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Suppressive Role of Tissue Factor Pathway Inhibitor-? in Platelet-Dependent Fibrin Formation under Flow Is Restricted to Low Procoagulant Strength.


ABSTRACT: Tissue factor pathway inhibitor-alpha (TFPI-?) is a Kunitz-type serine protease inhibitor, which suppresses coagulation by inhibiting the tissue factor (TF)/factor VIIa complex as well as factor Xa. In static plasma-phospholipid systems, TFPI-? thus suppresses both factor Xa and thrombin generation. In this article, we used a microfluidics approach to investigate how TFPI-? regulates fibrin clot formation in platelet thrombi at low wall shear rate. We therefore hypothesized that the anticoagulant effect of TFPI-? in plasma is a function of the local procoagulant strength-defined as the magnitude of thrombin generation under flow, due to local activities of TF/factor VIIa and factor Xa. To test this hypothesis, we modulated local coagulation by microspot coating of flow channels with 0 to 100 pM TF/collagen, or by using blood from patients with haemophilia A or B. For blood or plasma from healthy subjects, blocking of TFPI-? enhanced fibrin formation, extending from a platelet thrombus, under flow only at <2 pM coated TF. This enhancement was paralleled by an increased thrombin generation. For mouse plasma, genetic deficiency in TFPI enhanced fibrin formation under flow also at 0 pM TF microspots. On the other hand, using blood from haemophilia A or B patients, TFPI-? antagonism markedly enhanced fibrin formation at microspots with up to 100 pM coated TF. We conclude that, under flow, TFPI-? is capable to antagonize fibrin formation in a manner dependent on and restricted by local TF/factor VIIa and factor Xa activities.

SUBMITTER: Thomassen S 

PROVIDER: S-EPMC5880031 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

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Suppressive Role of Tissue Factor Pathway Inhibitor-α in Platelet-Dependent Fibrin Formation under Flow Is Restricted to Low Procoagulant Strength.

Thomassen Stella S   Mastenbroek Tom G TG   Swieringa Frauke F   Winckers Kristien K   Feijge Marion A H MAH   Schrijver Roy R   Cosemans Judith M E M JMEM   Maroney Susan A SA   Mast Alan E AE   Hackeng Tilman M TM   Heemskerk Johan W M JWM  

Thrombosis and haemostasis 20180216 3


Tissue factor pathway inhibitor-alpha (TFPI-α) is a Kunitz-type serine protease inhibitor, which suppresses coagulation by inhibiting the tissue factor (TF)/factor VIIa complex as well as factor Xa. In static plasma-phospholipid systems, TFPI-α thus suppresses both factor Xa and thrombin generation. In this article, we used a microfluidics approach to investigate how TFPI-α regulates fibrin clot formation in platelet thrombi at low wall shear rate. We therefore hypothesized that the anticoagulan  ...[more]

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