Adaptive Immunity in Immunothrombosis

Thrombosis is a comorbidity associated with autoimmune, allergic, and infectious conditions; however, the mechanistic basis for this elevated risk is poorly understood. The simultaneous activation of the immune and coagulation systems to assist in response to injury and efficient pathogen clearance, termed immunothrombosis, is typically described as a bidirectional interaction between the innate immune and coagulation systems. More recently, however, data have emerged highlighting the involvement of adaptive immune cells in this process. In this review, we discuss the role of adaptive immune cells in clot formation and resolution, and explore how the adaptive immune system modulates procoagulant activity in autoimmune diseases such as inflammatory bowel disease, systemic lupus erythematosus, and graft versus host disease; allergic disorders, such as dermatitis and asthma; infectious diseases, such as coronavirus disease 2019 (COVID-19) and human immunodeficiency virus (HIV); and ischemic conditions such as myocardial infarction and stroke.