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Neutrophil Extracellular Traps in Thrombosis of Ovine Extracorporeal Membrane Oxygenation Models

1Department of Laboratory Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China, 2Department of Cardiopulmonary Bypass, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Beijing, China

Abstract Number: LPB0037

Meeting: ISTH 2021 Congress

Theme: Vascular Biology » Blood Cells and Vessel Wall

Background: The balance between thrombosis and hemostasis is a difficult issue during extracorporeal membrane oxygenation (ECMO) support. The pathogenesis of thrombotic complications under ECMO support, as well as the exploration of predictive markers, are still largely unknown. Neutrophil extracellular traps (NETs) have been reported to participated in thrombosis and related to inflammation. However, the role in thrombotic complications of ECMO has not been studied.

Aims: To explore the role of NETs in thrombosis during ECMO support, and to investigate whether NETs as a predictive biomarker for thrombotic complications with ECMO assistance.

Methods: Ten ovine ECMO models were established, including five venoarterial (VA) and five venovenous (VV) models. Venous blood samples were collected at 1 day before ECMO (baseline), 6 hours (post-ECMO) and 1-5 days (D+1-D+5) after the ECMO runs. Markers of NETs were detected in plasma, neutrophils and thrombus specimens on the membrane. The study was approved by medical ethics committee. Statistical significance was assessed by unpaired t test.

Results: The levels of neutrophils and the markers of NETs (dsDNA and CitH3) were significantly elevated after 6h after the ECMO runs, compared with those at baseline (Figure1 A-B). The levels of dsDNA and CitH3 at the time points of 6h and D+1 – D+5 were significantly higher in the VA than in the VV mode (Figure 1C).

The increased levels of neutrophils and markers of NETs at 6h after the ECMO runs(A-B). The levels of dsDNA and CitH3 were significantly higher in the VA than in the VV mod(C).

The isolated neutrophils from fresh blood samples at the time of 6h could release more NETs (Figure 2A-B). NETs also existed in thrombi on the membrane (Figure 2C).
The isolated neutrophils at the time of 6h could release more NETs (Figure 2A-B). NETs existed in thrombi on the membrane (C).

Conclusions: We are the first to demonstrate that altered NETs levels might play a role in thrombosis during ovine models of ECMO support, especially in the VA mode. These findings provide a new insight into the prevention of thrombotic complications by targeting NETs.

To cite this abstract in AMA style:

Zhang Y, Peng R, Gao S, Ji B, Zhou Z. Neutrophil Extracellular Traps in Thrombosis of Ovine Extracorporeal Membrane Oxygenation Models [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/neutrophil-extracellular-traps-in-thrombosis-of-ovine-extracorporeal-membrane-oxygenation-models/. Accessed December 11, 2023.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/neutrophil-extracellular-traps-in-thrombosis-of-ovine-extracorporeal-membrane-oxygenation-models/