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Circulating Nucleosomes are Elevated in Trauma Patients with Venous Thromboembolism: A Prospective Case-Cohort Study
Sergio M Navarro1,2, Riley J Thompson1, Grant M Spears3
1Division of Trauma, Critical Care, and General Surgery, Department of Surgery, Mayo Clinic Minnesota, Rochester, Minnesota.
Shock (Augusta, Ga.)
|March 26, 2026
Summary
Elevated levels of circulating nucleosomes (H3.1 and H3R8 Cit) are found early after traumatic injury, particularly in patients who develop venous thromboembolism (VTE). These nucleosomes may serve as important biomarkers for VTE risk in trauma patients.
Area of Science:
- Biochemistry
- Trauma Medicine
- Hematology
Background:
- Traumatic injury is a significant risk factor for venous thromboembolism (VTE).
- The early pathophysiological mechanisms linking trauma to VTE are not fully understood.
- Circulating nucleosomes have emerged as potential biomarkers in various disease states.
Purpose of the Study:
- To investigate the association between circulating nucleosome levels (H3.1 and H3R8 Cit) and the occurrence of VTE in trauma patients.
- To compare nucleosome levels in trauma patients with and without VTE, and with healthy volunteers.
Main Methods:
- A prospective case-cohort study involving 639 trauma patients.
- Blood samples collected within 12 hours of injury; patients followed for up to 90 days for VTE occurrence.
- Quantification of circulating nucleosomes using Nu.Q® H3.1 and Nu.Q® H3R8 Cit assays.
Main Results:
- Trauma patients exhibited significantly higher levels of both H3.1 and H3R8 Cit nucleosomes compared to healthy volunteers.
- Patients who developed VTE had significantly higher levels of H3.1 and H3R8 Cit nucleosomes compared to those without VTE.
- Higher Injury Severity Scores (ISS) and BMI were associated with VTE development.
Conclusions:
- Circulating nucleosome levels (H3.1 and H3R8 Cit) are elevated early after traumatic injury, particularly in patients who develop VTE.
- These findings highlight the potential role of nucleosomes in VTE pathophysiology and as predictive biomarkers in trauma.
- Further research into nucleosome function in VTE is warranted.
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