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Endothelialized Microfluidics for Studying Microvascular Interactions in Hematologic Diseases
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Biological basis and pathological relevance of microvascular thrombosis

Susanne Pfeiler1, Steffen Massberg2, Bernd Engelmann1

  • 1Institut für Laboratoriumsmedizin, Ludwig-Maximilians-Universität, Munich, Germany.

Thrombosis Research
|April 25, 2014
PubMed

Insights

Microvascular thrombosis, the pathological occlusion of small blood vessels, is often underappreciated. Recent research reveals its role in the innate immune response, termed immunothrombosis, during infections.

Area of Science:

  • Vascular Biology
  • Immunology
  • Hematology

Background:

  • Microvascular thrombosis involves pathological occlusion of microvessels by fibrin and platelet-rich thrombi.
  • It is implicated in systemic infections, cancer, myocardial infarction, stroke, neurodegenerative diseases, and thrombotic microangiopathies.
  • The transient nature and detection difficulty of microthrombi lead to underappreciation of their role in disease.

Purpose of the Study:

  • To elucidate the biological basis and mechanisms of microvascular thrombosis.
  • To understand the role of microvascular thrombosis in systemic infections, specifically immunothrombosis.
  • To identify key molecular players driving microvascular thrombosis.

Main Methods:

  • Review of recent findings on microvascular thrombosis.
  • Analysis of the role of neutrophils, platelets, and extracellular nucleosomes in immunothrombosis.
  • Investigation of the involvement of neutrophil elastase, tissue factor, and factor XII in blood coagulation.

Main Results:

  • Microvascular thrombosis can mediate an intravascular innate immune response (immunothrombosis) during systemic infections.
  • Immunothrombosis involves fibrin generation within blood vessels, triggered by neutrophil-platelet interactions and neutrophil extracellular traps.
  • Neutrophil elastase, tissue factor, and factor XII are critical for supporting immunothrombosis.

Conclusions:

  • Microvascular thrombosis has a significant biological basis, particularly as an innate immune response (immunothrombosis).
  • Understanding the drivers of microvascular thrombosis, including neutrophil-derived factors, is crucial for elucidating pathological vessel occlusions.
  • This knowledge may aid in understanding mechanisms of thrombosis in both microvessels and large vessels.

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