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Biomedicines
Special Issues
Molecular Insights into Blood Coagulation and Inflammation
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Molecular Insights into Blood Coagulation and Inflammation

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 5296

Special Issue Editors

Dr. Krisztián Tánczos

E-Mail Website
Guest Editor
Department of Anesthesiology and Intensive Therapy, Semmelweis University, 1085 Budapest, Hungary
Interests: bleeding; haemodynamics; perioperative haemostasis; traumatic coagulopathy; inflammatory response; thrombo-inflammation
Dr. Anikó Sumdla

E-Mail Website1 Website2
Guest Editor
Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
Interests: sepsis; inflammation; thrombo-inflammation; septis coagulopathy; organ transplantation; donor management; bleeding
Dr. János Fazakas

E-Mail Website
Guest Editor
Department of Anaesthesiology and Intensive Therapy, Semmelweis University, Budapest, Hungary
Interests: organ transplantation; liver transplantation; kidney transplantation, sepsis; inflammation; immunology; coagulopathy; bleeding; thrombosis

Special Issue Information

Dear Colleagues,

During the COVID-19 pandemic, the importance of the interference between inflammatory and haemostatic processes has received special attention due to the frequent findings of microthrombi in the lungs and other organs. Microvascular thrombosis associated with inflammation has been a well-recognized feature in the context of severe sepsis and ischemia–reperfusion injury, but a growing body of evidence is emerging in organ transplant rejection, major trauma, severe burns, and preeclampsia. While immunothrombosis is considered a beneficial mechanism of innate immunity to reduce the spread and survival of invading pathogens, thrombo-inflammation refers to a pathological process which is initiated by the host’s dysregulated systemic inflammatory response in which endothelial injury plays a key role. In thrombo-inflammation, activated neutrophils and monocytes interact with platelets, complements and the coagulation cascade, leading to microvascular clot formation, organ failures and death in critically ill patients. Therefore, it is reasonable to hypothesize that anticoagulation or rather anti-inflammatory and cytoprotective therapy might improve microvascular perfusion, reduce inflammation, and preserve organ function.

This Special Issue focuses on defining the molecular mechanisms regulating thrombo-inflammation and its clinical importance in specific disease states. The aims of this Issue are:

  • To publish manuscripts focused on the pathogenesis of thrombo-inflammation in specific disease states;
  • To obtain insights into the parallels and differences between different thrombo-inflammatory disorders (sepsis, major trauma or severe COVID-19 infection);
  • To review the epidemiology as well as the laboratory and prognostic markers of severe thrombo-inflammation;
  • To analyse the data related to anticoagulation and immunomodulatory interventions and present novel therapeutic agents.

Dr. Krisztián Tánczos
Dr. Anikó Sumdla
Dr. János Fazakas
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • immunothrombosis
  • thrombo-inflammation
  • hypercoagulation
  • fibrinolysis resistance
  • fibrinolysis “shutdown”
  • anticoagulation
  • fibrinolytic therapy
  • immunomodulation

Published Papers (4 papers)

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Research

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15 pages, 15724 KiB  
Article
Laboratory Puzzle of Oxidative Stress, Parameters of Hemostasis and Inflammation in Hospitalized Patients with COVID-19
by Jelena Djordjevic, Vesna Ignjatovic, Vladimir Vukomanovic, Katarina Vuleta, Nevenka Ilic, Zivana Slovic, Marijana Stanojevic Pirkovic and Olgica Mihaljevic
Biomedicines 2024, 12(3), 636; https://doi.org/10.3390/biomedicines12030636 - 13 Mar 2024
Viewed by 681
Abstract
Bearing in mind that coronavirus disease (COVID-19) is associated with a wide range of laboratory abnormalities, the aim of this study was to examine the importance of determining the parameters of oxidative stress and antioxidant protection as well as markers of inflammation and [...] Read more.
Bearing in mind that coronavirus disease (COVID-19) is associated with a wide range of laboratory abnormalities, the aim of this study was to examine the importance of determining the parameters of oxidative stress and antioxidant protection as well as markers of inflammation and hemostasis in hospitalized patients with COVID-19. The study population included 105 patients with severe COVID-19 and 65 healthy control subjects. The parameters of oxidative stress and the activity of enzymes of the antioxidant system were determined from the obtained samples using spectrophotometric methods. Standard laboratory methods were performed for the determination of the biochemical and hematological parameters. Patients with COVID-19 showed a significantly higher level of pro-oxidative parameters (hydrogen peroxide (H2O2) and the index of lipid peroxidation in the form of thiobarbituric acid-reactive substances (TBARSs)) and a significantly lower activity of the antioxidant system (catalase (CAT)). Patients with COVID-19 had significantly higher values of inflammation parameters (C-reactive protein (CRP), procalcitonin (PCT), ratio of the number of neutrophils to lymphocytes (NLR), and ratio of the number of platelets to lymphocytes (PLR)) and parameters of hemostasis (activated partial thromboplastin time (aPTT), prothrombin time (PT), D-dimer, fibrinogen) than the control healthy subjects. In addition, changes in hemostatic parameters correlated positively with inflammatory markers in the group of patients with COVID-19. The early determination of hemostasis parameters and the parameters of inflammation can help in the prediction of poor prognosis in COVID-19 patients. Full article
(This article belongs to the Special Issue Molecular Insights into Blood Coagulation and Inflammation)
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13 pages, 914 KiB  
Article
Acquired Hemophilia A after SARS-CoV-2 Infection: A Case Report and an Updated Systematic Review
by Márton Németh, Diána Mühl, Csaba Csontos, Ágnes Nagy, Hussain Alizadeh and Zsolt Szakács
Biomedicines 2023, 11(9), 2400; https://doi.org/10.3390/biomedicines11092400 - 28 Aug 2023
Cited by 1 | Viewed by 1128
Abstract
The role of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been implicated in the pathogenesis of acquired hemophilia A (AHA). The aim of this study is to report our case and to summarize clinical studies on de novo AHA after SARS-CoV-2 infection. We [...] Read more.
The role of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been implicated in the pathogenesis of acquired hemophilia A (AHA). The aim of this study is to report our case and to summarize clinical studies on de novo AHA after SARS-CoV-2 infection. We performed a systematic search on the association of SARS-CoV-2 with AHA in four medical databases up to 28 May 2023. Eligible studies should include de novo AHA patients who had SARS-CoV-2 infection before or concomitant with the diagnosis of AHA. Findings were synthesized narratively. In addition, we report the case of a 62-year-old female patient, who presented to our clinic with left flank pain 2 weeks after SARS-CoV-2 infection. Clinical investigations confirmed AHA and imaging studies revealed retroperitoneal bleeding. Her hemostasis was successfully secured with bypassing agents; however, despite immunosuppressive therapy, high inhibitor titer persisted. In the systematic review, we identified only 12 relevant cases with a questionable cause–effect relationship between SARS-CoV-2 infection and AHA. Based on the qualitative analysis of the relevant publications, current clinical evidence is insufficient to support a cause–effect relationship. The analysis of data from ongoing AHA registries can serve further evidence. Full article
(This article belongs to the Special Issue Molecular Insights into Blood Coagulation and Inflammation)
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Review

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23 pages, 888 KiB  
Review
Blood Coagulation and Thrombotic Disorders following SARS-CoV-2 Infection and COVID-19 Vaccination
by Metodija Sekulovski, Niya Mileva, Georgi Vasilev Vasilev, Dimitrina Miteva, Milena Gulinac, Monika Peshevska-Sekulovska, Lyubomir Chervenkov, Hristiana Batselova, Georgi Hristov Vasilev, Latchezar Tomov, Snezhina Lazova, Dobrin Vassilev and Tsvetelina Velikova
Biomedicines 2023, 11(10), 2813; https://doi.org/10.3390/biomedicines11102813 - 17 Oct 2023
Cited by 3 | Viewed by 1819
Abstract
Although abundant data confirm the efficacy and safety profile of the developed vaccines against COVID-19, there are still some concerns regarding vaccination in high-risk populations. This is especially valid for patients susceptible to thrombotic or bleeding events and hesitant people due to the [...] Read more.
Although abundant data confirm the efficacy and safety profile of the developed vaccines against COVID-19, there are still some concerns regarding vaccination in high-risk populations. This is especially valid for patients susceptible to thrombotic or bleeding events and hesitant people due to the fear of thrombotic incidents following vaccination. This narrative review focuses on various inherited and acquired thrombotic and coagulation disorders and the possible pathophysiologic mechanisms interacting with the coagulation system during immunization in view of the currently available safety data regarding COVID-19 vaccines. Inherited blood coagulation disorders and inherited thrombotic disorders in the light of COVID-19, as well as blood coagulation and thrombotic disorders and bleeding complications following COVID-19 vaccines, along with the possible pathogenesis hypotheses, therapeutic interventions, and imaging for diagnosing are discussed in detail. Lastly, the lack of causality between the bleeding and thrombotic events and COVID-19 vaccines is debated, but still emphasizes the importance of vaccination against COVID-19, outweighing the minimal risk of potential rare adverse events associated with coagulation. Full article
(This article belongs to the Special Issue Molecular Insights into Blood Coagulation and Inflammation)
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Other

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15 pages, 3433 KiB  
Case Report
Thromboelastometry-Guided Individualized Fibrinolytic Treatment for COVID-19-Associated Severe Coagulopathy Complicated by Portal Vein Thrombosis: A Case Report
by Robin Forgács, Gergely Péter Bokrétás, Zoltán Monori, Zsolt Molnár and Zoltán Ruszkai
Biomedicines 2023, 11(9), 2463; https://doi.org/10.3390/biomedicines11092463 - 05 Sep 2023
Viewed by 1078
Abstract
COVID-19-associated coagulopathy (CAC), mainly characterized by hypercoagulability leading to micro- and macrovascular thrombotic events due to the fibrinolysis shutdown phenomenon, is a life-threatening complication of severe SARS-CoV-2 infection. However, optimal criteria to assess patients with the highest risk for progression of severe CAC [...] Read more.
COVID-19-associated coagulopathy (CAC), mainly characterized by hypercoagulability leading to micro- and macrovascular thrombotic events due to the fibrinolysis shutdown phenomenon, is a life-threatening complication of severe SARS-CoV-2 infection. However, optimal criteria to assess patients with the highest risk for progression of severe CAC are still unclear. Bedside point-of-care viscoelastic testing (VET) appears to be a promising tool to recognize CAC, to support the appropriate therapeutic decisions, and to monitor the efficacy of the treatment. The ClotPro VET has the potential to reveal fibrinolysis resistance indicated by a clot lysis time (LT) > 300 s on the TPA-test. We present a case of severe SARS-CoV-2 infection complicated by CAC-resulting portal vein thrombosis (PVT) and subsequent liver failure despite therapeutic anticoagulation. Since fibrinolysis shutdown (LT > 755 s) caused PVT, we performed a targeted systemic fibrinolytic therapy. We monitored the efficacy of the treatment with repeated TPA assays every three hours, while the dose of recombinant plasminogen activator (rtPA) was adjusted until fibrinolysis shutdown completely resolved and portal vein patency was confirmed by an ultrasound examination. Our case report highlights the importance of VET-guided personalized therapeutic approach during the care of severely ill COVID-19 patients, in order to appropriately treat CAC. Full article
(This article belongs to the Special Issue Molecular Insights into Blood Coagulation and Inflammation)
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