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Paar M, Aziz F, Sourij C, Tripolt NJ, Kojzar H, Müller A, Pferschy P, Obermayer A, Banfic T, Di Geronimo Quintero B, Goswami N, Schlagenhauf A, Köstenberger M, Bärnthaler T, Wagner T, Hrzenjak A, Wonisch W, Reibnegger G, Raggam RB, Sourij H, Cvirn G. Only Subclinical Alterations in the Haemostatic System of People with Diabetes after COVID-19 Vaccination. Viruses 2022; 15:10. [PMID: 36680051 PMCID: PMC9867445 DOI: 10.3390/v15010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
People with diabetes have an increased risk of experiencing adverse COVID-19 outcomes. COVID-19 vaccination is, therefore, highly recommended. However, people with diabetes have an inherently elevated risk of thrombotic events and the impact of the vaccination on the coagulation system in this patient population remains to be elucidated. The aim of this study was to investigate the impact of COVID-19 vaccination on the haemostatic system in people with type 1 or type 2 diabetes. We evaluated the effects of COVID-19 vaccination (BioNTech Pfizer, Moderna, AstraZeneca) on standard coagulation parameters, whole blood coagulation (Thrombelastometry), platelet function (impedance aggregation), and thrombin generation (calibrated automated thrombography) in people with type 1 diabetes mellitus (n = 41) and type 2 diabetes mellitus (n = 37). Blood sampling points were prior to vaccination and two weeks after the respective vaccination. Thrombelastometry measurements indicated moderately increased clot formation post-vaccination in people with type 1, as well as with type 2, diabetes: "Clot formation times" were significantly shorter, and both "maximum clot firmness" and "alpha angles" were significantly higher, as compared to the respective pre-vaccination values. Therefore, TEM parameters were not altered after vaccination in patients receiving ASA. Moreover, platelet aggregation was enhanced in people with type 1 diabetes, and plasma levels of D-Dimer were increased in people with type 2 diabetes, following COVID-19 vaccination. All other standard coagulation parameters, as well as thrombin generation, were not affected by the vaccination. The coagulation responses of people with diabetes to COVID-19 vaccination were only subclinical and comparable to those observed in healthy individuals. Our findings suggest that people with diabetes do not face an increased activation of the coagulation post-vaccination.
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Affiliation(s)
- Margret Paar
- Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
| | - Faisal Aziz
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
| | - Caren Sourij
- Division of Cardiology, Medical University of Graz, 8010 Graz, Austria
| | - Norbert J. Tripolt
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
| | - Harald Kojzar
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
| | - Alexander Müller
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
| | - Peter Pferschy
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
| | - Anna Obermayer
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
| | - Tamara Banfic
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
| | - Bruno Di Geronimo Quintero
- Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
| | - Nandu Goswami
- Division of Physiology, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
| | - Axel Schlagenhauf
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, 8010 Graz, Austria
| | - Martin Köstenberger
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, 8010 Graz, Austria
| | - Thomas Bärnthaler
- Division of Pharmacology, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
| | - Thomas Wagner
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8010 Graz, Austria
| | - Andelko Hrzenjak
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria
| | - Willibald Wonisch
- Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
| | - Gilbert Reibnegger
- Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
| | | | - Harald Sourij
- Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
| | - Gerhard Cvirn
- Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
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Lamprecht M, Moussalli H, Ledinski G, Leschnik B, Schlagenhauf A, Koestenberger M, Polt G, Cvirn G. Effects of a single bout of walking exercise on blood coagulation parameters in obese women. J Appl Physiol (1985) 2013; 115:57-63. [DOI: 10.1152/japplphysiol.00187.2013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Obesity is associated with increased prevalence of thromboembolic events. We aimed to investigate whether obese women might benefit from vigorous aerobic exercise. Forty-two overweight and obese women performed a 30-min walking exercise test (treadmill ergometer) at an intensity of 70% of individual peak oxygen uptake. Blood samples were collected before and immediately after exercise. Thrombelastometry and platelet function measurements were performed on whole blood. Standard coagulation times, thrombin generation curves, markers of thrombin generation, fibrinolytic parameters, plasma levels of pro- and anticoagulatory factors, and microparticle procoagulant activity were determined in platelet-poor plasma samples. Thrombelastometry revealed a significant prolongation of clot formation time ( P = 0.037) and a significant deceleration of fibrin build up (alpha angle, P = 0.034) after exercise. Calibrated automated thrombography revealed a significant exercise-induced decrease in endogenous thrombin potential ( P = 0.039). Moreover, thrombin formation stopped earlier postexercise, reflected in shortened StartTail ( P = 0.046). Significantly elevated tissue-plasminogen activator levels ( P = 0.001) indicate an exercise-induced activation of the fibrinolytic system. White blood cell count increased significantly from pre- to postexercise ( P = 0.045), indicating a mild exercise-induced leukocytosis. The results of this study demonstrate that vigorous aerobic exercise might be a suitable tool to protect obese women from thrombotic events. We show that a single bout of vigorous aerobic exercise is clearly associated with an activation of the fibrinolytic system and a decreased readiness of the postexercise samples to form a clot and to generate thrombin, the pivotal enzyme of hemostasis.
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Affiliation(s)
- Manfred Lamprecht
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
- Green Beat-Institute of Nutrient Research and Sport Nutrition, Graz, Austria; and
| | - Herve Moussalli
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Gerhard Ledinski
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
| | - Bettina Leschnik
- Department of Pediatrics, Medical University of Graz, Graz, Austria
| | | | | | - Guenter Polt
- Green Beat-Institute of Nutrient Research and Sport Nutrition, Graz, Austria; and
| | - Gerhard Cvirn
- Institute of Physiological Chemistry, Medical University of Graz, Graz, Austria
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Reed JH, Clancy RM, Purcell AW, Kim MY, Gordon TP, Buyon JP. β2-glycoprotein I and protection from anti-SSA/Ro60-associated cardiac manifestations of neonatal lupus. THE JOURNAL OF IMMUNOLOGY 2011; 187:520-6. [PMID: 21602492 DOI: 10.4049/jimmunol.1100122] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
One mechanism to molecularly explain the strong association of maternal anti-Ro60 Abs with cardiac disease in neonatal lupus (NL) is that these Abs initiate injury by binding to apoptotic cardiomyocytes in the fetal heart. Previous studies have demonstrated that β(2)-glycoprotein I (β(2)GPI) interacts with Ro60 on the surface of apoptotic Jurkat cells and prevents binding of anti-Ro60 IgG. Accordingly, the current study was initiated to test two complementary hypotheses, as follows: 1) competition between β(2)GPI and maternal anti-Ro60 Abs for binding apoptotic induced surface-translocated Ro60 occurs on human fetal cardiomyocytes; and 2) circulating levels of β(2)GPI influence injury in anti-Ro60-exposed fetuses. Initial flow cytometry experiments conducted on apoptotic human fetal cardiomyocytes demonstrated dose-dependent binding of β(2)GPI. In competitive inhibition experiments, β(2)GPI prevented opsonization of apoptotic cardiomyocytes by maternal anti-Ro60 IgG. ELISA was used to quantify β(2)GPI in umbilical cord blood from 97 neonates exposed to anti-Ro60 Abs, 53 with cardiac NL and 44 with no cardiac disease. β(2)GPI levels were significantly lower in neonates with cardiac NL. Plasmin-mediated cleavage of β(2)GPI prevented binding to Ro60 and promoted the formation of pathogenic anti-Ro60 IgG-apoptotic cardiomyocyte complexes. In aggregate these data suggest that intact β(2)GPI in the fetal circulation may be a novel cardioprotective factor in anti-Ro60-exposed pregnancies.
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Affiliation(s)
- Joanne H Reed
- Division of Rheumatology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA.
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Cvirn G, Gallistl S, Kutschera J, Wagner T, Ferstl U, Jurgens G, Koestenberger M. Clot strength: a comparison between cord and adult blood by means of thrombelastometry. J Pediatr Hematol Oncol 2008; 30:210-3. [PMID: 18376283 DOI: 10.1097/mph.0b013e318162bd2c] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To evaluate the clot strength in cord versus adult blood. METHOD Thrombelastometry (TEM) was the method of choice as it provides information on the clot strength in terms of the maximum clot firmness (MCF) and on the fibrin polymerization process in terms of the clot formation time and the alpha angle. RESULTS The MCFs were significantly lower in cord versus adult platelet rich plasma (PRP, 63.0+/-3.8 vs. 67.0+/-3.9 mm, P=0.006) and in cord versus adult whole blood (WB, 55.3+/-3.8 vs. 59.3+/-3.6 mm, P=0.001) employing the thrombelastometry with extrinsic activator assay. We suggest that the diminished clot strength in cord versus adult blood and plasma samples is attributable to an impaired polymerization of neonatal fibrin: (i) the thrombelastometry with extrinsic activator and inactivated platelets (FIBTEM) assay revealed significantly lower MCFs in cord versus adult PRP (23.0+/-3.1 mm vs. 27.3+/-3.9 mm, P=0.002) and in cord versus adult WB (11.6+/-2.3 mm vs. 15.3+/-3.3 mm, P<0.001); (ii) the alpha angle in the FIBTEM assay was significantly lower in cord versus adult WB (39.0+/-12.8 degrees vs. 55.5+/-12.3 degrees, P=0.02); (iii) the clot formation times in the FIBTEM assay were significantly longer in cord versus adult PRP (248.0+/-143.5 s vs. 81.5+/-39.8 s, P=0.001). CONCLUSIONS Neonatal fibrin shows impaired polymerization properties under our experimental conditions resulting in reduced clot strength compared with fibrin of adult origin.
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Affiliation(s)
- Gerhard Cvirn
- Institute of Physiological Chemistry, Department of Pediatrics, Medical University of Graz, Graz, Austria.
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