Stop the Clot Campaign

Blood clots are a major cause of disease. It may cause heart attacks, strokes and thrombosis (blockage of blood vessels). In your blood, you have small particles, called platelets. Also, in the watery part of your blood, called the plasma, you have plasma proteins circulating in the blood. Platelets and these plasma proteins work together and are in equilibrium if you are healthy. Your body sometimes needs the platelets and plasma proteins to react on events that disrupt the homeostasis* (for definition see previous blogs) (balance of the body). An example of this may be a small wound to your skin or even inside your body. A blood clot forms when platelets and plasma proteins form a small plug consisting of activated platelets and plasma proteins that after a trigger, form a meshwork or network of fine fibers to cover the damaged area. During normal homeostasis the body will break down the clot area and this is called lyses. If we smoke, have too mutch stress or high blood pressure and cholestrol, it will disturb our balance or general homeostasis. This will cause clots to form excessively or without a definite trigger. Also, these clots may then break down less effectively. This may trigger the clot to break loose and this may lead to heart attacks and stroke, depending where the clot is formed. Smoking is one of the major triggers for disruption in your homeostasis. Lets start a campaign to STOP THE CLOT by spreading our science knowledge!

Smoking and sticky fibrin fibers

We all know that smoking is bad for our health. However, do you know that research has proven that it also impacts on your coagulation system, and therefore on hemostasis and balance of your body? We know that smoking has a very visible effect on your skin. Perhaps not when you are in your twenties, but look at women particularly who have been smoking for ten years of longer. Unfortuanately, smoking impacts greatly on your platelets and fibrin networks. Researchers that have shown the impact of smoking on the coagulation system include:

Armani et at., in the journal Current Pharmacy, 2009; 15:1038 -1053 http://www.ncbi.nlm.nih.gov/pubmed/19355946

Erhardt et al., in the journal Artherosclerosis, 2009; 205: 23-32

http://www.ncbi.nlm.nih.gov/pubmed?term=Erhardt%20L.%20Cigarette%20smoking%3A%20an%20undertreated%20risk%20factor%20for%20cardiovascular%20disease

In research conducted by my research team at the University of Pretoria in 2010, we looked at how smoking affects the fibrin networks of healthy individuals who smoke (under ethical clearance). We drew blood from these individuals and sentrifuged the sample (this means we spinned the blood very vast in a machine called a centrifuge). We obtained plasma, which is the watery part of the blood.In the plasma, we find the plasma proteins and platelets that play a role in normal coagulation. In the body, if the coagulation cascade is triggered by e.g. damage to a small vessel inside the body, fibrin fibers will form. This is a natural process that will occur in all healthy individuals. In the body this network formations is facilitated by a special protein called thrombin. If we add thrombin to the plasma in the lab, we will mimic this fibrin creation process that will spontanously happen in the body when we have a small injury to e.g. a blood vessel. Therefore, if we add thrombin to the blood of a smoker, we can see how the smokers coagulation process via the fibrin networks, will look like. We use an electron microscope to view the fibers, as it is a very powerful instrument that can magnify up to a million times!

We found something very interesting when looking at the fibrin fibers of smokers. Their fibers seem to be sticking together and we coined a term: sticky fiber phenomenon when you smoke. What does this mean to your health? When you smoke, the toxins that you take in, affects the proteins in your plasma, and when you have a small injury e.g. in a blood vessel, you will form abnormally sticky fibrin networks. You may even perhaps spontanously form these thickened nets in your circulating blood. These thickened nets may struggle to break down by the normal process called lyses. If these thickened masses break loose it may cause you to have stroke or thrombosis. Unfortuanately, it is well-known that smoking causes stroke and thrombosis. This research was published in the journal Ultrastructural Pathology in 201o by Pretorius and co workers.

http://www.ncbi.nlm.nih.gov/pubmed?term=Smoking%20and%20coagulation%3A%20the%20sticky%20fibrin%20phenomenon

See the electron microscopy photo of a sticky fiber mass generated from the plasma of a smoker.

Your body, hemostasis and equilibrium

One of the most important functions of our body to keep us healthy, is to be in total equilibrium or balance. Therefore, all our systems must function in sinc with each other. An important part of this balance, is the functioning of our coagulation system. A simple definition for our coagulation system is how our blood reacts inside our body. We need a fine balance between bleeding and clotting. This process of is dependant on different pathways in our body that invloves small particles, called blood platelets and molecules that circulate in our blood plasma - the watery part of our blood. If we have a small wound after hurting ourselves, our platelets and plasma proteins will undergo a natural process of coagulation to try to prevent too much blood loss. This will result in a cascade of reactions that will form small thread-like fibers, that we call fibrin fibers. These fibers form nets over the wound to prevent further blood loss. You can see the nets in the electron microscope photo added to the post. After the formation of the nets, we need to lyse or break up the fibers again, especially if these fiber form inside our bodies, otherwise we form blood clots. So, you can see that we need a fine balance between formation of fibirn nets and breaking up of these nets. If our bodies do not for fibrin nets during injury, we may bleed too much and if our bodies do not break the nets up successfully, our equilibirum or balance is impaired. This may cause thrombosis, heart attacks and general bad health. Sometimes, external factors in a healthy individual, can cause a disturbance of equilibrium of this hemostasis. An example of this is smoking. In my next post I will discuss research that shows how smoking disturbes the coagulation system. Lets make sense of science!