory actions against ADP, epinephrine, collagen, and serotonin induced aggregation and release reactions. Although ristocetin induced aggregation was only slightly effected, a complete block of the release reaction was seen. ADP induced β-thrombo- globulin release was also inhibited by this peptide.Heptyl amide and esters of H-D-Phe-Pro-Arg-and free acid, amide and arginal forms of various other peptides exhibited relatively weaker antiplatelet actions. Our studies suggest that peptides with amino acid resembling serine protease sensitive sites can be molecularly manipulated to design potent antiplatelet agents. Furthermore these peptides may provide a useful probe to study the molecular mechanisms involved in the pathophysiology of thrombotic disorders and to design new antiplatelet drugs.


Author(s):  
Xin M. Liang ◽  
Nathan J. Sniadecki

We present a new biomechanical approach to measure nanoscale platelet contractile forces, which play an important role in the regulation of hemostasis and thrombosis. Previous studies have indicated that platelets generate contractile forces through actin-myosin interactions that lead to clot retraction and stability. If platelets are unable to generate forces, then the clots they form are loosely-bound and may detach to cause an embolism. Likewise, a higher propensity toward contractility by platelets may cause excessive clot formation in arteries and block blood flow.


Blood ◽  
2008 ◽  
Vol 112 (1) ◽  
pp. 90-99 ◽  
Author(s):  
Akiko Ono ◽  
Erik Westein ◽  
Sarah Hsiao ◽  
Warwick S. Nesbitt ◽  
Justin R. Hamilton ◽  
...  

Abstract A fundamental property of platelets is their ability to transmit cytoskeletal contractile forces to extracellular matrices. While the importance of the platelet contractile mechanism in regulating fibrin clot retraction is well established, its role in regulating the primary hemostatic response, independent of blood coagulation, remains ill defined. Real-time analysis of platelet adhesion and aggregation on a collagen substrate revealed a prominent contractile phase during thrombus development, associated with a 30% to 40% reduction in thrombus volume. Thrombus contraction developed independent of thrombin and fibrin and resulted in the tight packing of aggregated platelets. Inhibition of the platelet contractile mechanism, with the myosin IIA inhibitor blebbistatin or through Rho kinase antagonism, markedly inhibited thrombus contraction, preventing the tight packing of aggregated platelets and undermining thrombus stability in vitro. Using a new intravital hemostatic model, we demonstrate that the platelet contractile mechanism is critical for maintaining the integrity of the primary hemostatic plug, independent of thrombin and fibrin generation. These studies demonstrate an important role for the platelet contractile mechanism in regulating primary hemostasis and thrombus growth. Furthermore, they provide new insight into the underlying bleeding diathesis associated with platelet contractility defects.


2022 ◽  
Vol 8 ◽  
Author(s):  
Julie Niemann Holm-Jacobsen ◽  
Caspar Bundgaard-Nielsen ◽  
Louise Søndergaard Rold ◽  
Ann-Maria Jensen ◽  
Shakil Shakar ◽  
...  

Background: SARS-CoV-2 has resulted in a global pandemic since its outbreak in Wuhan, 2019. Virus transmission primarily occurs through close contact, respiratory droplets, and aerosol particles. However, since SARS-CoV-2 has been detected in fecal and rectal samples from infected individuals, the fecal-oral route has been suggested as another potential route of transmission. This study aimed to investigate the prevalence and clinical implications of rectal SARS-CoV-2 shedding in Danish COVID-19 patients.Methods: Hospitalized and non-hospitalized adults and children who were recently tested with a pharyngeal COVID-19 test, were included in the study. A rectal swab was collected from all participants. Hospitalized adults and COVID-19 positive children were followed with both pharyngeal and rectal swabs until two consecutive negative results were obtained. RT-qPCR targeting the envelope gene was used to detect SARS-CoV-2 in the samples. Demographic, medical, and biochemical information was obtained through questionnaires and medical records.Results: Twenty-eight of 52 (53.8%) COVID-19 positive adults and children were positive for SARS-CoV-2 in rectal swabs. Seven of the rectal positive participants were followed for more than 6 days. Two of these (28.6%) continued to test positive in their rectal swabs for up to 29 days after the pharyngeal swabs had turned negative. Hospitalized rectal positive and rectal negative adults were comparable regarding demographic, medical, and biochemical information. Furthermore, no difference was observed in the severity of the disease among the two groups.Conclusions: We provided evidence of rectal SARS-CoV-2 shedding in Danish COVID-19 patients. The clinical importance of rectal SARS-CoV-2 shedding appears to be minimal.


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