Fibrinopeptides and fibrin gel structure

Homophenotypic Aalpha R16H fibrinogen (Kingsport): uniquely altered polymerization associated with slower fibrinopeptide A than fibrinopeptide B release

We detail for the first time the uniquely altered fibrin polymerization of homophenotypic Aalpha R16H dysfibrinogen. By polymerase chain reaction amplification and DNA sequencing, our new proposita's genotype consisted of a G>A transition encoding for Aalpha R16H, and an 11 kb Aalpha gene deletion. High-performance liquid chromatography disclosed fibrinopeptide A release approximately six times slower than its fibrinopeptide B. Turbidimetric analyses revealed unimpaired fibrin repolymerization, and abnormal thrombin-induced polymerization (1-7 mumol/l fibrinogen, > 96% coagulable), consisting of a prolonged lag time, slow rate, and abnormal clot turbidity maxima, all varying with thrombin concentration. For example, at 0.2-3 U/ml, the resulting turbidity maxima ranged from lower to higher than normal control values. By scanning electron microscopy, clots formed by 0.3 and 3 thrombin U/ml displayed mean fibril diameters 42 and 254% of the respective control values (n = 400). Virtually no such differences from control values were demonstrable, however, when clots formed in the presence of high ionic strength (micro = 0.30) or of monoclonal antibeta(15-42)IgG. The latter also prolonged the thrombin clotting time approximately three-fold. Additionally, thrombin-induced clots displayed decreased elastic moduli, with G' values of clots induced by 0.3, 0.7 and 3 thrombin U/ml corresponding to 11, 34, and 45% of control values. The results are consistent with increased des-BB fibrin monomer generation preceding and during polymerization. This limited the inherent gelation delay, decreased the clot stiffness, and enabled a progressively coarser, rather than finer, network induced by increasing thrombin concentrations. We hypothesize that during normal polymerization these constitutive des-BB fibrin monomer properties attenuate their des-AA fibrin counterparts.

Rheometry and associated techniques for blood coagulation studies

This review considers various rheometrical approaches that have been adopted to study blood coagulation, with special reference to the rheological assessment of clotting time and studies of the evolution of viscoelasticity during the course of fibrin polymerization and cross-linking. The significance of the Gel Point in blood coagulation studies is discussed as a common feature of many of these studies in that they attempt to detect a liquid-to-solid transition during coagulation. Coagulation studies based on various forms of complex shear modulus measurements are considered, the latter being based principally on controlled stress and controlled strain rheometers. Also considered are the long established technique of thromboelastography and several emerging techniques such as wave propagation measurements, free oscillation rheometry, quartz crystal microbalance measurements and surface plasmon resonance.

Interaction of fibrinogen with nanosilica

Interaction of human plasma fibrinogen (HPF) with fumed nanosilica A-300 in a phosphate buffer solution (PBS) was studied using 1H NMR spectroscopy with layer-by-layer freezing-out of bulk and interfacial water in the temperature range of 210–273 K, TSDC (90 T FTIR, and UV spectroscopy methods. An increase in concentration of HPF in the PBS leads to a decrease in amounts of structured water (frozen at T FTIR and UV spectra show that the HPF adsorption on silica leads to structural changes of the protein molecules. These changes and formation of hybrid HPF/A-300 aggregates can increase the rate of clotting that is of importance on nanosilica application as a component of tourniquet preparations.

The adhesion of blood platelets on fibrinogen surface: comparison of two biochemical microplate assays

The biocompatibility of materials is frequently assessed by blood platelet adhesion, since platelet adhesion plays a considerable role in blood interaction with artificial surfaces. Blood platelets adhesion is an essential event in haemostatic and thrombotic processes. The aim of this study was to simultaneously compare simple biochemical assays widely used for evaluation of platelet static adhesion based on the determination of enzymatic activity of either lactate dehydrogenase (LDH) or acid phosphatase (ACP) in lysates of adhered platelets. Adhesion of platelets from platelet-rich plasma and washed platelets activated by either ADP or thrombin on surfaces covered with fibrinogen and well defined fibrin was studied. The results demonstrated that the amounts of adhered platelets estimated by the LDH method were significantly lower as compared with the amount obtained by ACP method. LDH but not ACP release from platelets during adhesion was shown to take place. It suggests that the LDH method should be used rather as an assay of platelet integrity. The ACP method is much more suitable for quantitative determination of platelet adhesion especially in the development and evaluation of haemocompatibility of new biomaterials.

Influence of thrombin concentration on the mechanical and morphological properties of cell-seeded fibrin hydrogels

Fibrin is a biopolymer that has been used in a variety of biomaterial, cell delivery and tissue engineering applications. The enzyme thrombin catalyzes the formation of fibrin microfibrils, which form a three-dimensional mesh in which cells can be directly embedded at the time of gel formation. In this study, fibrin hydrogels containing vascular smooth muscle cells were created using varying concentrations of thrombin. Over 7 days in culture, all gels decreased in volume as the fibrin matrix compacted, and the degree of gel compaction increased as thrombin concentration decreased. The material modulus and ultimate tensile stress of the gels also increased with decreasing thrombin concentration. Addition of thrombin to similar constructs made using collagen Type I did not show an effect on gel compaction or mechanical properties, suggesting that these effects were a result of thrombin's action on fibrin polymerization, and not cellular functions. Cell proliferation in fibrin hydrogels was not significantly affected by thrombin addition. Matrix examination using scanning electron microscopy showed increasing fibrin fiber diameters as thrombin concentration decreased. Confocal microscopic imaging of the actin cytoskeleton showed that cell morphology on two-dimensional substrates of fibrin showed marked changes, with higher thrombin concentrations producing cells with longer cellular projections. However, these morphological changes were not as apparent in cells embedded in three-dimensional (3-D) matrices, in which cells exhibited a similar morphology independent of thrombin concentration. These results relate features of the matrix and cellular components of 3-D fibrin constructs to mechanical properties, and contribute to the understanding of structure-function relationships in cell-seeded, 3-D protein hydrogels.

Elevated Serum Fibrin-Monomer Levels are Associated With High Long-Term Cerebrovascular Event Rates in Acute Ischemic Stroke Patients

BACKGROUND

Serum fibrin-monomer (FM) is a precursor of stable fibrin, and is a sensitive marker of a systemic hypercoagulable state. It has been reported that, in patients with acute ischemic stroke, higher levels of serum FM reflect intracardiac thrombus formation.

METHODS AND RESULTS

Serum coagulation and fibrinolytic activity were measured in 113 patients with acute ischemic stroke within 7 (6+/-1) days after onset. The patients were followed for a mean of 354 (range 36-585) days. The primary endpoints were ischemic stroke recurrence with/without death. FM was markedly higher in the 19 cases with stroke recurrence (49.6+/-53.6 microg/ml) than in the 94 patients without stroke recurrence (14.6+/-30.5 microg/ml; p=0.008). The cerebrovascular event rates were markedly higher in the 12 cases with FM > or =16.5 microg/ml (37.5%) than in the 7 cases with FM <16.5 microg/ml (8.6%; p<0.001). Cox proportional hazards multivariate analysis showed that the FM level was an independent predictor of ischemic stroke recurrence with/without death (hazard ratio, 1.516 per + 1 standard deviation increase; 95% confidence interval, 1.042-2.180; p=0.036).

CONCLUSIONS

Elevated serum FM levels in hospitalized ischemic stroke patients may be associated with a persistent systemic hypercoagulable state and high long-term rates of cerebrovascular events.

Platelet factor 4 (CXCL4) seals blood clots by altering the structure of fibrin

Platelet factor-4 (PF4/CXCL4) is an orphan chemokine released in large quantities in the vicinity of growing blood clots. Coagulation of plasma supplemented with a matching amount of PF4 results in a translucent jelly-like clot. Saturating amounts of PF4 reduce the porosity of the fibrin network 4.4-fold and decrease the values of the elastic and loss moduli by 31- and 59-fold, respectively. PF4 alters neither the cleavage of fibrinogen by thrombin nor the cross-linking of protofibrils by activated factor XIII but binds to fibrin and dramatically transforms the structure of the ensuing network. Scanning electron microscopy showed that PF4 gives rise to a previously unreported pattern of polymerization where fibrin assembles to form a sealed network. The subunits constituting PF4 form a tetrahedron having at its corners a RPRH motif that mimics (in reverse orientation) the Gly-His-Arg-Pro-amide peptides that co-crystallize with fibrin. Molecular modeling showed that PF4 could be docked to fibrin with remarkable complementarities and absence of steric clashes, allowing the assembly of irregular polymers. Consistent with this hypothesis, as little as 50 microm the QVRPRHIT peptide derived from PF4 affects the polymerization of fibrin.

Higher Levels of Serum Fibrin-Monomer Reflect Hypercoagulable State and Thrombus Formation in the Left Atrial Appendage in Patients With Acute Ischemic Stroke

BACKGROUND

It is sometimes difficult to make a diagnosis of cardioembolic stroke in the stroke care unit, because of the splashing and vanishing of the intracardiac source of the emboli on transesophageal echocardiography. Serum fibrin-monomer (FM) is a new marker for coagulation activity that is useful for identifying older individuals at increased risk of ischemic stroke.

METHODS AND RESULTS

Two hundred and four patients with acute ischemic stroke were examined for serum coagulation and fibrinolytic activity on admission, and underwent transesophageal echocardiography within 7 days of onset. Serum levels of FM was significantly higher in patients with left atrial appendage (LAA) thrombus formation (n=24) than in those with no thrombus (88+/-52 vs 14+/-9 microg/ml, p<0.0001). On multivariate logistic regression analysis, FM was an independent predictor for LAA thrombus (RR 2.975, 95% confidence interval 1.114 to 4.820, p=0.0214). In patients with LAA thrombus negative group, cases with LAA emptying flow velocity at atrial systole that was absent or smaller than at early diastole had significantly higher FM levels as compared to cases with larger velocity (42+/-12 vs 8+/-5 microg/ml, p<0.0001).

CONCLUSION

Higher levels of serum FM reflect LAA flow pattern alterations and thrombus formation in patients with acute ischemic stroke.