Procoagulant Activity of Endothelial Cells after Infection with Respiratory Viruses

F. L. J. Visseren; J. J. M. Bouwman; K. P. Bouter; R. J. A. Diepersloot; Ph. G. de Groot; D. W. Erkelens

doi:10.1055/s-0037-1614014

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2000; 84(02): 319-324
DOI: 10.1055/s-0037-1614014

Review Article

Schattauer GmbH

Procoagulant Activity of Endothelial Cells after Infection with Respiratory Viruses

Authors

F. L. J. Visseren

¹From the University Medical Center Utrecht, Department of Internal and Vascular Medicine, The Netherlands
J. J. M. Bouwman

²Diakonessen Hospital Utrecht, Department of Microbiology, The Netherlands
K. P. Bouter

³Bosch Medical Centre, Den Bosch, Department of Internal Medicine, The Netherlands
R. J. A. Diepersloot

²Diakonessen Hospital Utrecht, Department of Microbiology, The Netherlands
Ph. G. de Groot

⁴University Hospital Utrecht, Department of Hematology, The Netherlands
D. W. Erkelens

¹From the University Medical Center Utrecht, Department of Internal and Vascular Medicine, The Netherlands

Abstract

Summary

Influenza virus epidemics are associated with excess mortality due to cardiovascular diseases. There are several case reports of excessive coagulation during generalised influenza virus infection. In this study, we demonstrate the ability of respiratory viruses (influenza A, influenza B, parainfluenza-1, respiratory syncytial virus, adenovirus, cytomegalovirus) to infect lung fibroblasts and human umbilical vein endothelial cells in culture. All viral pathogens induced procoagulant activity in infected endothelial cells, as determined in a one-stage clotting assay, by causing an average 55% reduction in the clotting time. When factor VII deficient plasma was used clotting time was not reduced. The induction of procoagulant activity was associated with a 4- to 5-fold increase in the expression of tissue factor, as measured by the generation of factor Xa. Both experiments indicate that the procoagulant activity of endothelial cells in response to infection with respiratory viruses is caused by upregulation of the extrinsic pathway. Although both enveloped viruses and a non-enveloped virus (adenovirus) induced procoagulant activity in endothelial cells by stimulating tissue factor expression, the role of the viral envelope in the assembly of the prothrombinase complex remains uncertain.

We conclude that both enveloped and non-enveloped respiratory viruses are capable of infecting cultured human endothelial cells and causing a shift from anticoagulant to procoagulant activity associated with the induction of tissue factor expression.

Key words

Endothelium - tissue factor viruses

Full Text

References

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