Tissue Factor-Negative Cell-Derived Microparticles Play a Distinctive Role in Hemostasis: A Viewpoint Review

Lawrence L. Horstman, Robert F. McCauley, Wenche Jy, Yeon S. Ahn

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Circulating cell-derived microparticles (MPs) exhibit procoagulant activity and have been investigated for a possible role in some human pathologies. However, their potential role in hemostasis has been neglected and often denied. This review brings to attention a specific body of direct clinical evidence supporting an important but distinctive role of MPs in hemostasis. Evidence for a role of MPs in hemostasis includes: (1) two congenital bleeding disorders attributed to impaired release of MPs; (2) two recent studies of trauma patients relating naturally elevated endogenous MPs at admission to reduced transfusion requirements and better outcomes; (3) a study of coronary surgery patients showing that elevated MP before surgery reduces transfusion requirements during surgery; and (4) a clinical study of patients with immune thrombocytopenia demonstrating that those with high circulating MP have reduced bleeding compared to patients with similar platelet counts but lower MP levels. Mechanisms involving potentiating the contact factor pathway are thought to play a key role and are probably synergistic with polyphosphate released from activated platelets at sites of endothelial injury. Hemostatic defect of patients with deficient MP-mediated coagulation resembles deficiency of FXI (hemophilia C), distinct from hemophilia A or B, so can be termed type C hemostasis. A better understanding of this proposed hemostatic pathway may lead to improved methods for controlling excessive bleeding in surgery, trauma, and other clinical settings.

Original languageEnglish (US)
Pages (from-to)509-513
Number of pages5
JournalSeminars in Thrombosis and Hemostasis
Volume45
Issue number5
DOIs
StatePublished - Jan 1 2019

Fingerprint

Cell-Derived Microparticles
Thromboplastin
Hemostasis
Hemostatics
Hemorrhage
Wounds and Injuries
Factor XI Deficiency
Hemophilia B
Polyphosphates
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Idiopathic Thrombocytopenic Purpura
Hemophilia A
Platelet Count
Blood Platelets
Pathology

Keywords

  • cell-derived microparticles
  • coagulation
  • contact pathway
  • extracellular vesicles
  • hemostasis

ASJC Scopus subject areas

  • Hematology
  • Cardiology and Cardiovascular Medicine

Cite this

Tissue Factor-Negative Cell-Derived Microparticles Play a Distinctive Role in Hemostasis : A Viewpoint Review. / Horstman, Lawrence L.; McCauley, Robert F.; Jy, Wenche; Ahn, Yeon S.

In: Seminars in Thrombosis and Hemostasis, Vol. 45, No. 5, 01.01.2019, p. 509-513.

Research output: Contribution to journalReview article

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