Ranking the contributing risk factors in venous thrombosis in terms of therapeutic potential: Virchow's triad revisited.
OBJECTIVE
Thromboemoblism is an attendant feature of a variety of pathological conditions. We reconsidered Virchow's pathogenetic triad of stasis, humoral factors and vascular wall pathologies in the light of platelet behavior in vivo.


METHODS
Rat mesenteric microcirculation was examined by intravital microscopy. After isolated rat platelets had been injected i.v. into rats, their behavior in venules was examined under the following conditions: stasis from pressure, hemoconcentration from erythropoietin injections, or endothelial damage from tumor necrosis factor-alpha.


RESULTS
In the endothelial damage group, platelets displayed transient adhesion and rolling, while some platelets exhibited stationary adhesion to venular endothelium. The stasis and hemoconcentration groups exhibited only a slight change in adhesive response.


CONCLUSIONS
Endothelial dysfunction appears to be the most important contributing factor in the development of venous thrombosis. As such, targeting this dysfunction is suggested for therapeutic intervention.
Kiyomura
Masaki
M
Department of Obstetrics and Gynecology, Ehime University School of Medicine, Ehime, Japan.
Katayama
Tomihiro
T
Kusanagi
Yasuki
Y
Ito
Masaharu
M
D000818:Animals; D001792:Blood Platelets / Q000502:physiology; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology; D004912:Erythrocytes / Q000502:physiology; D018056:Hemorheology; D008297:Male; D010973:Platelet Adhesiveness; D051381:Rats; D017208:Rats, Wistar; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000494:pharmacology; D020246:Venous Thrombosis / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D014699:Venules / Q000473:pathology
D014409:Tumor Necrosis Factor-alpha