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Žigon P, Shao B. Editorial: Inflammation, the link between venous and arterial thrombosis. Front Cardiovasc Med 2024; 11:1433858. [PMID: 38873263 PMCID: PMC11171132 DOI: 10.3389/fcvm.2024.1433858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Polona Žigon
- Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
- FAMNIT, University of Primorska, Koper, Slovenia
| | - Bojing Shao
- Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY, United States
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2
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Popescu DE, Cerbu S, Rosca I, Lungu N, Trușculescu AA, Belengeanu V, Manea AM, Dima MA, Gorun F, Popa ZL, Crisan DC, Boia M. Comparative Analysis of Hematological and Biochemical Changes in Neonates among Women with and without COVID-19 Infection during Pregnancy. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1370. [PMID: 37628369 PMCID: PMC10453899 DOI: 10.3390/children10081370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/02/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
The aim of this study is to evaluate the test results of neonates delivered by COVID-19-positive mothers during pregnancy with those of neonates born to unvaccinated mothers who are COVID-19-free. A cohort study was conducted on 367 pregnant women who gave birth at Premiere Hospital, Timisoara, Romania, between May 2021 and February 2022. Two groups were established: Group 1, with 167 pregnant women infected with COVID-19, and Group 2, with 200 pregnant women who were not affected by COVID-19 during pregnancy. Maternal laboratory examination did not exhibit significant variations except for platelet count. In neonatal blood tests, WBC had a significantly lower median value in the group born to COVID-19-free mothers. Neonatal anemia and leukocytosis showed slightly higher prevalence in Group 1, but the differences were not statistically significant. This study suggests that maternal COVID-19 infection during pregnancy does not have significant associations with most maternal and neonatal characteristics.
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Affiliation(s)
- Daniela-Eugenia Popescu
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.-E.P.); (N.L.); (A.M.M.); (M.A.D.); (Z.L.P.); (D.C.C.); (M.B.)
- Department of Neonatology, Premiere Hospital, Regina Maria Health Network, 300645 Timisoara, Romania
| | - Simona Cerbu
- Discipline of Radiology and Medical Imaging, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Ioana Rosca
- Neonatology Department, Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. P.Sirbu”, 060251 Bucharest, Romania;
- Faculty of Midwifery and Nursery, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania
| | - Nicoleta Lungu
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.-E.P.); (N.L.); (A.M.M.); (M.A.D.); (Z.L.P.); (D.C.C.); (M.B.)
- Department of Neonatology, “Louis Țurcanu” Children Emergency Clinical Hospital Timișoara, 300011 Timisoara, Romania
| | - Ana Adriana Trușculescu
- Pulmonology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Valerica Belengeanu
- Department of Genetics, Institute of Life Science, Faculty of Medicine, “Vasile Goldiş” Western University of Arad, 310025 Arad, Romania;
| | - Aniko Maria Manea
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.-E.P.); (N.L.); (A.M.M.); (M.A.D.); (Z.L.P.); (D.C.C.); (M.B.)
| | - Mirabela Adina Dima
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.-E.P.); (N.L.); (A.M.M.); (M.A.D.); (Z.L.P.); (D.C.C.); (M.B.)
| | - Florin Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300172 Timisoara, Romania;
| | - Zoran Laurentiu Popa
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.-E.P.); (N.L.); (A.M.M.); (M.A.D.); (Z.L.P.); (D.C.C.); (M.B.)
| | - Doru Ciprian Crisan
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.-E.P.); (N.L.); (A.M.M.); (M.A.D.); (Z.L.P.); (D.C.C.); (M.B.)
| | - Marioara Boia
- Department of Obstetrics-Gynecology and Neonatology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (D.-E.P.); (N.L.); (A.M.M.); (M.A.D.); (Z.L.P.); (D.C.C.); (M.B.)
- Department of Neonatology, “Louis Țurcanu” Children Emergency Clinical Hospital Timișoara, 300011 Timisoara, Romania
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3
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Carnevale R, Cammisotto V, Bartimoccia S, Nocella C, Castellani V, Bufano M, Loffredo L, Sciarretta S, Frati G, Coluccia A, Silvestri R, Ceccarelli G, Oliva A, Venditti M, Pugliese F, Maria Mastroianni C, Turriziani O, Leopizzi M, D'Amati G, Pignatelli P, Violi F. Toll-Like Receptor 4-Dependent Platelet-Related Thrombosis in SARS-CoV-2 Infection. Circ Res 2023; 132:290-305. [PMID: 36636919 DOI: 10.1161/circresaha.122.321541] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND SARS-CoV-2 is associated with an increased risk of venous and arterial thrombosis, but the underlying mechanism is still unclear. METHODS We performed a cross-sectional analysis of platelet function in 25 SARS-CoV-2 and 10 healthy subjects by measuring Nox2 (NADPH oxidase 2)-derived oxidative stress and thromboxane B2, and investigated if administration of monoclonal antibodies against the S protein (Spike protein) of SARS-CoV-2 affects platelet activation. Furthermore, we investigated in vitro if the S protein of SARS-CoV-2 or plasma from SARS-CoV-2 enhanced platelet activation. RESULTS Ex vivo studies showed enhanced platelet Nox2-derived oxidative stress and thromboxane B2 biosynthesis and under laminar flow platelet-dependent thrombus growth in SARS-CoV-2 compared with controls; both effects were lowered by Nox2 and TLR4 (Toll-like receptor 4) inhibitors. Two hours after administration of monoclonal antibodies, a significant inhibition of platelet activation was observed in patients with SARS-CoV-2 compared with untreated ones. In vitro study showed that S protein per se did not elicit platelet activation but amplified the platelet response to subthreshold concentrations of agonists and functionally interacted with platelet TLR4. A docking simulation analysis suggested that TLR4 binds to S protein via three receptor-binding domains; furthermore, immunoprecipitation and immunofluorescence showed S protein-TLR4 colocalization in platelets from SARS-CoV-2. Plasma from patients with SARS-CoV-2 enhanced platelet activation and Nox2-related oxidative stress, an effect blunted by TNF (tumor necrosis factor) α inhibitor; this effect was recapitulated by an in vitro study documenting that TNFα alone promoted platelet activation and amplified the platelet response to S protein via p47phox (phagocyte oxidase) upregulation. CONCLUSIONS The study identifies 2 TLR4-dependent and independent pathways promoting platelet-dependent thrombus growth and suggests inhibition of TLR4. or p47phox as a tool to counteract thrombosis in SARS-CoV-2.
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Affiliation(s)
- Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C., S.S., G.F., M.L.).,IRCCS Neuromed, Località Camerelle, Pozzilli (IS), Italy (R.C., S.S., G.F.)
| | - Vittoria Cammisotto
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences (V. Cammisotto, S.B., C.N., L.L., P.P.), Sapienza University of Rome, Italy
| | - Simona Bartimoccia
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences (V. Cammisotto, S.B., C.N., L.L., P.P.), Sapienza University of Rome, Italy
| | - Cristina Nocella
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences (V. Cammisotto, S.B., C.N., L.L., P.P.), Sapienza University of Rome, Italy
| | - Valentina Castellani
- Department of General Surgery and Surgical Speciality (V. Castellani, F.P.), Sapienza University of Rome, Italy
| | - Marianna Bufano
- Laboratory affiliated with the Institute Pasteur Italy - Cenci Bolognetti Foundation, Department of Drug Chemistry and Technologies (M.B., A.C., R.S.), Sapienza University of Rome, Italy
| | - Lorenzo Loffredo
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences (V. Cammisotto, S.B., C.N., L.L., P.P.), Sapienza University of Rome, Italy
| | - Sebastiano Sciarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C., S.S., G.F., M.L.).,IRCCS Neuromed, Località Camerelle, Pozzilli (IS), Italy (R.C., S.S., G.F.)
| | - Giacomo Frati
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C., S.S., G.F., M.L.).,IRCCS Neuromed, Località Camerelle, Pozzilli (IS), Italy (R.C., S.S., G.F.)
| | - Antonio Coluccia
- Laboratory affiliated with the Institute Pasteur Italy - Cenci Bolognetti Foundation, Department of Drug Chemistry and Technologies (M.B., A.C., R.S.), Sapienza University of Rome, Italy
| | - Romano Silvestri
- Laboratory affiliated with the Institute Pasteur Italy - Cenci Bolognetti Foundation, Department of Drug Chemistry and Technologies (M.B., A.C., R.S.), Sapienza University of Rome, Italy
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases (G.C., A.O., M.V., C.M.M.), Sapienza University of Rome, Italy
| | - Alessandra Oliva
- Department of Public Health and Infectious Diseases (G.C., A.O., M.V., C.M.M.), Sapienza University of Rome, Italy
| | - Mario Venditti
- Department of Public Health and Infectious Diseases (G.C., A.O., M.V., C.M.M.), Sapienza University of Rome, Italy
| | - Francesco Pugliese
- Department of General Surgery and Surgical Speciality (V. Castellani, F.P.), Sapienza University of Rome, Italy
| | - Claudio Maria Mastroianni
- Department of Public Health and Infectious Diseases (G.C., A.O., M.V., C.M.M.), Sapienza University of Rome, Italy
| | - Ombretta Turriziani
- Laboratory of Virology, Department of Molecular Medicine (O.T.), Sapienza University of Rome, Italy
| | - Martina Leopizzi
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (R.C., S.S., G.F., M.L.)
| | - Giulia D'Amati
- Department of Radiological, Oncological and Pathological Sciences (G.D.), Sapienza University of Rome, Italy
| | - Pasquale Pignatelli
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences (V. Cammisotto, S.B., C.N., L.L., P.P.), Sapienza University of Rome, Italy.,Mediterranea Cardiocentro- Napoli, Italy (P.P., F.V.)
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4
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Buonsenso D. Childhood Immunity and Infections: Time to Consider Endothelial Cells and Platelets. CHILDREN 2022; 9:children9060841. [PMID: 35740778 PMCID: PMC9221571 DOI: 10.3390/children9060841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; ; Tel./Fax: +39-(0)-630154390
- Global Health Research Center, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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5
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Spasov AA, Kucheryavenko AF, Sirotenko VS, Gaidukova KA, Uskov GM. Antiplatelet Activity of Riamilovir under Conditions of Lipopolysaccharide Intoxication. Bull Exp Biol Med 2022; 173:41-45. [PMID: 35616790 PMCID: PMC9134143 DOI: 10.1007/s10517-022-05489-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Indexed: 12/27/2022]
Abstract
We studied the effect of antiviral agent riamilovir on ADP-induced platelet aggregation in the absence and presence of LPS. Unlike acetylsalicylic acid (reference drug), riamilovir did not exhibit antiplatelet effect in vitro. However, it markedly suppressed platelet reactivity in LPS-treated blood samples and was 2.2-fold superior to acetylsalicylic acid in terms of IC50 value. In in vivo experiments, riamilovir under conditions of hypercytokinemia blocked platelet aggregation in rats by 64%.
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Affiliation(s)
- A A Spasov
- Department of Pharmacology and Bioinformatics, Volgograd State Medical University, Ministry of Health of the Russian Federation, Volgograd, Russia
| | - A F Kucheryavenko
- Department of Pharmacology and Bioinformatics, Volgograd State Medical University, Ministry of Health of the Russian Federation, Volgograd, Russia.
| | - V S Sirotenko
- Department of Pharmacology and Bioinformatics, Volgograd State Medical University, Ministry of Health of the Russian Federation, Volgograd, Russia
| | - K A Gaidukova
- Department of Pharmacology and Bioinformatics, Volgograd State Medical University, Ministry of Health of the Russian Federation, Volgograd, Russia
| | - G M Uskov
- Department of Pharmacology and Bioinformatics, Volgograd State Medical University, Ministry of Health of the Russian Federation, Volgograd, Russia
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6
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Janus Kinase Signaling Pathway and Its Role in COVID-19 Inflammatory, Vascular, and Thrombotic Manifestations. Cells 2022; 11:cells11020306. [PMID: 35053424 PMCID: PMC8773838 DOI: 10.3390/cells11020306] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 12/12/2022] Open
Abstract
Acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection continues to be a worldwide public health crisis. Among the several severe manifestations of this disease, thrombotic processes drive the catastrophic organ failure and mortality in these patients. In addition to a well-established cytokine storm associated with the disease, perturbations in platelets, endothelial cells, and the coagulation system are key in triggering systemic coagulopathy, involving both the macro- and microvasculatures of different organs. Of the several mechanisms that might contribute to dysregulation of these cells following SARS-CoV-2 infection, the current review focuses on the role of activated Janus kinase (JAK) signaling in augmenting thrombotic processes and organ dysfunction. The review concludes with presenting the current understanding and emerging controversies concerning the potential therapeutic applications of JAK inhibitors for ameliorating the inflammation-thrombosis phenotype in COVID-19 patients.
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7
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Tokarz-Deptuła B, Palma J, Baraniecki Ł, Stosik M, Kołacz R, Deptuła W. What Function Do Platelets Play in Inflammation and Bacterial and Viral Infections? Front Immunol 2021; 12:770436. [PMID: 34970260 PMCID: PMC8713818 DOI: 10.3389/fimmu.2021.770436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/22/2021] [Indexed: 12/15/2022] Open
Abstract
The article presents the function of platelets in inflammation as well as in bacterial and viral infections, which are the result of their reaction with the endovascular environment, including cells of damaged vascular endothelium and cells of the immune system. This role of platelets is conditioned by biologically active substances present in their granules and in their specific structures - EV (extracellular vesicles).
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Affiliation(s)
| | - Joanna Palma
- Department of Biochemical Sciences, Pomeranian Medical University, Szczecin, Poland
| | | | - Michał Stosik
- Institute of Biological Science, Faculty of Biological Sciences, University of Zielona Góra, Zielona Góra, Poland
| | - Roman Kołacz
- Institute of Veterinary Medicine, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Wiesław Deptuła
- Institute of Veterinary Medicine, Faculty of Biological and Veterinary Sciences, Nicolaus Copernicus University in Toruń, Toruń, Poland
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8
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Higashikuni Y, Liu W, Obana T, Sata M. Pathogenic Basis of Thromboinflammation and Endothelial Injury in COVID-19: Current Findings and Therapeutic Implications. Int J Mol Sci 2021; 22:ijms222112081. [PMID: 34769508 PMCID: PMC8584434 DOI: 10.3390/ijms222112081] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic with a great impact on social and economic activities, as well as public health. In most patients, the symptoms of COVID-19 are a high-grade fever and a dry cough, and spontaneously resolve within ten days. However, in severe cases, COVID-19 leads to atypical bilateral interstitial pneumonia, acute respiratory distress syndrome, and systemic thromboembolism, resulting in multiple organ failure with high mortality and morbidity. SARS-CoV-2 has immune evasion mechanisms, including inhibition of interferon signaling and suppression of T cell and B cell responses. SARS-CoV-2 infection directly and indirectly causes dysregulated immune responses, platelet hyperactivation, and endothelial dysfunction, which interact with each other and are exacerbated by cardiovascular risk factors. In this review, we summarize current knowledge on the pathogenic basis of thromboinflammation and endothelial injury in COVID-19. We highlight the distinct contributions of dysregulated immune responses, platelet hyperactivation, and endothelial dysfunction to the pathogenesis of COVID-19. In addition, we discuss potential therapeutic strategies targeting these mechanisms.
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Affiliation(s)
- Yasutomi Higashikuni
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (W.L.); (T.O.)
- Correspondence: (Y.H.); (M.S.)
| | - Wenhao Liu
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (W.L.); (T.O.)
| | - Takumi Obana
- Department of Cardiovascular Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (W.L.); (T.O.)
| | - Masataka Sata
- Department of Cardiovascular Medicine, The University of Tokushima, Tokushima 770-8503, Japan
- Correspondence: (Y.H.); (M.S.)
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9
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Massaro G, Lecis D, Martuscelli E, Chiricolo G, Sangiorgi GM. Clinical Features and Management of COVID-19–Associated Hypercoagulability. Card Electrophysiol Clin 2021; 14:41-52. [PMID: 35221084 PMCID: PMC8556574 DOI: 10.1016/j.ccep.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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10
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Nori W, Hameed BH, Thamir AR, Fadhil A. COVID-19 in Pregnancy: Implication on Platelets and Blood Indices. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:595-599. [PMID: 34547793 PMCID: PMC10183934 DOI: 10.1055/s-0041-1733912] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women. METHODS A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation. RESULTS Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87 ± 66.92 fL for the case group versus 9.84 ± 1.2 fL for the control group; PDW: 14.82 ± 3.18 fL for the case group versus 13.3 ± 2.16 fL for the controls). The criterion value of the receiver operating characteristic (ROC) curve for PDW at a cutoff point of > 11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of > 10.17 fL showed a good diagnostic marker. CONCLUSION The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.
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Affiliation(s)
- Wassan Nori
- Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Ban Hadi Hameed
- Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Asmaa Rajih Thamir
- Department of Obstetrics and Gynecology, AL Yarmouk Teaching Hospital, Baghdad, Iraq
| | - Amenah Fadhil
- Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq
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11
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Salva O, Alasino R, Giller C, Borello J, Doresky A, Karayan G, Beltramo D. Nebulization with alkaline hipertonic ibuprofen induces a rapid increase in platelets circulating in COVID-19 patients but not in healthy subjects. Platelets 2021; 33:471-478. [PMID: 34423724 DOI: 10.1080/09537104.2021.1967918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We analyze changes in circulating platelets in COVID-19 positive patients who received conventional treatment Dexamethasone and Enoxaparin (Dexa-Enoxa) compared to patients treated with conventional therapy plus nebulization with alkaline hypertonic ibuprofenate (AHI). Results show that after 24 h of nebulization with AHI, circulating platelets shows an increase about 40% at 24 h and reach 65% at 96 h. In patients with platelets content below 200,000 by microliter the increase was 49% and 79% at 24 and 96 h respectively. In patients with platelets above 200,000 by microliter the increase was 24% and 31% at 24 and 96 h, respectively. The increase of platelets via AHI was similar in both, men and women.To evaluate whether this action of AHI was related to platelets from COVID-19 positive patients or also for healthy people, two controls were included: one of them with 10 healthy volunteers and another one with COVID-19 positive patients hospitalized and treated only with Dexa-Enoxa. Results show that, in healthy volunteers, the number of circulating platelets remains unchanged even after 7 days of treatment with AHI. In COVID-19 positive patients treated only with Dexa-Enoxa for 4 days, platelets increased only 16%.
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Affiliation(s)
- Oscar Salva
- Departamento de Clínica Médica, Clínica Independencia, Ciudad de Munro, Provincia de Buenos Aires, Argentina
| | - Roxana Alasino
- Programa de Biociencias, Centro De Excelencias En Productos Y Procesos (CEPROCOR), Ministerio de Ciencia y Tecnología de la Provincia de Córdoba, Cordoba, Argentina.,Consejo Nacional de Investigaciones Científicas (CONICET), Ministerio de Ciencia Tecnología e Innovación de la República Argentina, Provincia de Buenos Aires, Argentina
| | - Celia Giller
- Departamento de Clínica Médica, Clínica Independencia, Ciudad de Munro, Provincia de Buenos Aires, Argentina
| | - Julieta Borello
- Programa de Biociencias, Centro De Excelencias En Productos Y Procesos (CEPROCOR), Ministerio de Ciencia y Tecnología de la Provincia de Córdoba, Cordoba, Argentina
| | - Alexis Doresky
- Departamento de Investiagación Clinica, Fundación Respirar, Ciudad Autónoma de Buenos Aires, Provincia de Buenos Aires, Argentina
| | - Galia Karayan
- Departamento de Investiagación Clinica, Fundación Respirar, Ciudad Autónoma de Buenos Aires, Provincia de Buenos Aires, Argentina
| | - Dante Beltramo
- Programa de Biociencias, Centro De Excelencias En Productos Y Procesos (CEPROCOR), Ministerio de Ciencia y Tecnología de la Provincia de Córdoba, Cordoba, Argentina.,Consejo Nacional de Investigaciones Científicas (CONICET), Ministerio de Ciencia Tecnología e Innovación de la República Argentina, Provincia de Buenos Aires, Argentina
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12
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Gu SX, Tyagi T, Jain K, Gu VW, Lee SH, Hwa JM, Kwan JM, Krause DS, Lee AI, Halene S, Martin KA, Chun HJ, Hwa J. Thrombocytopathy and endotheliopathy: crucial contributors to COVID-19 thromboinflammation. Nat Rev Cardiol 2021; 18:194-209. [PMID: 33214651 PMCID: PMC7675396 DOI: 10.1038/s41569-020-00469-1] [Citation(s) in RCA: 255] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 02/06/2023]
Abstract
The core pathology of coronavirus disease 2019 (COVID-19) is infection of airway cells by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that results in excessive inflammation and respiratory disease, with cytokine storm and acute respiratory distress syndrome implicated in the most severe cases. Thrombotic complications are a major cause of morbidity and mortality in patients with COVID-19. Patients with pre-existing cardiovascular disease and/or traditional cardiovascular risk factors, including obesity, diabetes mellitus, hypertension and advanced age, are at the highest risk of death from COVID-19. In this Review, we summarize new lines of evidence that point to both platelet and endothelial dysfunction as essential components of COVID-19 pathology and describe the mechanisms that might account for the contribution of cardiovascular risk factors to the most severe outcomes in COVID-19. We highlight the distinct contributions of coagulopathy, thrombocytopathy and endotheliopathy to the pathogenesis of COVID-19 and discuss potential therapeutic strategies in the management of patients with COVD-19. Harnessing the expertise of the biomedical and clinical communities is imperative to expand the available therapeutics beyond anticoagulants and to target both thrombocytopathy and endotheliopathy. Only with such collaborative efforts can we better prepare for further waves and for future coronavirus-related pandemics.
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Affiliation(s)
- Sean X Gu
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Tarun Tyagi
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Kanika Jain
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Vivian W Gu
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Seung Hee Lee
- Division of Cardiovascular Diseases, Center for Biomedical Sciences, National Institute of Health, Cheongju, Chungbuk, Korea
| | - Jonathan M Hwa
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Jennifer M Kwan
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Diane S Krause
- Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Alfred I Lee
- Section of Hematology, Department of Internal Medicine and Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA
| | - Stephanie Halene
- Section of Hematology, Department of Internal Medicine and Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT, USA
| | - Kathleen A Martin
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Hyung J Chun
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - John Hwa
- Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
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O'Kennedy N, Duttaroy AK. Platelet hyperactivity in COVID-19: Can the tomato extract Fruitflow® be used as an antiplatelet regime? Med Hypotheses 2021; 147:110480. [PMID: 33421690 PMCID: PMC7781513 DOI: 10.1016/j.mehy.2020.110480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/24/2020] [Indexed: 12/14/2022]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus is now considered a global public health threat. The primary focus has been on reducing the viral spread and treating respiratory symptoms; as time goes on, the impact of COVID-19 on neurological and haemostatic systems becomes more evident. The clinical data suggest that platelet hyperactivity plays a role in the pathology of COVID-19 from its onset and that platelets may serve critical functions during COVID‐19 progression. Hyperactivation of blood platelets and the coagulation system are emerging as important drivers of inflammation and may be linked to the severity of the ‘cytokine storm’ induced in severe cases of COVID-19, in which disseminated intravascular coagulation, and platelet hyperactivity are associated with poor prognosis and increased risk of mortality. We propose that targeting platelet hyperactivity in the early stages of COVID-19 infection may reduce the immunothrombotic complications of COVID-19 and subdue the systemic inflammatory response. Lowering baseline platelet activity may be of particular importance for higher-risk groups. As an alternative to antiplatelet drugs, an inappropriate intervention in public health, we propose that the dietary antiplatelet agent Fruitflow®, derived from tomatoes, may be considered a suitable therapy. Fruitflow® contains antiplatelet and anti-inflammatory compounds that target the mechanisms of platelet activation specific to COVID-19 and can be considered a safe and natural antiplatelet regime.
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Affiliation(s)
- Niamh O'Kennedy
- Provexis PLC, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, United Kingdom
| | - Asim K Duttaroy
- Department of Nutrition, Institute of Biomedical Sciences, Faculty of Medicine, University of Oslo, Norway.
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