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Silachev DN, Goryunov KV, Shpilyuk MA, Beznoschenko OS, Morozova NY, Kraevaya EE, Popkov VA, Pevzner IB, Zorova LD, Evtushenko EA, Starodubtseva NL, Kononikhin AS, Bugrova AE, Evtushenko EG, Plotnikov EY, Zorov DB, Sukhikh GT. Effect of MSCs and MSC-Derived Extracellular Vesicles on Human Blood Coagulation. Cells 2019; 8:cells8030258. [PMID: 30893822 PMCID: PMC6468445 DOI: 10.3390/cells8030258] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/09/2019] [Accepted: 03/15/2019] [Indexed: 01/10/2023] Open
Abstract
Mesenchymal stem cells (MSCs) have emerged as a potent therapeutic tool for the treatment of a number of pathologies, including immune pathologies. However, unwelcome effects of MSCs on blood coagulation have been reported, motivating us to explore the thrombotic properties of human MSCs from the umbilical cord. We revealed strong procoagulant effects of MSCs on human blood and platelet-free plasma using rotational thromboelastometry and thrombodynamic tests. A similar potentiation of clotting was demonstrated for MSC-derived extracellular vesicles (EVs). To offer approaches to avoid unwanted effects, we studied the impact of a heparin supplement on MSC procoagulative properties. However, MSCs still retained procoagulant activity toward blood from children receiving a therapeutic dose of unfractionated heparin. An analysis of the mechanisms responsible for the procoagulant effect of MSCs/EVs revealed the presence of tissue factor and other proteins involved in coagulation-associated pathways. Also, we found that some MSCs and EVs were positive for annexin V, which implies the presence of phosphatidylserine on their surfaces, which can potentiate clot formation. Thus, we revealed procoagulant activity of MSCs/EVs associated with the presence of phosphatidylserine and tissue factor, which requires further analysis to avoid adverse effects of MSC therapy in patients with a risk of thrombosis.
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Affiliation(s)
- Denis N. Silachev
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow 119992, Russia
| | - Kirill V. Goryunov
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
| | - Margarita A. Shpilyuk
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
| | - Olga S. Beznoschenko
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
| | - Natalya Y. Morozova
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
| | - Elizaveta E. Kraevaya
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
| | - Vasily A. Popkov
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow 119992, Russia
| | - Irina B. Pevzner
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow 119992, Russia
| | - Ljubava D. Zorova
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow 119992, Russia
| | | | - Natalia L. Starodubtseva
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- Moscow Institute of Physics and Technology, Moscow 141701, Russia
| | - Alexey S. Kononikhin
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- Moscow Institute of Physics and Technology, Moscow 141701, Russia
| | - Anna E. Bugrova
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow 119334, Russia
| | | | - Egor Y. Plotnikov
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow 119992, Russia
- Correspondence: (E.Y.P.); (D.B.Z.); Tel.: +7-495-939-5944 (E.Y.P. & D.B.Z.)
| | - Dmitry B. Zorov
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- A.N. Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow 119992, Russia
- Correspondence: (E.Y.P.); (D.B.Z.); Tel.: +7-495-939-5944 (E.Y.P. & D.B.Z.)
| | - Gennady T. Sukhikh
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Moscow 117198, Russia; (D.N.S.); (K.V.G.); (M.A.S.); (N.Y.M.); (E.E.K.); (V.A.P.); (I.B.P.); (L.D.Z.); (N.L.S.); (A.S.K.); (A.E.B.); (G.T.S.)
- Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, First Moscow State Medical University Named after I.M. Sechenov, Moscow 119992, Russia
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Koltsova EM, Balandina AN, Grischuk KI, Shpilyuk MA, Seregina EA, Dashkevich NM, Poletaev AV, Pyregov AV, Sukhih GT, Serebriyskiy II, Ataullakhanov FI. The laboratory control of anticoagulant thromboprophylaxis during the early postpartum period after cesarean delivery. J Perinat Med 2018; 46:251-260. [PMID: 28599392 DOI: 10.1515/jpm-2016-0333] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 04/19/2017] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The incidence of venous thromboembolism (VTE) after cesarean section is up to 0.6%, and the widespread use of cesarean section draws attention to this group. The dosage and duration of low-molecular-weight heparin (LMWH) prophylaxis after delivery is estimated by anamnestic risk-scales; however, the predictive potency for an individual patient's risk can be low. Laboratory hemostasis assays are expected to solve this problem. The aim of this study was to estimate the potency of tests to reflect the coagulation state of patients receiving LMWH in the early postpartum period. MATERIALS AND METHODS We conducted an observational study on 97 women undergoing cesarean section. Standard coagulation tests (Fg, APTT, prothrombin, D-dimer), an anti-Xa assay, rotation thromboelastometry and thrombodynamics/thrombodynamics-4D were performed. Coagulation assay parameters were compared in groups formed in the presence or absence of LMWH to estimate the laboratory assays' sensitivity to anticoagulation. RESULTS Coagulation assays revealed hypercoagulation after delivery and a tendency toward normalization of coagulation during early postpartum. The thromboprophylaxis results revealed a higher percentage of coagulation parameters within the normal range in the LMWH group. CONCLUSION This research is potentially beneficial for the application of thrombodynamics and thrombodynamics-4D in monitoring coagulation among patients with high VTE risk who receive thromboprophylaxis with heparin.
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Affiliation(s)
- Ekaterina M Koltsova
- Department of Biophysics and Systems Biology, Dmitry Rogachev National Research and Clinical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Anna N Balandina
- Department of Biophysics and Systems Biology, Dmitry Rogachev National Research and Clinical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation.,Center for Theoretical Problems of Physicochemical Pharmacology RAS, Moscow, Russian Federation
| | - Konstantin I Grischuk
- Department of Anesthesiology and Critical Care Medicine, Kulakov Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
| | - Margarita A Shpilyuk
- Laboratory of Clinical Immunology, Kulakov Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
| | - Elena A Seregina
- Department of Biophysics and Systems Biology, Dmitry Rogachev National Research and Clinical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Natalia M Dashkevich
- Center for Theoretical Problems of Physicochemical Pharmacology RAS, Moscow, Russian Federation.,Hemacore Labs LLC, Moscow, Russian Federation
| | - Alexander V Poletaev
- Department of Biophysics and Systems Biology, Dmitry Rogachev National Research and Clinical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Alexey V Pyregov
- Department of Anesthesiology and Critical Care Medicine, Kulakov Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
| | - Gennady T Sukhih
- Department of Anesthesiology and Critical Care Medicine, Kulakov Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
| | | | - Fazly I Ataullakhanov
- Department of Biophysics and Systems Biology, Dmitry Rogachev National Research and Clinical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation.,Center for Theoretical Problems of Physicochemical Pharmacology RAS, Moscow, Russian Federation.,Faculty of Physics, Lomonosov Moscow State University, Moscow, Russian Federation.,Faculty of Biological and Medical Physics, Moscow Institute of Physics and Technology, Dolgoprudny, Russian Federation
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