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Updated: Apr 5, 2026

In Vitro Microfluidic Disease Model to Study Whole Blood-Endothelial Interactions and Blood Clot Dynamics in Real-Time
Published on: May 24, 2020
Thrombosis, Microangiopathies, and Inflammation
Karen Matevosyan1, Ravi Sarode1
1Division of Transfusion Medicine and Hemostasis, Department of Pathology, UT Southwestern Medical Center, Dallas, Texas.
Abstract:
Thrombotic microangiopathy (TMA) is characterized by the presence of microangiopathic hemolytic anemia and thrombocytopenia. There are several disorders with varied etiopathogenesis, both genetic and acquired, that result in TMA. The neutrophils play an important role in inflammation and thrombosis through the formation of neutrophil extracellular traps (NETs). NETs are formed in response to a variety of stimuli including infections, chemical factors, and platelet activation. The classic TMA, thrombotic thrombocytopenic purpura (TTP) is caused by a severe deficiency of ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin type-I motif, member 13), mostly acquired due to autoantibodies, whereas atypical hemolytic uremic syndrome (aHUS) is mostly attributed to genetic defects in complement pathway regulatory proteins. The management of these well-known disorders has evolved over the last decade. Similarly, there is also better understanding of diverse and unusual clinical presentations of both of these conditions. Since there are many other causes of TMAs, which may mimic some of the clinical features of TTP or aHUS, it is essential to thoroughly investigate each patient so that appropriate therapy can be offered. This review focuses on some important developments in understanding of etiopathogenesis, diagnosis, and treatment of more commonly encountered TMAs.
Insights
Thrombotic microangiopathy (TMA) involves microangiopathic hemolytic anemia and thrombocytopenia. This review covers key developments in understanding the causes, diagnosis, and treatment of common TMAs like TTP and aHUS.
Area of Science:
- Hematology
- Pathology
- Immunology
Background:
- Thrombotic microangiopathy (TMA) is a condition characterized by microangiopathic hemolytic anemia and thrombocytopenia.
- Neutrophils and their extracellular traps (NETs) play a role in TMA pathogenesis.
- Key TMAs include thrombotic thrombocytopenic purpura (TTP) due to ADAMTS-13 deficiency and atypical hemolytic uremic syndrome (aHUS) linked to complement dysregulation.
Purpose of the Study:
- To review recent advancements in the etiopathogenesis, diagnosis, and treatment of commonly encountered TMAs.
- To highlight the importance of differentiating various TMA causes for appropriate management.
- To discuss the role of neutrophil extracellular traps in TMA.
Main Methods:
- Literature review of recent studies on TMA.
- Analysis of current understanding of TTP and aHUS pathogenesis.
- Discussion of diagnostic approaches and evolving treatment strategies for TMAs.
Main Results:
- Significant progress has been made in understanding the molecular mechanisms underlying TTP and aHUS.
- Improved diagnostic tools allow for more precise identification of TMA subtypes.
- Treatment strategies for TMAs have evolved, with better outcomes reported.
Conclusions:
- TMAs encompass diverse disorders with genetic and acquired causes, requiring thorough investigation.
- Understanding the specific etiology of TMA is crucial for selecting effective therapies.
- Continued research into TMA pathogenesis, including the role of NETs, is essential for further therapeutic advancements.
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