Haus, Moritz and Foltan, Maik and Philipp, Alois and Mueller, Thomas and Gruber, Michael and Lingel, Maximilian P. and Krenkel, Lars and Lehle, Karla (2024) Neutrophil extracellular traps - a potential trigger for the development of thrombocytopenia during extracorporeal membrane oxygenation. FRONTIERS IN IMMUNOLOGY, 15: 1339235. ISSN 1664-3224,
Full text not available from this repository. (Request a copy)Abstract
Neutrophil extracellular traps (NETs) have recently emerged as a potential link between inflammation, immunity, and thrombosis, as well as other coagulation disorders which present a major challenge in the context of extracorporeal membrane oxygenation (ECMO). By examining blood from ECMO patients for NETs and their precursors and correlating them with clinical and laboratory biomarkers of coagulation and inflammation, this study aims to evaluate the association between the presence of NETs in the bloodstream of ECMO patients and the development of potentially severe coagulation disorders during ECMO therapy. Therefore, blood samples were collected from healthy volunteers (n=13) and patients receiving veno-venous (VV) ECMO therapy (n=10). To identify NETs and their precursors, DNA and myeloperoxidase as well as granulocyte marker CD66b were visualized simultaneously by immunofluorescence staining in serial blood smears. Differentiation of DNA-containing objects and identification of NETs and their precursors was performed semiautomatically by a specific algorithm using the shape and size of DNA staining and the intensity of MPO and CD66b signal. Neutrophil extracellular traps and their precursors could be detected in blood smears from patients requiring VV ECMO. Compared to volunteers, ECMO patients presented significantly higher rates of NETs and NET precursors as well as an increased proportion of neutrophil granulocytes in all detected nucleated cells. A high NET rate prior to the initiation of ECMO therapy was associated with both increased IL-6 and TNF-alpha levels as an expression of a high cytokine burden. These patients with increased NET release also presented an earlier and significantly more pronounced decrease in platelet counts and ATIII activity following initiation of therapy compared with patients with less elevated NETs. These findings provide further indications for the development of immune-mediated acquired thrombocytopenia in ECMO patients.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TISSUE FACTOR; RESPIRATORY-FAILURE; ACTIVATION; THROMBOSIS; BLOOD; IDENTIFICATION; EXPRESSION; PLATELETS; SEVERITY; ADHESION; neutrophil extracellular traps (NET); immunoflorescence; thrombocytopenia; extracorporeal membrane oxygenation (ECMO); sepsis; immunothrombosis; coagulation disorder |
| Subjects: | 500 Science > 570 Life sciences |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Jul 2025 08:40 |
| Last Modified: | 15 Jul 2025 08:40 |
| URI: | https://pred.uni-regensburg.de/id/eprint/63358 |
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