Abstract
Background: Chronic obstructive pulmonary disease (COPD) is associated with a high incidence of veonous and arterial thrombotic events, especially during exacerbations. Emerging evidence indicates that extracellular vesicles (EV), a heterogeneous population of vesicles with procoagulant properties, ranging in size between 0.1 and 1μm, are involved in COPD.
Aim: To evaluate the potential prothrombotic role of EV during COPD acute exacerbations (AECOPD).
Methods: In this pilot, observational study, we enrolled 10 subjects with AECOPD within 48 hours of hospital access (V0); patients were re-evaluated in stable conditions 6-8 weeks later (V1). Circulating EV were obtained from 4 mL of peripheral blood. Platelet poor plasma (PPP) was obtained by two subsequent centrifugations, 1,500xg for 15' and 16,000xg for 2' at 4°C. EV pellet was obtained by adding a centrifugation at 16,000xg for 45' at 4°C. Total EV concentration in PPP was assessed by a functional assay that measures the concentration of phosphatidylserine (PS) on the EV surface; EV-associated tissue factor (TF) activity was assessed by a one-stage clotting assay.
Results: There was a statistically significant difference between total EV at V0 and V1 (3.20 nM PS [0.71] vs 2.17 nM PS [0.56], respectively, p<0.05). Furthermore, EV-TF decreased significantly from V0 to V1 (52.6 pg/mL [100.6] vs 9.4 pg/mL [5.9], respectively, p<0.05) (median [IQR]).
Conclusions: EV, by providing both PS and TF (the main initiator of the coagulation cascade in vivo) might represent an ideal substrate for the activation of coagulation during AECOPD, thus contributing to the increased thrombotic risk in this condition.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 3503.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2022