Effects on coagulation and fibrinolysis induced by influenza in mice with a reduced capacity to generate activated protein C and a deficiency in plasminogen activator inhibitor type 1

Circ Res. 2006 Nov 24;99(11):1261-9. doi: 10.1161/01.RES.0000250834.29108.1a. Epub 2006 Oct 26.

Abstract

Influenza infections increase the risk of diseases associated with a prothrombotic state, such as venous thrombosis and atherothrombotic diseases. However, it is unclear whether influenza leads to a prothrombotic state in vivo. To determine whether influenza activates coagulation, we measured coagulation and fibrinolysis in influenza-infected C57BL/6 mice. We found that influenza increased thrombin generation, fibrin deposition, and fibrinolysis. In addition, we used various anti- and prothrombotic models to study pathways involved in the influenza-induced prothrombotic state. A reduced capacity to generate activated protein C in TM(pro/pro) mice increased thrombin generation and fibrinolysis, whereas treatment with heparin decreased thrombin generation in influenza-infected C57Bl/6 mice. Thrombin generation was not changed in hyperfibrinolytic mice, deficient in plasminogen activator inhibitor type-1 (PAI-1(-/-)); however, increased fibrin degradation was seen. Treatment with tranexamic acid reduced fibrinolysis, but thrombin generation was unchanged. We conclude that influenza infection generates thrombin, increased by reduced levels of protein C and decreased by heparin. The fibrinolytic system appears not to be important for thrombin generation. These findings suggest that influenza leads to a prothrombotic state by coagulation activation. Heparin treatment reduces the influenza induced prothrombotic state.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Coagulation*
  • Female
  • Fibrinolysis*
  • Genetic Predisposition to Disease
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Mutation
  • Orthomyxoviridae Infections / blood
  • Orthomyxoviridae Infections / complications
  • Orthomyxoviridae Infections / metabolism*
  • Orthomyxoviridae Infections / physiopathology
  • Orthomyxoviridae*
  • Plasminogen Activator Inhibitor 1 / deficiency*
  • Proline
  • Protein C / biosynthesis*
  • Protein C / metabolism
  • Thrombomodulin / genetics
  • Thrombosis / genetics
  • Thrombosis / virology

Substances

  • Plasminogen Activator Inhibitor 1
  • Protein C
  • Thrombomodulin
  • Proline