Effects on coagulation and fibrinolysis induced by influenza in mice with a reduced capacity to generate activated protein C and a deficiency in plasminogen activator …

TT Keller, KF van der Sluijs, MD de Kruif… - Circulation …, 2006 - Am Heart Assoc
TT Keller, KF van der Sluijs, MD de Kruif, VEA Gerdes, JCM Meijers, S Florquin…
Circulation research, 2006Am Heart Assoc
Influenza infections increase the risk of diseases associated with a prothrombotic state, such
as venous thrombosis and atherothrombotic diseases. However, it is unclear whether
influenza leads to a prothrombotic state in vivo. To determine whether influenza activates
coagulation, we measured coagulation and fibrinolysis in influenza-infected C57BL/6 mice.
We found that influenza increased thrombin generation, fibrin deposition, and fibrinolysis. In
addition, we used various anti-and prothrombotic models to study pathways involved in the …
Influenza infections increase the risk of diseases associated with a prothrombotic state, such as venous thrombosis and atherothrombotic diseases. However, it is unclear whether influenza leads to a prothrombotic state in vivo. To determine whether influenza activates coagulation, we measured coagulation and fibrinolysis in influenza-infected C57BL/6 mice. We found that influenza increased thrombin generation, fibrin deposition, and fibrinolysis. In addition, we used various anti- and prothrombotic models to study pathways involved in the influenza-induced prothrombotic state. A reduced capacity to generate activated protein C in TMpro/pro mice increased thrombin generation and fibrinolysis, whereas treatment with heparin decreased thrombin generation in influenza-infected C57Bl/6 mice. Thrombin generation was not changed in hyperfibrinolytic mice, deficient in plasminogen activator inhibitor type-1 (PAI-1−/−); however, increased fibrin degradation was seen. Treatment with tranexamic acid reduced fibrinolysis, but thrombin generation was unchanged. We conclude that influenza infection generates thrombin, increased by reduced levels of protein C and decreased by heparin. The fibrinolytic system appears not to be important for thrombin generation. These findings suggest that influenza leads to a prothrombotic state by coagulation activation. Heparin treatment reduces the influenza induced prothrombotic state.
Am Heart Assoc