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Blood, 1 March 2004, Vol. 103, No. 5, pp. 1702-1709.
Prepublished online as a Blood First Edition Paper on October 30, 2003; DOI 10.1182/blood-2002-05-1380.


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HEMOSTASIS, THROMBOSIS, AND VASCULAR BIOLOGY

Thrombomodulin mutant mice with a strongly reduced capacity to generate activated protein C have an unaltered pulmonary immune response to respiratory pathogens and lipopolysaccharide

Anita W. Rijneveld, Sebastiaan Weijer, Sandrine Florquin, Charles T. Esmon, Joost C. M. Meijers, Peter Speelman, Pieter H. Reitsma, Hugo Ten Cate, and Tom van der Poll

From the Academic Medical Center, University of Amsterdam, The Netherlands; Laboratory for Experimental Internal Medicine, Department of Internal Medicine, Department of Pathology, Department of Vascular Medicine, Department of Infectious Diseases, Tropical Medicine and AIDS, and Oklahoma Medical Research Foundation, University of Oklahoma Health Sciences Center, Cardiovascular Research Program, Oklahoma City.

The thrombomodulin–protein C–protein S (TM-PC-PS) pathway exerts anticoagulant and anti-inflammatory effects. We investigated the role of TM in the pulmonary immune response in vivo by the use of mice with a mutation in the TM gene (TMpro/pro) that was earlier found to result in a minimal capacity for activated PC (APC) generation in the circulation. We here demonstrate that TMpro/pro mice also display a strongly reduced capacity to produce APC in the alveolar compartment upon intrapulmonary delivery of PC and thrombin. We monitored procoagulant and inflammatory changes in the lung during Gram-positive (Streptococcus pneumoniae) and Gram-negative (Klebsiella pneumoniae) pneumonia and after local administration of lipopolysaccharide (LPS). Bacterial pneumonia was associated with fibrin(ogen) depositions in the lung that colocalized with inflammatory infiltrates. LPS also induced a rise in thrombin-antithrombin complexes in bronchoalveolar lavage fluid. These pulmonary procoagulant responses were unaltered in TMpro/pro mice, except for enhanced fibrin(ogen) deposition during pneumococcal pneumonia. In addition, TMpro/pro mice displayed unchanged antibacterial defense, neutrophil recruitment, and cytokine/chemokine levels. These data suggest that the capacity of TM to generate APC does not play a role of importance in the pulmonary response to respiratory pathogens or LPS.


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