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1.
ACS Infect Dis ; 10(9): 3256-3272, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39231002

RESUMO

The survival and proliferation of pathogenic Leptospira within a host are complex phenomena that require careful consideration. The ErpY-like lipoprotein, found on the outer membrane surface of Leptospira, plays a crucial role in enhancing the bacterium's pathogenicity. The rErpY-like protein, in its recombinant form, contributes significantly to spirochete virulence by interacting with various host factors, including host complement regulators. This interaction facilitates the bacterium's evasion of the host complement system, thereby augmenting its overall pathogenicity. The rErpY-like protein exhibits a robust binding affinity to soluble fibrinogen, a vital component of the host coagulation system. In this study, we demonstrate that the rErpY-like protein intervenes in the clotting process of the platelet-poor citrated plasma of bovines and humans in a concentration-dependent manner. It significantly reduces clot density, alters the viscoelastic properties of the clot, and diminishes the average clotting rate in plasma. Furthermore, the ErpY-like protein inhibits thrombin-catalyzed fibrin formation in a dose-dependent manner and exhibits saturable binding to thrombin, suggesting its significant role in leptospiral infection. These findings provide compelling evidence for the anticoagulant effect of the ErpY-like lipoprotein and its significant role in leptospiral infection.


Assuntos
Coagulação Sanguínea , Fibrinogênio , Trombina , Fibrinogênio/metabolismo , Fibrinogênio/química , Humanos , Trombina/metabolismo , Animais , Bovinos , Ligação Proteica , Leptospira/metabolismo , Leptospirose/microbiologia , Proteínas da Membrana Bacteriana Externa/metabolismo , Lipoproteínas/metabolismo , Interações Hospedeiro-Patógeno
2.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 32(4): 1271-1277, 2024 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-39192430

RESUMO

OBJECTIVE: To explore the key factors affecting plasma clot retraction and optimize the experimental method of plasma clot retraction, in order to study the regulation of platelet function and evaluate the modulatory effects of drugs on plasma clot retraction. METHODS: The effects of different concentrations of thrombin, Ca2 + and platelets on plasma clot retraction were studied, and the detection system of plasma clot retraction was optimized. The availability of the detection system was then validated by analyzing the regulatory effects of multiple signaling pathway inhibitors on plasma clot retraction. RESULTS: Through the optimization study of multiple factors, platelet rich plasma (PRP) containing 0.5 mmol/L Ca2 + and 40×109/L platelets was treated with 0.2 U/ml thrombin to perform plasma clot retraction analysis. After treatment with thrombin for 15 min, plasma clot retracted significantly. After treatment with thrombin for 30 min, the percentage of plasma clot retraction was more than 50%. The regulatory effects of multiple signaling pathway inhibitors on plasma clot retraction were studied in this detection system. PKC inhibitor Go 6983 exhibited a significant inhibitory effect on plasma clot retraction, while PI3K inhibitor Ly294002 and p38 MAPK inhibitor SB203580 slightly suppressed plasma clot retraction. CONCLUSION: PRP containing 0.5 mmol/L Ca2 + and 40×109/L platelets can be induced with 0.2 U/ml thrombin to conduct plasma clot retraction analysis, which can be used to study the regulation of platelet function and evaluate the modulatory effects of drugs on plasma clot retraction.


Assuntos
Plaquetas , Retração do Coágulo , Plasma Rico em Plaquetas , Trombina , Humanos , Trombina/farmacologia , Transdução de Sinais , Coagulação Sanguínea , Cálcio , Piridinas/farmacologia , Morfolinas/farmacologia , Cromonas/farmacologia , Plasma , Imidazóis/farmacologia
3.
Materials (Basel) ; 17(8)2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38673106

RESUMO

The development of bone-filling biomaterials capable of delivering in situ bone growth promoters or therapeutic agents is a key area of research. We previously developed a biomaterial constituting biphasic calcium phosphate (BCP) microparticles embedded in an autologous blood or plasma clot, which induced bone-like tissue formation in ectopic sites and mature bone formation in orthotopic sites, in small and large animals. More recently, we showed that activated carbon (AC) fiber cloth is a biocompatible material that can be used, due to its multiscale porosity, as therapeutic drug delivery system. The present work aimed first to assess the feasibility of preparing calibrated AC microparticles, and second to investigate the properties of a BCP/AC microparticle combination embedded in a plasma clot. We show here, for the first time, after subcutaneous (SC) implantation in mice, that the addition of AC microparticles to a BCP/plasma clot does not impair bone-like tissue formation and has a beneficial effect on the vascularization of the newly formed tissue. Our results also confirm, in this SC model, the ability of AC in particle form to adsorb and deliver large molecules at an implantation site. Altogether, these results demonstrate the feasibility of using this BCP/AC/plasma clot composite for bone reconstruction and drug delivery.

4.
Pharmaceutics ; 15(9)2023 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-37765289

RESUMO

Fibrin clot structure and function are major determinants of venous and arterial thromboembolic diseases, as well as the key determinants of the efficiency of clot lysis. Studies have revealed that fungi fibrinolytic compound 1 (FGFC1) is a novel marine pyranisoindolone natural product with fibrinolytic activity. Here, we explore the impacts of FGFC1 on clot structure, lysis, and plasminogen activation in vitro using turbidimetric, enzyme-linked immunosorbent assay, confocal and electron microscopy, urokinase, or plasmin chromogenic substrate. Clots formed in the presence of FGFC1 expressed reduced fibrin polymerization rate and maximum turbidity; however, they did not influence the lag phase of fibrin polymerization. In the absence of scu-PA (single-chain urokinase plasminogen activator), microscopy revealed that FGFC1 increased the number of protofibrils within fibrin fiber and the pore diameter between protofibrils, inducing clots to form a region of thinner and looser networks separated by large pores. The effects of FGFC1 on scu-PA-mediated plasma clot structure were similar to those in the absence of scu-PA. In addition, FGFC1 promoted the lysis of clots and increased the D-dimer concentration in lysate. FGFC1 increased the generation rate of p-nitroaniline in plasma. These results show that FGFC1 has fibrinolytic activity in plasma, leading to interference with the release of fibrinopeptide B to affect lateral aggregation of protofibrils and increase clot susceptibility to fibrinolysis by altering its structure.

5.
Cancers (Basel) ; 15(16)2023 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-37627058

RESUMO

Pancreatic cancer is one of the most prothrombotic malignancies. Plasma clot properties may be altered in patients with pancreatic cancer, and circulating tissue factor (TF) may play an important role. We applied a modified plasma clot formation assay (only CaCl2 and phospholipids were added to initiate clotting) and a standard clotting assay (lipidated TF was also added) to investigate whether plasma clot properties are altered in pancreatic cancer patients (n = 40, 23 female) compared to sex-matched healthy controls. The modified assay was also performed in the presence of a TF blocking antibody. With this modified assay, we detected an increased plasma clot formation rate (Vmax) and an increased delta absorbance (ΔAbs, indicating fibrin fiber thickness) in patients compared to controls. These differences were not detected with the standard clotting assay. Following addition of a TF blocking antibody in in our modified assay, Vmax decreased significantly in patients only, ΔAbs significantly decreased in patients and in healthy controls, the lag phase did not change, and the time to peak fibrin generation increased in patients only. Taken together, these findings indicate the presence of a prothrombotic state in pancreatic cancer patients, which depends on TF and is detectable with our modified assay but not with a standard clotting assay.

6.
Cell Tissue Res ; 382(3): 499-507, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32789682

RESUMO

The hematopoietic niche is a specialized microenvironment that supports the survival, proliferation and differentiation of hematopoietic stem progenitor cells (HSPCs). Three-dimensional (3D) models mimicking hematopoiesis might allow in vitro and in vivo studies of the hematopoietic (HP) process. Here, we investigate the capacity of a 3D construct based on non-adherent murine bone marrow mononuclear cells (NA-BMMNCs), mesenchymal stromal cells (MSCs) and collagen microspheres (CMs), all embedded into plasma clot (PC) to support in vitro and in vivo hematopoiesis. Confocal analysis of the 3D hematopoietic construct (3D-HPC), cultured for 24 h, showed MSC lining the CM and the NA-BMMNCs closely associated with MSC. In vivo hematopoiesis was examined in 3D-HPC subcutaneously implanted in mice and harvested at different intervals. Hematopoiesis in the 3D-HPC was evaluated by histology, cell morphology, flow cytometry, confocal microscopy and hematopoietic colony formation assay. 3D-HPC implants were integrated and vascularized in the host tissue, after 3 months of implantation. Histological studies showed the presence of hematopoietic tissue with the presence of mature blood cells. Cells from 3D-HPC showed viability greater than 90%, expressed HSPCs markers, and formed hematopoietic colonies, in vitro. Confocal microscopy studies showed that MSCs adhered to the CM and NA-BMMNCs were scattered across the 3D-HPC area and in close association with MSC. In conclusion, the 3D-HPC mimics a hematopoietic niche supporting the survival, proliferation and differentiation of HSPCs, in vivo. 3D-HPC may allow evaluation of regulatory mechanisms involved in hematopoiesis.


Assuntos
Células-Tronco Hematopoéticas/metabolismo , Imageamento Tridimensional/métodos , Células-Tronco Mesenquimais/metabolismo , Microesferas , Animais , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Feminino , Humanos , Camundongos , Análise de Sobrevida
7.
J Proteomics ; 229: 103946, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-32810596

RESUMO

It has been reported that 476 proteins can be detected in plasma fibrin clots from patients with venous thromboembolism. Plasma fibrin clots proteomic composition in relation to their properties has not been studied in acute pulmonary embolism (PE). Clots generated from plasma of 20 PE patients and 20 healthy controls were assessed using mass spectrometry, clot permeability (Ks), and clot lysis time (CLT). The proteomic composition of plasma fibrin clots from acute PE patients differed from that of control subjects in regard to 198 clot-bound proteins. In the acute PE group, we observed increased clot-bound fibrinogen, apolipoprotein B-100, platelet glycoprotein Ib, lipopolysaccharide-binding protein, and histones H3 + 4 and reduced fibronectin, α2-antiplasmin, α2-macroglobulin, factor (F)XIII, histidine-rich glycoprotein, antithrombin, von Willebrand Factor, plasminogen, and prothrombin. Among PE patients, low Ks (≤3.83 × 10-9 cm2) was associated with increased clot-bound C-reactive protein, kininogen-1, protein S, ß-2-microglobulin, and thromboxane-A synthase when compared with patients having Ks > 3.83 × 10-9 cm2. Ks correlated inversely with FIX and FV, thrombin-activatable fibrinolysis inhibitor, complement C1s, C7, C8, and apolipoprotein A-I. The specific protein composition in plasma fibrin clots from acute PE patients is associated with denser clot formation. Several proteins unrelated to the coagulation system can modulate fibrin phenotype in acute thrombotic states. SIGNIFICANCE: Our study significantly advances the field of thrombosis and hemostasis. The plasma fibrin clot proteomics findings fill the gap of knowledge about the presence and the role of other proteins to the plasma fibrin clot in the acute phase of pulmonary embolism, aside fibrinogen, which is the main component of fibrin. The reported methodology, which involves the sample preparation using Multienzyme Digestion-Filter Aided Sample Preparation (MED FASP), data acquisition with the Quadrupole-Orbitrap mass spectrometer, and data analysis using the advanced tools such as MaxQuant, Total Protein Approach and Perseus, allows to gain not only the qualitative, but also the quantitative insights into the microworld of proteins entangled among the fibrin network. By comparing the clots formed from plasma of patients with acute pulmonary embolism with the clots from healthy control, we provide the specific protein composition associated with unfavorable clot properties observed in this disease. Moreover, our findings emphasize that several proteins unrelated to the coagulation system, can modulate fibrin phenotype in acute thrombotic states.


Assuntos
Embolia Pulmonar , Trombose , Fibrina , Tempo de Lise do Coágulo de Fibrina , Fibrinólise , Humanos , Proteômica , Embolia Pulmonar/complicações
8.
Tissue Eng Part A ; 24(9-10): 809-818, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29096582

RESUMO

Platelet-free blood plasma clots were loaded either with antibiotics (vancomycin, gentamicin, or linezolid) at concentrations of 5-300 µg/mL or with silver ions (silver acetate) at concentrations of 3.3-129 µg/mL. The release of antibiotics or silver from the clot matrix was analyzed after repeated immersion of the plasma clots using reversed-phase high-performance liquid chromatography (RP-HPLC) or atomic absorption spectroscopy (AAS). The antimicrobial activity was tested against Staphylococcus aureus; tissue cell compatibility was analyzed using human mesenchymal stem cells (hMSC). Fibrin fiber thickness of the clots was analyzed by scanning electron microscopy. While addition of linezolid and vancomycin did not significantly change the fibrin fiber thickness, gentamicin and silver ions led to an increase in fiber thickness. All antibiotics showed a concentration-dependent burst-like release from the plasma clots within 1 h followed by a general decay in elution. The release of vancomycin and gentamicin, or silver lasted up to 7 days (depending on initial concentrations), but lasted only up to 4 h for linezolid. A correlation (p < 0.0001) was noted between the concentration of released antibiotics analyzed by HPLC and antimicrobial activity (agar diffusion test). A decrease in antibacterial activity of gentamicin- and vancomycin-containing clots occurred within 4 or 5 days. In contrast, the corresponding antibacterial activity of plasma clots containing linezolid was limited to 3 h. Antibacterial activity of plasma clots containing silver at the highest concentrations decreased after day 3, but clots with lower concentrations induced incomplete bacterial lysis or displayed no antibacterial activity. The antibiotic-containing clots did not induce cytotoxic effects on the embedded hMSC in contrast to all clots containing silver. Our results indicate that an autologous plasma clot can be used to deliver antibiotics such as vancomycin and gentamicin in combination with hMSC and the antibacterial effects persist for days without inducing cytotoxic effects on the embedded stem cells.


Assuntos
Antibacterianos/administração & dosagem , Sistemas de Liberação de Medicamentos/métodos , Células-Tronco Mesenquimais/fisiologia , Plasma/química , Antibacterianos/uso terapêutico , Cromatografia Líquida de Alta Pressão , Gentamicinas/administração & dosagem , Gentamicinas/uso terapêutico , Humanos , Osteomielite/tratamento farmacológico , Espectrofotometria Atômica , Vancomicina/administração & dosagem , Vancomicina/uso terapêutico
9.
Cytotherapy ; 19(7): 881-894, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28479049

RESUMO

BACKGROUND: Cell source plays a deterministic role in defining the outcome of a cell-based cartilage regenerative therapy and its clinical translational ability. Recent efforts in the direction of co-culture of two or more cell types attempt to combine the advantages of constituent cell types and negate their demerits. METHODS: We examined the potential of co-culture of infrapatellar fat pad-derived mesenchymal stromal cells (IFP MSCs) and articular chondrocytes (ACs) in plasma clots in terms of their ratios and culture formats for cartilage tissue engineering. RESULTS AND DISCUSSION: It was observed that IFP MSCs and ACs interact positively to produce a better quality hyaline cartilage-like matrix. While a supra-additive deposition of sulfated Glycosaminoglycans (sGAG), collagen type II, aggrecan and link protein was observed, deposition of collagen type I and X was sub-additive. (Immuno)-histologically similar cartilage was generated in vitro in IFP MSC:AC ratio of 50:50 and pure AC groups thus yielding a hyaline cartilage with 50% reduced requirement of ACs. Subsequently, we investigated if this response could be improved further by enabling better cell-cell interactions using scaffold-free systems such as self-assembled cartilage or by encapsulating cellular micro-aggregates in plasma clot. However, it was inferred that while self-assembly may have enabled better cell-cell interaction, poor cell survival negated its overall beneficial role, whereas the micro-aggregate group demonstrated highly heterogeneous matrix deposition within the construct, thus diminishing its translational utility. Overall, it was concluded that co-culture of IFP MSCs and ACs at a ratio of 50:50 within plasma clots demonstrated potential for cell-based cartilage regenerative therapy.


Assuntos
Tecido Adiposo/citologia , Cartilagem Articular/citologia , Condrócitos/citologia , Células-Tronco Mesenquimais/citologia , Engenharia Tecidual/métodos , Agrecanas/metabolismo , Animais , Diferenciação Celular , Células Cultivadas , Técnicas de Cocultura , Colágeno Tipo II/metabolismo , Proteínas da Matriz Extracelular/metabolismo , Glicosaminoglicanos/metabolismo , Cabras , Patela/citologia , Plasmócitos , Proteoglicanas/metabolismo
10.
Methods Mol Biol ; 1493: 237-246, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27787855

RESUMO

The guidance of axons within the developing nervous system is orchestrated by a variety of cues that successively and complementary attract or repel axons to achieve a stereotyped wiring of neural circuits. Here we present a version of a method that has been widely used to identify and characterize the effect of guidance cues on the orientation of axons. We describe the coculture, within a three-dimensional environment, of dorsal spinal cord explants together with a cell aggregate secreting a candidate cue and the method to quantify the effect of this cue on axon orientation.


Assuntos
Axônios/fisiologia , Semaforinas/metabolismo , Medula Espinal/citologia , Animais , Técnicas de Cocultura , Feminino , Células HEK293 , Humanos , Camundongos , Gravidez , Medula Espinal/metabolismo
11.
Acta Biomater ; 46: 68-78, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27693666

RESUMO

Matrix stiffness is known to play a pivotal role in cellular differentiation. Studies have shown that soft scaffolds (<2-3kPa) promote cellular aggregation and chondrogenesis, whereas, stiffer ones (>10kPa) show poor chondrogenesis in vitro. In this work we investigated if fibrin matrix from clotted blood can act as a soft surrogate which nullifies the influence of the underlying stiff scaffold, thus promoting chondrogenesis irrespective of bulk scale scaffold stiffness. For this we performed in vitro chondrogenesis on soft (∼1.5kPa) and stiff (∼40kPa) gelatin scaffolds in the presence and absence of pericellular plasma clot. Our results demonstrated that in absence of pericellular plasma clot, chondrocytes showed efficient condensation and cartilaginous matrix secretion only on soft scaffolds, whereas, in presence of pericellular plasma clot, cell rounding and cartilaginous matrix secretion was observed in both soft and stiff scaffolds. More specifically, significantly higher collagen II, chondroitin sulfate and aggrecan deposition was observed in soft scaffolds, and soft and stiff scaffolds with pericellular plasma clot as compared to stiff scaffolds without pericellular plasma clot. Moreover, collagen type I, a fibrocartilage/bone marker was significantly higher only in stiff scaffolds without plasma clot. Therefore, it can be concluded that chondrocytes surrounded by a soft fibrin network were unable to sense the stiffness of the underlying scaffold/substrate and hence facilitate chondrogenesis even on stiff scaffolds. This understanding can have significant implications in the design of scaffolds for cartilage tissue engineering. STATEMENT OF SIGNIFICANCE: Cell fate is influenced by the mechanical properties of cell culture substrates. Outside the body, cartilage progenitor cells express significant amounts of cartilage-specific markers on soft scaffolds but not on stiff scaffolds. However, when implanted in joints, stiff scaffolds show equivalent expression of markers as seen in soft scaffolds. This disparity in existing literature prompted our study. Our results suggest that encapsulation of cells in a soft plasma clot, present in any surgical intervention, prevents their perception of stiffness of the underlying scaffold, and hence the ability to distinguish between soft and stiff scaffolds vanishes. This finding would aid the design of new scaffolds that elicit cartilage-like biochemical properties while simultaneously being mechanically comparable to cartilage tissue.


Assuntos
Coagulação Sanguínea , Diferenciação Celular , Condrogênese , Plasma/fisiologia , Alicerces Teciduais/química , Animais , Forma Celular , Células Cultivadas , Condrócitos/citologia , Matriz Extracelular/metabolismo , Gelatina/química , Cabras , Imuno-Histoquímica
12.
Acta Biomater ; 31: 71-79, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26654763

RESUMO

(RADA)4 peptides are promising biomaterials due to their high degree of hydration (<99.5% (w/v)), programmability at the molecular level, and their subsequent potential to respond to external stimuli. Interestingly, these peptides have also demonstrated the ability to cause rapid (∼15s) hemostasis when applied directly to wounds. General hemocompatibility of (RADA)4 nanofibers was investigated systematically using clot formation kinetics, C3a generation, and platelet activation (morphology and CD62P) studies. (RADA)4 nanofibers caused a rapid clot formation, but yielded a low platelet activation and low C3a activation. The study suggests that the rapid hemostasis observed when these materials are employed results principally from humoral coagulation, despite these materials having a net neutral charge and high hydration at physiological conditions. The observed rapid hemostasis may be induced due to the available nanofiber surface area within the hydrogel construct. In conclusion, our experiments strongly support further development of (RADA)4 peptide based biomaterials. STATEMENT OF SIGNIFICANCE: Biomedicine based applications of (RADA)4 peptides are being extensively studied for the purpose of improving drug carriers, and 3D peptide nanofiber scaffolds. However, this peptide's biocompatibility has not been investigated till now. One particular study has reported a revolutionary and very desirable ability of (RADA)4 peptide to achieve complete and rapid hemostasis, nevertheless, the literature remains inconclusive on the underlying molecular mechanism. In this manuscript we bridge these two main knowledge gaps by providing the much needed systematic biocompatibility analysis (morphology analysis, platelet and C3a activation) of the (RADA)4 based hydrogels, and also investigate the underlying hemostatic mechanism of this peptide-induced hemostasis. Our work not only provides the much-needed biocompatibility of the peptide for applicative research, but also explores the molecular mechanism of hemostasis, which will help us design novel biomaterials to achieve hemostasis.


Assuntos
Hemostasia , Hidrogéis/química , Peptídeos/química , Engenharia Tecidual/métodos , Materiais Biocompatíveis/química , Coagulação Sanguínea , Complemento C3/química , Complemento C3a/química , Proteínas do Sistema Complemento , Portadores de Fármacos , Sistemas de Liberação de Medicamentos , Humanos , Inflamação , Cinética , Teste de Materiais , Microscopia Eletrônica de Transmissão , Nanofibras/química , Nefelometria e Turbidimetria , Selectina-P/química , Ativação Plaquetária
13.
J Thromb Haemost ; 12(7): 1121-30, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24815347

RESUMO

BACKGROUND: Factor XI (FXI) deficiency is a rare autosomal recessive disorder. Many patients with even very low FXI levels (< 20 IU dL(-1) ) are asymptomatic or exhibit only mild bleeding, whereas others experience severe bleeding, usually following trauma. Neither FXI antigen nor activity predicts the risk of bleeding in FXI-deficient patients. OBJECTIVES: (i) Characterize the formation, structure and stability of plasma clots from patients with severe FXI deficiency and (ii) determine whether these assays can distinguish asymptomatic patients ('non-bleeders') from those with a history of bleeding ('bleeders'). METHODS: Platelet-poor plasmas were prepared from 16 severe FXI-deficient patients who were divided into bleeders or non-bleeders, based on bleeding associated with at least two tooth extractions without prophylaxis. Clot formation was triggered by recalcification and addition of tissue factor and phospholipids in the absence or presence of tissue plasminogen activator and/or thrombomodulin. Clot formation and fibrinolysis were measured by turbidity and fibrin network structure by laser scanning confocal microscopy. RESULTS: Non-bleeders and bleeders had similarly low FXI levels, normal prothrombin times, normal levels of fibrinogen, factor VIII, von Willebrand factor and factor XIII, and normal platelet number and function. Compared with non-bleeders, bleeders exhibited lower fibrin network density and lower clot stability in the presence of tissue plasminogen activator. In the presence of thrombomodulin, seven of eight bleeders failed to form a clot, whereas only three of eight non-bleeders did not clot. CONCLUSIONS: Plasma clot structure and stability assays distinguished non-bleeders from bleeders. These assays may reveal hemostatic mechanisms in FXI-deficient patients and have clinical utility for assessing the risk of bleeding.


Assuntos
Coagulação Sanguínea , Deficiência do Fator XI/diagnóstico , Hemorragia/diagnóstico , Adulto , Idoso , Estudos de Coortes , Fator XI/metabolismo , Deficiência do Fator XI/sangue , Fator XIII/metabolismo , Feminino , Fibrinólise , Humanos , Masculino , Microscopia Confocal , Pessoa de Meia-Idade , Fosfolipídeos/química , Plasma/metabolismo , Fatores de Risco , Trombina/química , Fator de von Willebrand/metabolismo
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