Haemostatic function and biomarkers of endothelial damage before and after RBC transfusion in patients with haematologic disease

Larsen, Axel; Leinøe, Eva; Johansson, Pär I.; Birgens, Henrik; Ostrowski, Sisse Rye

doi:10.1111/vox.12249

Cited by 14 publications

(16 citation statements)

References 27 publications

(38 reference statements)

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“…In addition, biomarkers of the GCX are also being considered as possible indicators of the prognosis and diagnosis of various other diseases. Positive associations with these biomarkers have already been demonstrated for diabetes mellitus [ 57 ], cardiac surgery [ 58 ], Alzheimer disease [ 59 ], hematological disease [ 60 , 61 ], and Crohn’s disease [ 62 ] (Table 2 ). Thus, damage to the GCX, as reflected by the plasma syndecan-1 concentration, is attracting attention in critical care fields.…”

Section: Pathophysiologies Involving the Gcxmentioning

confidence: 99%

Glycocalyx and its involvement in clinical pathophysiologies

2016

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Vascular hyperpermeability is a frequent intractable feature involved in a wide range of diseases in the intensive care unit. The glycocalyx (GCX) seemingly plays a key role to control vascular permeability. The GCX has attracted the attention of clinicians working on vascular permeability involving angiopathies, and several clinical approaches to examine the involvement of the GCX have been attempted. The GCX is a major constituent of the endothelial surface layer (ESL), which covers most of the surface of the endothelial cells and reduces the access of cellular and macromolecular components of the blood to the surface of the endothelium. It has become evident that this structure is not just a barrier for vascular permeability but contributes to various functions including signal sensing and transmission to the endothelium. Because GCX is a highly fragile and unstable layer, the image had been only obtained by conventional transmission electron microscopy. Recently, advanced microscopy techniques have enabled direct visualization of the GCX in vivo, most of which use fluorescent-labeled lectins that bind to specific disaccharide moieties of glycosaminoglycan (GAG) chains. Fluorescent-labeled solutes also enabled to demonstrate vascular leakage under the in vivo microscope. Thus, functional analysis of GCX is advancing. A biomarker of GCX degradation has been clinically applied as a marker of vascular damage caused by surgery. Fragments of the GCX, such as syndecan-1 and/or hyaluronan (HA), have been examined, and their validity is now being examined. It is expected that GCX fragments can be a reliable diagnostic or prognostic indicator in various pathological conditions. Since GCX degradation is strongly correlated with disease progression, pharmacological intervention to prevent GCX degradation has been widely considered. HA and other GAGs are candidates to repair GCX; further studies are needed to establish pharmacological intervention. Recent advancement of GCX research has demonstrated that vascular permeability is not regulated by simple Starling’s law. Biological regulation of vascular permeability by GCX opens the way to develop medical intervention to control vascular permeability in critical care patients.

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Section: Pathophysiologies Involving the Gcxmentioning

confidence: 99%

Glycocalyx and its involvement in clinical pathophysiologies

2016

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“…RBCs undergo biochemical and physiologic changes during storage known as the “storage lesion.” Numerous observational studies have documented posttransfusion complications of older RBC units, including multiple organ failure, sepsis, and mortality . Some of these complications have been attributed to the interaction of RBCs with the endothelium, resulting in microvascular occlusion and cellular hypoxia . In light of building observational evidence, randomized clinical trials (RCTs) were recently completed to assess the clinical significance of older RBC units .…”

mentioning

confidence: 99%

“…4,6 Some of these complications have been attributed to the interaction of RBCs with the endothelium, resulting in microvascular occlusion and cellular hypoxia. [7][8][9] In light of building observational evidence, randomized clinical trials (RCTs) were recently completed to assess the clinical significance of older RBC units. 10,11 The RCTs failed to show a statistical difference between the clinical outcome of patients receiving fresh versus old RBC units for complex cardiac surgery, 11 as well as fresh versus standard-of-care RBC units for adult 10 and neonatal intensive care unit patients.…”

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confidence: 99%

Identified metabolic signature for assessing red blood cell unit quality is associated with endothelial damage markers and clinical outcomes

et al. 2016

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“…91 Transfusion was also associated with a longer partial thromboplastin time (PTT). In another study of chronically anemic patients, Larsen et al 92 found a generally similar picture of decreased coagulation, however, the specifics differed. They found no effect of RBC transfusion on R time or PTT, but did find decreased clot strength.…”

Section: Effects Of Rbc Transfusion On Functional Hemostatic Assaysmentioning

confidence: 87%

Thrombotic Risks in Red Blood Cell Transfusions

Dubovoy

Engoren

2016

Semin Thromb Hemost

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Red blood cells play a key role in normal hemostasis and thrombosis. Their ability to affect coagulation is multifactorial and depends on their mechanical properties affecting viscosity and blood flow, ability to aggregate and adhere to each other and potentially to vascular endothelium, molecular signaling via microvesicles and surface proteins, including blood group antigens, and participation in nitric oxide metabolism. Transfused red blood cells suffer from a storage lesion that damages the cells leading to changes in shape, function, and intracellular communication. In this article, we review if and how transfused red blood cells may lead to both increased hemorrhage and increased thrombosis.

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Haemostatic function and biomarkers of endothelial damage before and after RBC transfusion in patients with haematologic disease

Cited by 14 publications

References 27 publications

Glycocalyx and its involvement in clinical pathophysiologies

Glycocalyx and its involvement in clinical pathophysiologies

Identified metabolic signature for assessing red blood cell unit quality is associated with endothelial damage markers and clinical outcomes

Thrombotic Risks in Red Blood Cell Transfusions

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