{"title":"Red Blood Cells in Thrombosis: Active Participants in Clot Formation and Stability: A Systematic Review.","authors":"Amin A Alamin, Amar I O Yahia, Hatim M Hussien","doi":"10.1055/a-2552-9525","DOIUrl":null,"url":null,"abstract":"<p><p>Thrombosis, the formation of blood clots within blood vessels, has traditionally been attributed to platelets and clotting factors. Red blood cells (RBCs) play a significant role in thrombosis by impacting clot formation, stability, and fibrinolysis through mechanisms such as platelet margination, thrombin generation, and microvesicle release. However, their prothrombotic functions remain insufficiently studied. In this systematic review, which follows PRISMA guidelines, the aim is to explore how RBCs contribute to thrombus formation, stabilization, and resolution. This review analyzed peer-reviewed English-language studies and reviews on RBC involvement in thrombosis, focusing on clot formation, stability, and fibrinolysis. Studies in humans and relevant animal models were included, while case reports, non-English studies, and articles lacking methodological details were excluded. The research commenced in September 2024, utilizing PubMed, Scopus, SpringerLink, and Web of Science databases, with searches conducted up to that date. The risk of bias was assessed using the Newcastle-Ottawa Scale, and data were synthesized qualitatively. A total of 37 studies were included. RBCs contribute to thrombosis by influencing blood viscosity, interacting with platelets, and integrating into clots. Procoagulant activity induced by phosphatidylserine exposure and RBC-derived microvesicle products that promote thrombin generation and clot stability were also identified as key mechanisms. In conclusion, RBCs play an active role in thrombosis formation, contributing to clot formation and stability. Targeting RBC-mediated processes, such as aggregation, deformability, and microvesicle release, may offer novel strategies for thrombosis management. Further research and meta-analyses are needed to refine these therapeutic approaches.</p>","PeriodicalId":21673,"journal":{"name":"Seminars in thrombosis and hemostasis","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in thrombosis and hemostasis","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2552-9525","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
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Abstract
Thrombosis, the formation of blood clots within blood vessels, has traditionally been attributed to platelets and clotting factors. Red blood cells (RBCs) play a significant role in thrombosis by impacting clot formation, stability, and fibrinolysis through mechanisms such as platelet margination, thrombin generation, and microvesicle release. However, their prothrombotic functions remain insufficiently studied. In this systematic review, which follows PRISMA guidelines, the aim is to explore how RBCs contribute to thrombus formation, stabilization, and resolution. This review analyzed peer-reviewed English-language studies and reviews on RBC involvement in thrombosis, focusing on clot formation, stability, and fibrinolysis. Studies in humans and relevant animal models were included, while case reports, non-English studies, and articles lacking methodological details were excluded. The research commenced in September 2024, utilizing PubMed, Scopus, SpringerLink, and Web of Science databases, with searches conducted up to that date. The risk of bias was assessed using the Newcastle-Ottawa Scale, and data were synthesized qualitatively. A total of 37 studies were included. RBCs contribute to thrombosis by influencing blood viscosity, interacting with platelets, and integrating into clots. Procoagulant activity induced by phosphatidylserine exposure and RBC-derived microvesicle products that promote thrombin generation and clot stability were also identified as key mechanisms. In conclusion, RBCs play an active role in thrombosis formation, contributing to clot formation and stability. Targeting RBC-mediated processes, such as aggregation, deformability, and microvesicle release, may offer novel strategies for thrombosis management. Further research and meta-analyses are needed to refine these therapeutic approaches.
血栓形成，即血管内血栓的形成，传统上被认为是血小板和凝血因子造成的。红细胞（rbc）在血栓形成中发挥重要作用，通过血小板边缘、凝血酶生成和微囊泡释放等机制影响血栓形成、稳定性和纤维蛋白溶解。然而，它们的血栓前功能仍未得到充分研究。在这篇遵循PRISMA指南的系统综述中，目的是探讨红细胞如何促进血栓形成、稳定和溶解。本综述分析了同行评议的关于红细胞参与血栓形成的英文研究和评论，重点关注血栓形成、稳定性和纤维蛋白溶解。纳入了人类和相关动物模型的研究，排除了病例报告、非英语研究和缺乏方法学细节的文章。该研究于2024年9月开始，利用PubMed， Scopus， SpringerLink和Web of Science数据库，并进行了截至该日期的搜索。偏倚风险采用纽卡斯尔-渥太华量表进行评估，并对数据进行定性综合。共纳入37项研究。红细胞通过影响血液黏度、与血小板相互作用和整合成凝块来促进血栓形成。磷脂酰丝氨酸暴露诱导的促凝活性和红细胞衍生的微泡产物促进凝血酶的生成和凝块稳定性也被确定为关键机制。综上所述，红细胞在血栓形成中起着积极的作用，有助于血栓的形成和稳定。靶向红细胞介导的过程，如聚集性、变形性和微泡释放，可能为血栓形成管理提供新的策略。需要进一步的研究和荟萃分析来完善这些治疗方法。
期刊介绍：
Seminars in Thrombosis and Hemostasis is a topic driven review journal that focuses on all issues relating to hemostatic and thrombotic disorders. As one of the premiere review journals in the field, Seminars in Thrombosis and Hemostasis serves as a comprehensive forum for important advances in clinical and laboratory diagnosis and therapeutic interventions. The journal also publishes peer reviewed original research papers.
Seminars offers an informed perspective on today''s pivotal issues, including hemophilia A & B, thrombophilia, gene therapy, venous and arterial thrombosis, von Willebrand disease, vascular disorders and thromboembolic diseases. Attention is also given to the latest developments in pharmaceutical drugs along with treatment and current management techniques. The journal also frequently publishes sponsored supplements to further highlight emerging trends in the field.
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