Oxidative stress-induced fibrinogen modifications in liver transplant recipients: unraveling a novel potential mechanism for cardiovascular risk

肝移植受者氧化应激诱导的纤维蛋白原修饰:揭示心血管风险的新潜在机制

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作者:Stefano Gitto, Claudia Fiorillo, Flavia Rita Argento, Eleonora Fini, Serena Borghi, Margherita Falcini, Davide Roccarina, Rosario La Delfa, Ludovica Lillo, Tommaso Zurli, Paolo Forte, Davide Ghinolfi, Paolo De Simone, Francesca Chiesi, Angelica Ingravallo, Francesco Vizzutti, Silvia Aspite, Giacomo

Background

Cardiovascular events represent a major cause of non-graft-related death after liver transplant. Evidence suggest that chronic inflammation associated with a remarkable oxidative stress in the presence of endothelial dysfunction and procoagulant environment plays a major role in the promotion of thrombosis. However, the underlying molecular mechanisms are not completely understood. Objectives: In order to elucidate the mechanisms of posttransplant thrombosis, the

Conclusion

ROS-induced fibrinogen structural changes might increase the risk of thrombosis in liver transplant recipients.

Methods

A case-control study was conducted on 40 clinically stable liver transplant recipients and 40 age-matched, sex-matched, and risk factor-matched controls. Leukocyte reactive oxygen species (ROS) production, lipid peroxidation, glutathione content, plasma antioxidant capacity, fibrinogen oxidation, and fibrinogen structural and functional features were compared between patients and controls.

Results

Patients displayed enhanced leukocyte ROS production and an increased plasma lipid peroxidation with a reduced total antioxidant capacity compared with controls. This systemic oxidative stress was associated with fibrinogen oxidation with fibrinogen structural alterations. Thrombin-catalyzed fibrin polymerization and fibrin resistance to plasmin-induced lysis were significantly altered in patients compared with controls. Moreover, steatotic graft and smoking habit were associated with high fibrin degradation rate.

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