Heat stress-induced platelet dysfunction is associated with loss of fibrinogen and is improved by fibrinogen supplementation.

Autor: Ke HY; Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC., Chen JH; Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, Taiwan, ROC., Kao SY; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan, ROC., Tsao CM; Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan, ROC., Kuo CW; Department of Nephrology, Taichung Armed Forces General Hospital, Taichung, Taiwan, ROC., Wu CC; Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, Taiwan, ROC., Shih CC; Department and Graduate Institute of Pharmacology, National Defense Medical Center, Taipei, Taiwan, ROC. Electronic address: ccshih@mail.ndmctsgh.edu.tw.
Jazyk: angličtina
Zdroj: Thrombosis research [Thromb Res] 2024 Sep; Vol. 241, pp. 109091. Date of Electronic Publication: 2024 Jul 05.
DOI: 10.1016/j.thromres.2024.109091
Abstrakt: Introduction: Heatstroke is a critical heat-related condition characterized by coagulopathy and multiple organ dysfunction. One of the most severe complications of heatstroke is disseminated intravascular coagulation. This condition manifests as excessive clot formation and bleeding that are primarily due to platelet depletion and dysfunction. Fibrinogen plays a crucial role in hemostasis because it links integrin αIIbβ3 on adjacent platelets, thereby promoting the platelet activation and aggregation necessary for clot formation. However, reduced fibrinogen levels may impair the formation of the initial platelet plug and increase the risk of bleeding. The current study explored the effect of fibrinogen on platelet dysfunction in a heatstroke model.
Materials and Methods: Male Wistar rats were subjected to heat stress, and subsequent changes in hemodynamic, biochemical, and coagulation parameters were analyzed. Platelet viability, aggregation, adhesion, spreading and fibrin clot retraction were assessed.
Results: The rats with heatstroke exhibited a variety of clinical symptoms, including hypotension, tachycardia, multiple organ dysfunction, and coagulopathy. Platelet viability in the heatstroke group was comparable to that in the healthy control group. However, the heatstroke group exhibited significant reductions in plasma fibrinogen levels and platelet aggregation, adhesion, spreading, and fibrin clot retraction. Notably, fibrinogen supplementation markedly augmented the aggregation responses of platelets in the heatstroke group. The impairment of platelet adhesion, spreading, and fibrin clot retraction in the rats with heatstroke was partially ameliorated by fibrinogen supplementation.
Conclusions: An early use of fibrinogen replacement may serve as a therapeutic intervention to alleviate platelet hyporeactivity and prevent the complications in patients with heatstroke.
Competing Interests: Declaration of competing interest All authors declared that they have no conflict of interest.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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