Changes of tissue factor-dependent coagulant activity mediated by adhesion between polymorphonuclear leukocytes and endothelial cells

Influence of polymorphonuclear leukocytes on the plasma clot formation as evaluated by thromboelastometry (ROTEM®)

OBJECTIVE

It has been emphasized that polymorphonuclear leukocytes (PMN) participate in the regulation of coagulation. However, the mechanisms of action are not clear. Besides a procoagulant activity, anticoagulant or fibrinolytic properties are attributed to these cells. To explore their global effect, we have studied their involvement in the clot formation with thromboelastometry, which gives global view over the clotting process, in particular on the structure of the clot and on the kinetic of its formation.

METHODS

PMN were isolated from healthy blood donors and resuspended into autologous platelet-free plasma. The ROTEM device was used. Coagulation was triggered only by adding calcium chloride. Thromboelastometric profiles of PMN-rich plasma (PMN-RP) were compared with autologous platelet-rich (PRP) and platelet-poor plasma (PPP). The inhibition of both tissue factor and intrinsic pathways was also studied.

RESULTS AND CONCLUSIONS

The procoagulant activity of resting PMN was demonstrated as the initiation of fibrin formation with PMN-RP was significantly faster compared with both PRP and PPP. The kinetic of plasma clotting was remarkably improved with PMN-RP compared with PPP. However, the clot with PMN-RP had the same poor viscoelastical properties as PPP. Thromboelastometry gives a new point of view in the involvement of PMN in coagulation, in the absence of any PMN pre-activation. Their impact was centred on the kinetic and the facilitation of the clot formation.

Involvement of adenosine A2 receptors in the changes of tissue factor-dependent coagulant activity induced by polymorphonuclear leukocytes in endothelial cells

We have already reported that polymorphonuclear leukocytes (PMNs) could increase tissue factor-dependent coagulant activity (TF activity) in endothelial cells mediated by adhesion of PMNs to endothelial cells. In the present study, the role of adenosine receptors in the changes of TF activity and of adhesion between PMNs and endothelial cells was examined. The increases of the TF activity and adhesion were significantly reduced in a concentration-dependent manner by pretreatment of adenosine (0.1 and 1.0 mM); an adenosine A1/A2-receptor agonist, CGS-21680 (5, 10 and 50 microM); and an adenosine A2-receptor agonist, 5'-(N-cyclopropyl)-carboxamidoadenosine (CPCA; 1.0, 10 and 100 nM). An adenosine A2-receptor antagonist, 3,7-dimethyl-1-(2-propynyl) xanthine (DMPX; 1.0 and 100 nM), antagonized significantly the reduction of the TF activity and the adhesion induced by adenosine (1.0 mM), while 8-cyclopentyl-1,3-dimethylxanthine (CPDMX; 1.0 and 100 nM), an adenosine A1-receptor antagonist, did not affect it. On the other hand, the TF activity and the adhesion were not changed by N6-cyclohexyladenosine (CHA; 10 and 100 nM) and 2-chloro-N-cyclopentyladenosine (CCPA; 10 and 100 nM), adenosine A1-receptor agonists in the same conditions. These results suggest that the reduction in the TF activity stimulated by PMNs is closely related to the adhesive inhibition between PMNs and endothelial cells through the adenosine A2-receptor-mediated system.