Complement inhibition can decrease the haemostatic response in a microvascular bleeding model at multiple levels.

Golomingi, Murielle; Kohler, Jessie; Lamers, Christina; Pouw, Richard B; Ricklin, Daniel; Dobó, József; Gál, Péter; Pál, Gábor; Kiss, Bence; Dopler, Arthur; Schmidt, Christoph Q; Hardy, Elaissa Trybus; Lam, Wilbur; Schroeder, Verena (2023). Complement inhibition can decrease the haemostatic response in a microvascular bleeding model at multiple levels. Frontiers in immunology, 14(1226832), p. 1226832. Frontiers Research Foundation 10.3389/fimmu.2023.1226832

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Haemostasis is a crucial process by which the body stops bleeding. It is achieved by the formation of a platelet plug, which is strengthened by formation of a fibrin mesh mediated by the coagulation cascade. In proinflammatory and prothrombotic conditions, multiple interactions of the complement system and the coagulation cascade are known to aggravate thromboinflammatory processes and increase the risk of arterial and venous thrombosis. Whether those interactions also play a relevant role during the physiological process of haemostasis is not yet completely understood. The aim of this study was to investigate the potential role of complement components and activation during the haemostatic response to mechanical vessel injury.


We used a microvascular bleeding model that simulates a blood vessel, featuring human endothelial cells, perfusion with fresh human whole blood, and an inducible mechanical injury to the vessel. We studied the effects of complement inhibitors against components of the lectin (MASP-1, MASP-2), classical (C1s), alternative (FD) and common pathways (C3, C5), as well as a novel triple fusion inhibitor of all three complement pathways (TriFu). Effects on clot formation were analysed by recording of fibrin deposition and the platelet activation marker CD62P at the injury site in real time using a confocal microscope.


With the inhibitors targeting MASP-2 or C1s, no significant reduction of fibrin formation was observed, while platelet activation was significantly reduced in the presence of the FD inhibitor. Both common pathway inhibitors targeting C3 or C5, respectively, were associated with a substantial reduction of fibrin formation, and platelet activation was also reduced in the presence of the C3 inhibitor. Triple inhibition of all three activation pathways at the C3-convertase level by TriFu reduced both fibrin formation and platelet activation. When several complement inhibitors were directly compared in two individual donors, TriFu and the inhibitors of MASP-1 and C3 had the strongest effects on clot formation.


The observed impact of complement inhibition on reducing fibrin clot formation and platelet activation suggests a role of the complement system in haemostasis, with modulators of complement initiation, amplification or effector functions showing distinct profiles. While the interactions between complement and coagulation might have evolved to support haemostasis and protect against bleeding in case of vessel injury, they can turn harmful in pathological conditions when aggravating thromboinflammation and promoting thrombosis.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Hämatologie (Erwachsene)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Pavillon 52 > Forschungsgruppe Experimentelle Hämostase

UniBE Contributor:

Golomingi, Murielle Koni-Kepo, Schröder, Verena


600 Technology > 610 Medicine & health




Frontiers Research Foundation




Pubmed Import

Date Deposited:

02 Oct 2023 15:24

Last Modified:

22 Nov 2023 12:07

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

MBL-associated serine protease-2 (MASP-2) complement C1s complement C3 complement C5 complement factor D (FD) complement system haemostasis microfluidics




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