The relation between fibrinogen level, neutrophil activity and nucleosomes in the onset of disseminated intravascular coagulation in the critically ill.

Müller, Marcella C A; Dujardin, Romein W G; Thachil, Jecko; van Mierlo, Gerard; Zeerleder, Sacha S; Juffermans, Nicole P (2021). The relation between fibrinogen level, neutrophil activity and nucleosomes in the onset of disseminated intravascular coagulation in the critically ill. Journal of internal medicine, 290(4), pp. 922-927. Wiley 10.1111/joim.13346

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BACKGROUND

Nucleosomes and neutrophil extracellular traps (NETs) are important in the pathophysiology of disseminated intravascular coagulation (DIC). Fibrinogen, as an acute phase reactant, may be protective by engaging neutrophils. We hypothesize that DIC can occur when NET formation becomes uncontrolled in relation to low fibrinogen levels.

PATIENTS/METHOD

The ratio of both circulating nucleosomes and human neutrophil elastase alpha-1-antitrypsine complexes (HNE-a1ATc) to fibrinogen was correlated to thrombocytopenia, DIC and organ failure in 64 critically ill coagulopathic patients.

RESULTS

A high nucleosome to fibrinogen ratio correlated with thrombocytopenia and organ failure (ρ - 0.391, p 0.01 and ρ 0.556, p 0.01, respectively). A high HNE-a1ATc to fibrinogen ratio correlated with thrombocytopenia, DIC and organ failure (ρ -0.418, p 0.01, ρ 0.391, p 0.01 and ρ 0.477, p 0.01 respectively).

CONCLUSION

These findings support the hypothesis that fibrinogen is protective against DIC by counterbalancing excessive neutrophil activation. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene)

UniBE Contributor:

Zeerleder, Sacha Sergio

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0954-6820

Publisher:

Wiley

Language:

English

Submitter:

Pierrette Durand Lüthi

Date Deposited:

01 Jul 2021 10:44

Last Modified:

21 Sep 2021 01:32

Publisher DOI:

10.1111/joim.13346

PubMed ID:

34137469

BORIS DOI:

10.48350/157236

URI:

https://boris.unibe.ch/id/eprint/157236

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