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    Oral Communication

    Coagulation and Natural Anticoagulants

    Integrating Knowledge on Coagulation

    OC 45.4 - Crucial roles of red blood cells and platelets in coagulation

    Monday, June 26, 2023
    15:30 – 15:45 ET
    Room: 511
    Session Available As: On-Demand

      Presenting Author(s)

    • Siyu Sun, MS

      PhD student
      Synapse rsearch institute
      MAASTRICHT, Limburg, Netherlands

      • Co-Author(s)

    • JZ

      Jinmi Zou

      PhD
      Synapse research insitute
      MAASTRICHT, Limburg, Netherlands

    • Elena Campello, MD, PhD (she/her/hers)

      Assistant Professor
      Department of Medicine, University of Padova, Italy
      Padova, Veneto, Italy

    • JK

      Joke Konings, PhD

      Senior Scientist
      Synapse Research Institute
      Maastricht, Limburg, Netherlands

    • Dana Huskens, PhD

      PhD, Research Project Leader
      Synapse research insitute
      MAASTRICHT, Limburg, Netherlands

    • Jun Wan, PhD (he/him/his)

      Research Associate
      Cyrus Tang Hematology Center, Soochow University
      Suzhou, Jiangsu, China (People's Republic)

    • DF

      Delia Fernandez

      PhD
      Maastricht university
      MAASTRICHT, Limburg, Netherlands

    • CR

      Chris Reutelingsperger

      Professor, PhD
      Maastricht university
      MAASTRICHT, Limburg, Netherlands

    • Hugo ten Cate, MD, PhD, FAHA (he/him/his)

      Professor, MD, PhD
      Thrombosis Expertise Center, Heart & Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands
      Maastricht, Limburg, Netherlands

    • ST

      Serena Toffanin

      PhD
      University of Padua
      Padova, Marche, Italy

    • CB

      Cristiana Bulato

      PhD
      Department of Medicine, Thrombotic and Haemorrhagic Diseases Unit, University of Padua Medical School, Padua (Italy)
      Padova, Veneto, Italy

    • PG

      Philip G. de Groot

      Emeritus Professor
      Department of Functional Coagulation, Synapse Research Institute, Maastricht, the Netherlands
      MAASTRICHT, Limburg, Netherlands

    • Bd

      Bas de Laat, MD, PhD

      General Director
      Department of Functional Coagulation, Synapse Research Institute, Maastricht, the Netherlands
      Maastricht, Limburg, Netherlands

    • Paolo Simioni, MD, PhD (he/him/his)

      Full Professor
      Department of Medicine, Thrombotic and Haemorrhagic Diseases Unit, University of Padua Medical School, Padua (Italy)
      Padua, Veneto, Italy

    • JW

      Johan W. M. Heemskerk

      Emeritus Professor
      Synapse research insitute
      MAASTRICHT, Limburg, Netherlands

    • Mark Roest, PhD (he/him/his)

      Clinical Director
      Department of Platelet pathophysiology, Synapse Research Institute, Maastricht, the Netherlands
      Maastricht, Limburg, Netherlands

    Background: Red blood cells (RBC) and platelets affect the coagulation capacity in bleeding and thrombotic disorders. The (patho)physiology of the interactions of blood cells and coagulation manifest in the thrombin generation (TG) process.

    Aims: To redefine the blood cell contributions to the clotting process.

    Methods: Using a new calibrated method, we directly compared TG in whole blood and platelet-rich plasma (PRP).

    Results: We report a faster and initially higher generation of thrombin and a shorter coagulation time in whole blood than in PRP upon low concentrations of coagulant triggers, including tissue factor, Russell's viper venom factor X (Rvv-X), factor Xa and thrombin. The TG accelerated with increased RBC counts, and delayed after prior treatment of RBC with annexin A5. Ionomycin treatment of RBC increased phosphatidylserine exposure, as confirmed by flow cytometry, and enhanced the initial TG. In reconstituted whole blood, the glycoprotein VI-induced platelet procoagulant activity was enhanced by annexin A5-blocked RBC. In patients with anemia or erythrocytosis, cluster analysis revealed abnormal whole-blood TG profiles in specific cases of anemia. These differences normalized by annexin A5 addition, and were thus linked to the extent of phosphatidylserine exposure of blood cells. Profiles for patients with polycythemia vera undergoing treatment who had normal RBC count were similar to those of control subjects.

    Conclusion(s): We concluded that both RBC and platelets play crucial roles in coagulation, which are detected by the measurement of TG in whole blood. Determination of the RBC- and platelet- dependent hypo-or hyper-coagulation activity is recommended in disorders with bleeding or thrombosis risk.

    Learning Objectives:

    • Upon completion, participant will be able to improve the knowlegde of hemostasis and thrombosis.
    • Upon completion, participant will be able to discover interesting ideas about hemostasis and thrombosis.
    • Upon completion, participant will be able to explore new therapeutic or diagnosis method.