Fasciola hepatica alters coagulation parameters in sheep plasma in vivo and in vitro

The blood-sucking activities of the liver fluke, Fasciola hepatica, are likely to cause alterations in coagulation during the course of infection; and the effect of F. hepatica on various coagulation parameters was studied during the course of acute and chronic fasciolosis of sheep over a period of 17 weeks. Whole blood and plasma samples from infected sheep (with 800 metacercariae each) and uninfected controls were collected weekly until 17 weeks post-infection (w.p.i.) and the activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) were determined. Additionally, adult F. hepatica were recovered from bile ducts, incubated for the production of excretory/secretory products (ESP) or homogenised and the effect of fluke products on APTT, PT and TT was determined. Anaemia was evident in infected sheep from 8 w.p.i. until 17 w.p.i. Plasma APTT was accelerated during 8, 9, 12, 14, 16 and 17 w.p.i., while PT was prolonged at 8-11 w.p.i. and TT at 10, 14 and 17 w.p.i. Addition of worm ESP or homogenate to plasma resulted in an enhancement of the intrinsic pathway (APTT) together with a prolongation of the extrinsic and common pathways (PT, TT) of coagulation. It was concluded that F. hepatica contains and releases substances that may contribute to coagulation changes in vivo. Further characterisation of the active substance(s) in vitro revealed heat inactivation, a size >30 kDa and inhibition by the proteinase inhibitors Complete and EDTA for the APTT-accelerating substance(s). The TT-deceleration, in contrast, was increased after heating.