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Emerging Technologies for the Assessment and Treatment of Hemostasis (Bleeding...
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Emerging Technologies for the Assessment and Treatment of Hemostasis (Bleeding and/or Thrombosis) Disorders

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (20 March 2025) | Viewed by 11173

Special Issue Editor

Dr. Emmanuel Favaloro

E-Mail Website
Guest Editor
Department of Haematology, Institute of Clinical Pathology and Medical Research (ICPMR), Sydney Centres for Thrombosis and Haemostasis, NSW Health Pathology, Westmead Hospital, Westmead, NSW 2145, Australia
Interests: hemostasis/haemostasis; thrombosis; von willebrand factor/VWF; von willebrand disease/VWD; coagulation; platelet function; thrombophilia; lupus anticoagulant; antiphospholipid antibodies

Special Issue Information

Dear Colleagues,

The field of hemostasis and thrombosis is continually advancing. In this Special Issue, we will explore emerging technologies in the field related to both the assessment and treatment of associated disorders. Hemostasis is a homeostatic mechanism that helps to maintain blood flow in the circulation and to prevent bleeding; thus, imbalance or dysfunction in this process can lead to adverse bleeding or thrombosis. In either case, patients with suspected thrombosis or bleeding can be investigated via a multitude of approaches and methods, and treatment or therapy can also be achieved using a variety of approaches and management tools. In this issue, we wish to explore the current state of the art. For example, historical approaches to managing hemophilia were largely restricted to replacement therapy using plasma-derived factor concentrates. Nowadays, there is a plethora of options in addition to plasma-derived factor concentrates, including replacement with recombinant factors, extended life factor products and nonfactor replacement therapies that mimic the activity of the missing factors. In terms of the assessment of hemophilia and hemophilia therapy, the past practice involved one-stage factor clotting assays. In contemporary times, this has been expanded to the use of various chromogenic assays, which can be specifically tailored, to measuring either the replacement factor products or the alternate therapies, to other procedures such as thrombin generation. In terms of thrombosis management, the armamentarium was once restricted to heparin, warfarin and aspirin. The available tools for this purpose have since been extended, first with the emergence of direct oral anticoagulants (DOACs), and currently with many novel products under investigation. Against this background, high-quality submissions related to the contemporary and emerging assessment (clinical and/or laboratory) and treatment/management of bleeding or thrombosis disorders will be considered for this Special Issue.

Dr. Emmanuel Favaloro
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

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Published Papers (3 papers)

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23 pages, 7704 KiB  
Review
Shear Stress and Endothelial Mechanotransduction in Trauma Patients with Hemorrhagic Shock: Hidden Coagulopathy Pathways and Novel Therapeutic Strategies
by Athanasios Chalkias
Int. J. Mol. Sci. 2023, 24(24), 17522; https://doi.org/10.3390/ijms242417522 - 15 Dec 2023
Cited by 12 | Viewed by 3396
Abstract
Massive trauma remains a leading cause of death and a global public health burden. Post-traumatic coagulopathy may be present even before the onset of resuscitation, and correlates with severity of trauma. Several mechanisms have been proposed to explain the development of abnormal coagulation [...] Read more.
Massive trauma remains a leading cause of death and a global public health burden. Post-traumatic coagulopathy may be present even before the onset of resuscitation, and correlates with severity of trauma. Several mechanisms have been proposed to explain the development of abnormal coagulation processes, but the heterogeneity in injuries and patient profiles makes it difficult to define a dominant mechanism. Regardless of the pattern of death, a significant role in the pathophysiology and pathogenesis of coagulopathy may be attributed to the exposure of endothelial cells to abnormal physical forces and mechanical stimuli in their local environment. In these conditions, the cellular responses are translated into biochemical signals that induce/aggravate oxidative stress, inflammation, and coagulopathy. Microvascular shear stress-induced alterations could be treated or prevented by the development and use of innovative pharmacologic strategies that effectively target shear-mediated endothelial dysfunction, including shear-responsive drug delivery systems and novel antioxidants, and by targeting the venous side of the circulation to exploit the beneficial antithrombogenic profile of venous endothelial cells. Full article
(This article belongs to the Special Issue Emerging Technologies for the Assessment and Treatment of Hemostasis (Bleeding and/or Thrombosis) Disorders)
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19 pages, 703 KiB  
Review
The Fibrinolytic System and Its Measurement: History, Current Uses and Future Directions for Diagnosis and Treatment
by Christine Lodberg Hvas and Julie Brogaard Larsen
Int. J. Mol. Sci. 2023, 24(18), 14179; https://doi.org/10.3390/ijms241814179 - 16 Sep 2023
Cited by 25 | Viewed by 6175
Abstract
The fibrinolytic system is a key player in keeping the haemostatic balance, and changes in fibrinolytic capacity can lead to both bleeding-related and thrombosis-related disorders. Our knowledge of the fibrinolytic system has expanded immensely during the last 75 years. From the first successful [...] Read more.
The fibrinolytic system is a key player in keeping the haemostatic balance, and changes in fibrinolytic capacity can lead to both bleeding-related and thrombosis-related disorders. Our knowledge of the fibrinolytic system has expanded immensely during the last 75 years. From the first successful use of thrombolysis in myocardial infarction in the 1960s, thrombolytic therapy is now widely implemented and has reformed treatment in vascular medicine, especially ischemic stroke, while antifibrinolytic agents are used routinely in the prevention and treatment of major bleeding worldwide. Despite this, this research field still holds unanswered questions. Accurate and timely laboratory diagnosis of disturbed fibrinolysis in the clinical setting remains a challenge. Furthermore, despite growing evidence that hypofibrinolysis plays a central role in, e.g., sepsis-related coagulopathy, coronary artery disease, and venous thromboembolism, there is currently no approved treatment of hypofibrinolysis in these settings. The present review provides an overview of the fibrinolytic system and history of its discovery; measurement methods; clinical relevance of the fibrinolytic system in diagnosis and treatment; and points to future directions for research. Full article
(This article belongs to the Special Issue Emerging Technologies for the Assessment and Treatment of Hemostasis (Bleeding and/or Thrombosis) Disorders)
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Other

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13 pages, 2771 KiB  
Case Report
Acquired Hemophilia Associated with Rheumatoid Arthritis: A Case Report and Review of the Literature
by Chiara Gioia, Marino Paroli, Valentina Morace, Lucrezia Nardacci, Sara Martina Ruffo, Elisabetta Rossi, Pasquale Pignatelli and Daniele Accapezzato
Int. J. Mol. Sci. 2025, 26(8), 3628; https://doi.org/10.3390/ijms26083628 - 11 Apr 2025
Viewed by 657
Abstract
A 63-year-old woman with rheumatoid arthritis and Hashimoto’s thyroiditis was admitted to the emergency room, because of left leg pain associated with spontaneous subcutaneous hematomas, for 15 days. Their symptoms also occurred after the discontinuation of aspirin, which the patient had taken for [...] Read more.
A 63-year-old woman with rheumatoid arthritis and Hashimoto’s thyroiditis was admitted to the emergency room, because of left leg pain associated with spontaneous subcutaneous hematomas, for 15 days. Their symptoms also occurred after the discontinuation of aspirin, which the patient had taken for a previous case of ocular papillitis. Laboratory tests showed anemia, a normal platelet count, but a prolonged activated partial thromboplastin time (aPTT) ratio; a computerized tomography scan of the left lower limb detected a recent hematoma in the left lateral rectus muscle, and subcutaneous soft tissue edema also involving the knee, without vascular involvement. Coagulation tests were performed showing normal levels of Lupus Anticoagulant, very low-factor FVIII activity (2.2%), normal FIX, FXI, and FXII activity, and the detection of FVIII inhibitors by a Bethesda assay (7.6 U). A diagnosis of acquired hemophilia A (AHA) was made, and hemostatic and immunosuppressive treatment was immediately started (activated prothrombin complex concentrates and methylprednisolone). Malignancies and infections were excluded. An autoantibodies panel confirmed the positivity to rheumatoid factor and anti-cyclic citrullinated peptide antibodies. In treatment, the patient did not present any new bruises, with aPTT normalizing, FVIII increasing, and inhibitors reducing until disappearance. A close follow-up continued every 1–2 week after discharge, with hemostatic treatment discontinuation and methylprednisolone decalage. Underlying autoimmune conditions induced this rare, autoimmune and life-threating disorder. Full article
(This article belongs to the Special Issue Emerging Technologies for the Assessment and Treatment of Hemostasis (Bleeding and/or Thrombosis) Disorders)
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