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Blood, Vol. 95 No. 3 (February 1), 2000:
pp. 930-935
Cellular origin and procoagulant properties of microparticles
in meningococcal sepsis
Rienk Nieuwland,
René J. Berckmans,
Sarah McGregor,
Anita N. Böing,
Fred P. H. Th. M. Romijn,
Rudi G. J. Westendorp,
C. Erik Hack, and
Augueste Sturk
From the Departments of Clinical Chemistry, General Internal
Medicine, and Clinical Epidemiology, Leiden University Medical Center,
Leiden, The Netherlands; Department of Physiology, University of
Edinburgh, Edinburgh, United Kingdom; University Hospital Vrije
Universiteit, Amsterdam; and CLB, Sanquin Blood Supply Foundation,
Amsterdam, The Netherlands.
Patients with meningococcal sepsis generally suffer from
disseminated intravascular coagulation (DIC). The aim of this study was
to address whether these patients have elevated numbers of circulating
microparticles that contribute to the development of DIC. Plasma
samples from 5 survivors, 2 nonsurvivors, and 5 healthy volunteers were
analyzed for the presence of microparticles by flow cytometry.
Ongoing coagulation activation in vivo was quantified by enzyme-linked
immunosorbent assay of plasma prothrombin fragment
F1 + 2, and procoagulant properties of microparticles
in vitro were estimated by thrombin-generation assay. On admission, all
patients had increased numbers of microparticles originating from
platelets or granulocytes when compared with controls
(P = .004 and P = .008, respectively). Patients
had elevated levels of F1 + 2 (P = .004),
and their microparticles supported thrombin generation more strongly in
vitro (P = .003) than those of controls. Plasma from
the patient with the most fulminant disease course and severe DIC
contained microparticles that expressed both CD14 and tissue factor,
and these microparticles demonstrated extreme thrombin generation in
vitro. We conclude that patients with meningococcal sepsis have
elevated numbers of circulating microparticles that are procoagulant.
These findings may suggest a novel therapeutic approach to combat
clinical conditions with excessive coagulation activation.

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