NEUTROPHIL EXTRACELLULAR TRAPS` IMPACT ON PLASMA CLOTTING AND FIBRINOLYSIS IN COLON CANCER PATIENTS IN VITRO
The aim of the study. We aimed to assess NETs affect on plasma coagulation/fibrinolysis processes and to determine tissue factor and neutrophil elastase plasma levels in colon cancer patients in vitro. Materials and methods. We used experimental in vitro models of isolated intact and PMA-activated (NETotic) neutrophils suspended in autoplasma. Coagulation properties, fibrinolytic potential, levels of tissue factor and neutrophil elastase were measured in each sample. The study was performed using methods of spatiotemporal dynamics of a fibrin clot formation, Astrup`s fibrin plates and ELISA (for quantitative analysis). Results. Hypercoaguability state of varying degrees was observed in both control and patients groups, however activated cells impact on indicated parameters proved to be different in patients and in healthy volunteers. Fibrin plates lysis area was the largest in both intact and activated patients neutrophils when comparing with control. We did not observe significant dependence between tissue factor or elastase levels shifts and thrombodynamics parameters in tested plasma samples. Conclusion. NETs could interact with cellular and plasma-derived components of haemostatic system thus localizing them in the sites of thrombus formation and facilitating subsequent fibrinolysis. There is chronic hypercoaguability state in cancer patients even with normal standart coagulation tests, that was confirmed by the given experiment and corresponds clinical observations. The absence of significant difference between NETs- and control-plasma samples suggests high in vivo netosis level, impaired neutrophils PMA-response and the influence of supplementary, NETs- level independend factors providing hypercoaguability in cancer patients