The role of microparticles in coagulation changes in patients with hereditary spherocytosis

Introduction. Hereditary spherocytosis is a congenital disease the pathogenesis of which is based on the abnormalities of proteins in the erythrocyte membrane, resulting in impaired membrane permeability and elasticity. During the circulation in the blood flow, the surface to volume ratio of the red blood cell is disturbed, and the erythrocyte acquires a spherical shape. After passing through small capillaries, parts of the membrane, microparticles, are “laced off” from the red blood cell. There is a perception that one of the mechanisms of the development of hypercoagulation leading to thromboembolism in patients with hemolysis is the contribution of procoagulant microparticles. Indeed, the microparticles that have separated from the erythrocyte rapidly become adenosine triphosphate-free, resulting in the loss of asymmetric lipid distribution in the microparticle membrane. Phosphatidylserine, a factor important for blood clotting, is exposed on the outside surface of the microparticle. Aim: to investigate microparticles in the patients with hereditary spherocytosis. Materials and methods. Microparticles were assessed using flow cytometry; procoagulant (phosphatidylserine-positive) microparticles were labeled with annexin V, and erythrocyte microparticles were labeled with antibodies to glycophorin A. Coagulation state in the patients was assessed using activated partial thromboplastin time and thrombodynamics. Results. It has been shown that the number of procoagulant microparticles increases during hemolytic crisis in children with hereditary spherocytosis, which leads to hypercoagulation. It was detected using a global hemostasis assay, thrombodynamics. The increased number of microparticles is one of the possible mechanisms underlying blood clotting disorders. At the same time, the procoagulant properties of microparticles isolated from the blood of the patients with spherocytosis did not differ from those of microparticles isolated from the blood of healthy donors. Conclusion. Presumably, an increased number of microparticles can be considered a biomarker of cell damage and prothrombotic conditions.