Publications by authors named "Debora Bertaggia-Calderara"

Background: Production of platelet concentrates (PCs) involves several steps that significantly affect platelet behavior. To gain a deeper understanding of how storage conditions impact donor platelet recirculation and functionality post-transfusion, ex vivo platelet labeling is a feasible approach. However, before pursuing clinical investigations of platelet recirculation and function in humans, we aimed to determine the effects of pathogen inactivation technology (PIT) and storage conditions (4°C vs.

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Cirrhosis is a major health concern worldwide with a complex pathophysiology affecting various biological systems, including all aspects of haemostasis. Bleeding risk is mainly driven by portal hypertension, but in end-stage liver disease it is further increased by alterations in haemostatic components, including platelet function, coagulation, and fibrinolysis. Concurrently, patients with cirrhosis are prone to venous thromboembolic events (VTE) because of the altered haemostatic balance, in particular an increase in thrombin generation.

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Background: Pediatric patients with acute lymphoblastic leukemia (ALL) are at highest risk of venous thromboembolism during the induction therapy (IT). These events are not predictable by conventional coagulation assays.

Objectives: To investigate the utility of global coagulation assays (GCAs) for assessing the hemostatic state in children with ALL during IT.

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Introduction: ADP-stimulated elevation of cytosolic Ca is an important effector mechanism for platelet activation. The rapidly elevating cytosolic Ca is also transported to mitochondrial matrix via Mitochondrial Ca Uniporter (MCU) and extruded via Na/Ca/Li Exchanger (NCLX). However, the exact contribution of MCU and NCLX in ADP-mediated platelet responses remains incompletely understood.

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  • Emicizumab is a bispecific antibody used to treat hemophilia A, but typical coagulation tests can't accurately measure its effects due to over-correction.
  • This study involved six adult patients receiving emicizumab, where their treatment response was monitored through thrombin generation (TG) and fibrin clot formation (FCF) over several weeks.
  • Results indicated that TG and FCF improved significantly with treatment, suggesting that these global coagulation assays could serve as valuable indicators of emicizumab's effectiveness and contribute to more personalized treatment plans.
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Background: Storage of platelet concentrates (PCs) has an impact on platelet quality and possibly affects their functions after transfusion. The influence of processing and storage conditions of PCs on their in vivo function upon transfusion is unknown. One option for investigating this question is to implement an ex vivo labeling of human platelets, to analyze them after transfusion into heathy volunteers and/or patients.

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Procoagulant platelets are a subtype of activated platelets that sustains thrombin generation in order to consolidate the clot and stop bleeding. This aspect of platelet activation is gaining more and more recognition and interest. In fact, next to aggregating platelets, procoagulant platelets are key regulators of thrombus formation.

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  • Platelet activation involves changes like shape shifts and granule release, with epinephrine (EPI) enhancing activation from other stimulants but being a weak activator on its own.
  • A study tested how EPI interacts with platelet activators like convulxin and thrombin, observing that EPI boosts platelet aggregation while reducing procoagulant activity.
  • The findings show that higher doses of EPI limit calcium fluctuations in activated platelets, thus altering their reactivity and reducing their tendency to become procoagulant.
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  • Platelets are crucial for stopping bleeding (haemostasis) and their dysfunction can lead to hemorrhagic or clotting disorders (thrombocytopathies).
  • The review discusses traditional issues with platelets, including how they stick to each other and release chemicals in the blood.
  • It emphasizes the importance of studying procoagulant platelets—those that help blood clotting—when investigating potential platelet-related diseases.
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Knowledge on heparin-induced thrombocytopenia keeps increasing. Recent progress on diagnosis and management as well as several discoveries concerning its pathogenesis have been made. However, many aspects of heparin-induced thrombocytopenia remain partly unknown, and exact application of these new insights still need to be addressed.

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  • Glanzmann thrombasthenia (GT) patients have defective levels of a protein called GP IIb/IIIa, leading to difficulties in platelet aggregation.
  • A study examined the procoagulant abilities of GT patients' platelets using flow cytometry and found they generated more procoagulant COAT platelets compared to healthy individuals.
  • GT patients also showed higher cytosolic calcium levels during activation, suggesting a potential link between GP IIb/IIIa signaling and increased procoagulant activity.
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Procoagulant collagen-and-thrombin (COAT)-activated platelets represent a subpopulation of activated platelets, which retain a coat of prohemostatic proteins and express phosphatidylserine on their surface. Dichotomous intracellular signaling generating procoagulant platelet activity instead of traditional aggregating endpoints is still not fully elucidated. It has been demonstrated that secondary messengers such as calcium and sodium play a critical role in platelet activation.

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Factor XI (FXI) is a serine protease involved in the propagation phase of coagulation and in providing clot stability. Several mutations in the gene lead to FXI deficiency, a rare mild bleeding disorder. Current laboratory methods are unable to assess bleeding risk in FXI-deficient patients, because the degree of bleeding tendency does not correlate with plasma FXI activity as measured by routine coagulometric aPTT-based assays.

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  • FXI deficiency leads to unpredictable bleeding, and the study investigates how analyzing both tissue factor (TF)-dependent and -independent coagulation phases can improve diagnostics.
  • The research examined plasma samples from healthy individuals, FXI-deficient patients with varying bleeding phenotypes, and those who received FXI replacement to understand hemostasis.
  • Findings indicate that specific TF-independent coagulation parameters can effectively differentiate between FXI-deficient bleeders and non-bleeders, highlighting their potential for better clinical assessment and treatment management.
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  • Study explored the relationship between liver dysfunction biomarkers and thrombin generation in cirrhosis patients to evaluate bleeding risk assessment.
  • A total of 260 patients were analyzed, revealing that thrombin generation inhibition decreased significantly in patients with advanced liver dysfunction (Child-Pugh B and C).
  • The findings suggest that traditional coagulation parameters like PT/INR and aPTT may indicate thrombotic risk rather than bleeding risk in cirrhosis patients, which calls for alternative biomarkers for better assessment.
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The interaction of platelet agonists with their respective membrane receptors triggers intracellular signaling, among which cytosolic ion fluxes play an important role in activation processes. While the key contribution of intercellular free calcium is accepted, sodium and potassium roles in platelet activation have been less investigated in recent studies. Here, we implemented a novel flow-cytometric method to monitor over time cytosolic free calcium, sodium, and potassium ion fluxes upon platelet activation and we demonstrate the feasibility of real-time visualization of ion kinetics, in particular with a focus on sodium and potassium.

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Combined oral contraceptives and factor V Leiden mutation are multiplicative risk factors for venous thromboembolism. However, it remains unknown whether this multiplicative effect is reflected in thrombin generation assays. We report here the evolution of the thrombin generation profile while taking combined oral contraceptives and after their discontinuation in a woman with heterozygous factor V Leiden mutation.

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In the setting of liver cirrhosis (LC), profound hemostatic changes occur, which affect primary hemostasis, coagulation, and fibrinolysis. They involve prohemorrhagic and prothrombotic alterations at each of these steps. Patients with cirrhosis exhibit multifactorial thrombocytopenia and in vitro thrombocytopathy, counterbalanced by increased von Willebrand factor.

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Background: Routine laboratory methods are insensitive to hyper-coagulation, which may be detected by global hemostasis tests. Calibrated Automated Thrombogram (CAT) is a gold standard method to measure thrombin generation and coagulation potential. Thrombodynamics (TD) is a new global assay that monitors the spatio-temporal propagation of blood coagulation, separating initiation from amplification/propagation phases of coagulation and visualizing fibrin clot formation.

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Background: Thromboembolic disease is a potentially serious complication in bariatric surgery patients. Direct oral anticoagulants (DOAC) have been investigated in orthopedic surgery patients. DOAC data after bariatric surgery are still limited to the early postsurgical period.

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Article Synopsis
  • Collagen- and thrombin-activated platelets (COAT PLTs) enhance clotting at injury sites, with implications for stroke risk and bleeding disorders.
  • The study examined the effects of processing, pathogen inactivation, and storage on platelet concentrates from buffy coat, focusing on COAT PLT generation and reactivity.
  • Findings showed that the preparation and storage of platelet concentrates led to a significant reduction in COAT PLTs and impaired platelet response to certain stimulants, with minimal differences between treated and untreated samples.
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Aims: The circadian variation of platelet aggregation is well demonstrated. However, whether this has an impact on antiplatelet inhibition therapy is poorly documented. We aimed to observe whether ticagrelor-induced platelet inhibition follows a circadian rhythm.

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