Anticoagulant SERPINs: Endogenous Regulators of Hemostasis and Thrombosis

Appropriate activation of coagulation requires a balance between procoagulant and anticoagulant proteins in blood. Loss in this balance leads to hemorrhage and thrombosis. A number of endogenous anticoagulant proteins, such as antithrombin and heparin cofactor II, are members of the serine protease inhibitor (SERPIN) family. These SERPIN anticoagulants function by forming irreversible inhibitory complexes with target coagulation proteases. Mutations in SERPIN family members, such as antithrombin, can cause hereditary thrombophilias. In addition, low plasma levels of SERPINs have been associated with an increased risk of thrombosis. Here, we review the biological activities of the different anticoagulant SERPINs. We further consider the clinical consequences of SERPIN deficiencies and insights gained from preclinical disease models. Finally, we discuss the potential utility of engineered SERPINs as novel therapies for the treatment of thrombotic pathologies

Ammonia emissions from cattle urine and dung excreted on pasture

Twelve cattle were kept for three days in a circular area of 16 m radius on short pasture and fed with freshly-cut pasture. Ammonia (NH₃) emissions from the urine and dung excreted by the cattle were measured with a micrometeorological mass-balance method, during the cattle presence and for 10 subsequent days. Daily-integrated emission rates peaked on Day 3 of the experiment (last day of cattle presence) and declined steadily for five days thereafter. Urine patches were the dominant sources for these emissions. On Day 9, a secondary emissions peak occurred, with dung pats likely to be the main sources. This interpretation is based on simultaneous observations of the pH evolution in urine patches and dung pats created next to the circular plot. Feed and dung samples were analysed to estimate the amounts of nitrogen (N) ingested and excreted. Total N volatilised as NH₃ was 19.8 (± 0.9)% of N intake and 22.4 (± 1.3)% of N excreted. The bimodal shape of the emissions time series allowed to infer separate estimates for volatilisation from urine and dung, respectively, with the result that urine accounted for 88.6 (± 2.6)% of the total NH₃ emissions. The emissions from urine represented 25.5 (± 2.0)% of the excreted urine-N, while the emissions from dung amounted to 11.6 (± 2.7)% of the deposited dung-N. Emissions from dung may have continued after Day 13 but were not resolved by the measurement technique. A simple resistance model shows that the magnitude of the emissions from dung is controlled by the resistance of the dung crust. © Author(s) 2013

Respect, bullying, and public sector work outcomes in Vietnam

This article examines empirical links between a subordinate’s felt recognition respect from his/her supervisor, the subordinate’s appraisal respect for that supervisor, and bullying, work engagement, and organizational citizenship behaviour in Vietnam’s public sector. Data from 274 employees in six branches of a public sector agency were used to test the hypothesized model. Within Vietnam’s public sector, the followers who receive recognition respect from the leaders have greater appraisal respect for their leaders, experience less bullying, and reveal higher work engagement and organizational citizenship behaviour. This article theoretically and empirically contributes to the respect literature developed in the Western context

Expression of factor V by resident macrophages boosts host defense in the peritoneal cavity

Macrophages resident in different organs express distinct genes, but understanding how this diversity fits into tissue-specific features is limited. Here, we show that selective expression of coagulation factor V (FV) by resident peritoneal macrophages in mice promotes bacterial clearance in the peritoneal cavity and serves to facilitate the well-known but poorly understood macrophage disappearance reaction. Intravital imaging revealed that resident macrophages were nonadherent in peritoneal fluid during homeostasis. Bacterial entry into the peritoneum acutely induced macrophage adherence and associated bacterial phagocytosis. However, optimal control of bacterial expansion in the peritoneum also required expression of FV by the macrophages to form local clots that effectively brought macrophages and bacteria in proximity and out of the fluid phase. Thus, acute cellular adhesion and resident macrophage-induced coagulation operate independently and cooperatively to meet the challenges of a unique, open tissue environment. These events collectively account for the macrophage disappearance reaction in the peritoneal cavity

Patients With COVID-19 Have Elevated Levels of Circulating Extracellular Vesicle Tissue Factor Activity That Is Associated With Severity and Mortality

OBJECTIVE: Patients with coronavirus disease 2019 (COVID-19) have a high rate of thrombosis. We hypothesized that severe acute respiratory syndrome coronavirus 2 leads to induction of TF (tissue factor) expression and increased levels of circulating TF-positive extracellular vesicles (EV) that may drive thrombosis. Approach and Results: We measured levels of plasma EV TF activity in 100 patients with COVID-19 with moderate and severe disease and 28 healthy controls. Levels of EV TF activity were significantly higher in patients with COVID-19 compared with controls. In addition, levels of EV TF activity were associated with disease severity and mortality. Finally, levels of EV TF activity correlated with several plasma markers, including D-dimer, which has been shown to be associated with thrombosis in patients with COVID-19. CONCLUSIONS: Our results indicate that severe acute respiratory syndrome coronavirus 2 infection induces the release of TF-positive EVs into the circulation that are likely to contribute to thrombosis in patients with COVID-19. EV TF activity was also associated with severity and mortality

PTCOG Head and Neck Subcommittee Consensus Guidelines on Particle Therapy for the Management of Head and Neck Tumors

Purpose: Radiation therapy is a standard modality in the treatment for cancers of the head and neck, but is associated with significant short- and long-term side effects. Proton therapy, with its unique physical characteristics, can deliver less dose to normal tissues, resulting in fewer side effects. Proton therapy is currently being used for the treatment of head and neck cancer, with increasing clinical evidence supporting its use. However, barriers to wider adoption include access, cost, and the need for higher-level evidence.Methods: The clinical evidence for the use of proton therapy in the treatment of head and neck cancer are reviewed here, including indications, advantages, and challenges.Results: The Particle Therapy Cooperative Group Head and Neck Subcommittee task group provides consensus guidelines for the use of proton therapy for head and neck cancer.Conclusion: This report can be used as a guide for clinical use, to understand clinical trials, and to inform future research efforts.</p

Intravitreal ranibizumab, photodynamic therapy, and vitreous surgery for the treatment of juxtapapillary retinal capillary hemangioma

published_or_final_versionSpringer Open Choice, 21 Feb 201

High plasma levels of C1-inhibitor are associated with lower risk of future venous thromboembolism

Background - C1-inhibitor (C1INH) is a broad-acting serine protease inhibitor with anticoagulant activity. The impact of C1INH plasma levels within the normal physiological range on risk of venous thromboembolism (VTE) is unknown. We assessed the association of plasma C1INH levels and VTE risk and evaluated the impact of C1INH on thrombin and plasmin generation in ex vivo assays. Methods - A nested case-control study with 405 patients with VTE and 829 age- and sex-matched controls was derived from the Tromsø Study. Odds ratios (ORs) with 95% confidence intervals (95% CI) for VTE were estimated across plasma C1INH quartiles. Genetic regulation of C1INH was explored using quantitative trait loci analysis of whole exome sequencing data. The effect of plasma C1INH levels on coagulation was evaluated ex vivo by calibrated automated thrombography. Results - Individuals with C1INH levels in the highest quartile had a lower risk of VTE (OR 0.68, 95% CI: 0.49-0.96) compared with those with C1INH in the lowest quartile. In subgroup analysis, the corresponding ORs were 0.60 (95% CI: 0.39-0.89) for deep vein thrombosis and 0.85 (95% CI: 0.52-1.38) for pulmonary embolism, respectively. No significant genetic determinants of plasma C1INH levels were identified. Addition of exogenous C1INH to normal human plasma reduced thrombin generation triggered by an activator of the intrinsic coagulation pathway, but not when triggered by an activator of the extrinsic coagulation pathway. Conclusions - High plasma levels of C1INH were associated with lower risk of VTE, and C1INH inhibited thrombin generation initiated by the intrinsic coagulation pathway ex vivo

Real-time infrared spectroscopy coupled with blind source separation for nuclear waste process monitoring

On-line infrared absorbance spectroscopy enables rapid measurement of solution-phase molecular species. Many spectra-to-concentration models exist for spectral data, with some models able to handle overlapping spectral bands and nonlinearities. However, model accuracy is limited by the quality of training data used in model fitting. The process spectra of nuclear waste simulants at the Savannah River Site display incongruity between training and process spectra; the glycolate spectral signature in the training data does not match the glycolate signature in Savannah River National Laboratory process data. A novel blind source separation algorithm is proposed that preprocesses spectral data so that process spectra more closely resemble training spectra, thereby improving model quantification accuracy when unexpected sources of variation appear in process spectra. The novel blind source separation preprocessing algorithm is shown to improve nitrate quantification from an R2 of 0.934 to 0.988 and from 0.267 to 0.978 in two instances analyzing nuclear waste simulants from the Slurry Receipt Adjustment Tank and Slurry Mix Evaporator cycle at the Savannah River Site