Thrombo-inflammation describes the complex interplay between blood coagulation and inflammation that plays a critical role in cardiovascular diseases. The third Maastricht Consensus Conference on... Show moreThrombo-inflammation describes the complex interplay between blood coagulation and inflammation that plays a critical role in cardiovascular diseases. The third Maastricht Consensus Conference on Thrombosis assembled basic, translational, and clinical scientists to discuss the origin and potential consequences of thrombo-inflammation in the etiology, diagnostics, and management of patients with cardiovascular disease, including myocardial infarction, stroke, and peripheral artery disease. This article presents a state-of-the-art reflection of expert opinions and consensus recommendations regarding the following topics: (1) challenges of the endothelial cell barrier; (2) circulating cells and thrombo-inflammation, focused on platelets, neutrophils, and neutrophil extracellular traps; (3) procoagulant mechanisms; (4) arterial vascular changes in atherogenesis; attenuating atherosclerosis and ischemia/reperfusion injury; (5) management of patients with arterial vascular disease; and (6) pathogenesis of venous thrombosis and late consequences of venous thromboembolism. Show less
Asten, I. van; Blaauwgeers, M.; Granneman, L.; Heijnen, H.F.G.; Kruip, M.J.H.A.; Beckers, E.A.M.; ... ; Urbanus, R.T. 2020
Background delta-storage pool disease (delta-SPD) is a bleeding disorder characterized by a reduced number of platelet-dense granules. The diagnosis of delta-SPD depends on the measurement of... Show moreBackground delta-storage pool disease (delta-SPD) is a bleeding disorder characterized by a reduced number of platelet-dense granules. The diagnosis of delta-SPD depends on the measurement of platelet ADP content, but this test is time consuming and requires a relatively large blood volume. Flow cytometric analysis of platelet mepacrine uptake is a potential alternative, but this approach lacks validation, which precludes its use in a diagnostic setting.Objectives To evaluate the performance of platelet mepacrine uptake as a diagnostic test for delta-SPD.Patients/Methods Mepacrine fluorescence was determined with flow cytometry before and after platelet activation in 156 patients with a suspected platelet function disorder and compared with platelet ADP content as a reference test. Performance was analyzed with a receiver operating characteristic (ROC) curve.Results Eleven of 156 patients had delta-SPD based on platelet ADP content. Mepacrine fluorescence was inferior to platelet ADP content in identifying patients with delta-SPD, but both mepacrine uptake (area under the ROC curve [AUC] 0.87) and mepacrine release after platelet activation (AUC 0.80) had good discriminative ability. In our tertiary reference center, mepacrine uptake showed high negative predicitive value (97%) with low positive predictive value (35%). Combined with a negative likelihood ratio of 0.1, these data indicate that mepacrine uptake can be used to exclude delta-SPD in patients with a bleeding tendency.Conclusion Mepacrine fluorescence can be used as a screening tool to exclude delta-SPD in a large number of patients with a suspected platelet function disorder. Show less
Laan, S.W. van der; Slenders, L.; Depuydt, M.; Prange, K.; Granneman, L.; Elbersen, D.; ... ; Pasterkamp, G. 2019
To date, genome-wide association studies (GWAS) have identified hundreds of risk loci for coronary artery disease (CAD), and other cardiometabolic diseases and traits. However, identifying the key... Show moreTo date, genome-wide association studies (GWAS) have identified hundreds of risk loci for coronary artery disease (CAD), and other cardiometabolic diseases and traits. However, identifying the key genes for atherosclerotic disease in these loci remains challenging. Here, we systematically mapped 14 GWAS and leveraged transcriptomics of advanced atherosclerotic plaques (AP) at a single-cell resolution.We isolated viable, nucleated single-cells from plaques of 3 carotid endarterectomy patients using enzymatic digestion and fluorescence-activated cell sorting. We applied a CEL-seq2/SORT-seq protocol and the Seurat pipeline for single-cell RNA sequencing (scRNAseq) and cell identification, respectively. Next we annotated public GWAS data of cardiovascular diseases, and cardiometabolic traits using FUMA, which is based on LD clumping, physical location, regulatory and transcriptomic data.Using scRNAseq we identified 11 cellular clusters in AP, and integrated these data to map 1,336 loci across 14 cardiometabolic GWAS. For CAD 105 mapped genes in 35 established loci were differentially expressed between cellular clusters. Some of these loci harboured upto 10 differentially expressed genes, highly expressed in endothelial cells, mast cells, and smooth muscle cells. Notably, some CAD genes are almost exclusively expressed in a specific cell: in the NOS3 locus, KCNH2 is highly expressed in mast cells, whereas NOS3 itself, but also AMPD2 (SORT1 locus) are highly expressed in endothelial cells.We systematically mapped and annotated risk loci, and integrated this at a single-cell resolution with transcriptomics from AP. We identified specific genes and cellular clusters relevant to atherosclerotic plaques development and progression, informative for future mechanistic studies. Show less
