Thrombelastography for the monitoring of lipopolysaccharide induced activation of coagulation

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
Issue: 2006: 95/3 (Mar) pp. 397-590
Pages: 557-561

Thrombelastography for the monitoring of lipopolysaccharide induced activation of coagulation

Kai Zacharowski*1,2, Christoph Sucker * 3 , Paula Zacharowski 1,2, Matthias Hartmann1
1 Department of Anesthesiology, 2 Molecular Cardioprotection and Inflammation Group, 3 Department of Haemostasis and Transfusion Medicine, University Hospital Düsseldorf, Germany


Human whole blood, lipopolysaccharide, thrombelastography


During Gram-negative sepsis, lipopolysaccharide (LPS) activates toll-like receptor (TLR) 4 and induces complex responses of immune system and haemostasis. In the present study we investigated whether thrombelastography is suitable to monitor the LPS-induced activation of coagulation. Whole blood samples from healthy volunteers were incubated with LPS for various incubation periods (0–5 hrs), thereafter rotation thrombelastography was performed.Incubation of whole blood ( = 3 h) with LPS markedly reduced clotting time; after 5 hrs the variable was reduced from 459 ± 39 sec to 80 ± 20 sec while the other thrombelastography variables (angle α , clot formation time, maximal clot formation) remained unaltered. EC50 of the LPSeffect on whole blood clotting time was 18 µg/ml.In isolated l kocytes, diluted in platelet poor plasma, far lower LPS-concentrations were effective: 10 ng/ml LPS reduced clotting time from 439 ± 68 sec to 200 ± 56 sec. Experiments with the protein synthesis inhibitor cycloheximide and active site-inhibited factor VIIa revealed that LPS exerts its effects via the synthesis of tissue factor.Addition of tissue factor to whole blood samples revealed that a concentration of 100 fmol/l can be detected using thrombelastography. In whole blood samples the tissue factor concentration induced by LPS amounted up to 12 pmol/l. In summary, thrombelastography proved to be a sensitive and reliable tool for the determination of LPS-induced tissue factor mediated activation of haemostasis in whole blood samples.

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