title: Air pollution-associated procoagulant changes: the role of  circulating microvesicles.
abstract: BACKGROUND
  Epidemiological studies suggest an association between exposure to particulate matter (PM) in air pollution and the risk of venous thromboembolism (VTE).
  
  
  OBJECTIVE
  To investigate the underlying pathophysiological pathways linking PM exposure and VTE.
  
  
  METHODS
  We assessed potential associations between PM exposure and coagulation and inflammation parameters, including circulating microvesicles, in a group of 233 patients with diabetes.
  
  
  RESULTS
  The numbers of circulating blood platelet-derived and annexin V-binding microvesicles were inversely associated with the current levels of PM(2.5) or PM(10), measured on the day of sampling. Recent past exposure to PM(10), up to 1 week prior to blood sampling, estimated at the patients' residential addresses, was associated with elevated high-sensitivity C-reactive protein (CRP), leukocytes and fibrinogen, as well as with tissue factor (TF)-dependent procoagulant changes in thrombin generation assays. When longer windows of past exposure were considered, up to 1 year preceding blood sampling, procoagulant changes were evident from the strongly increased numbers of red blood cell-derived circulating microvesicles and annexin V-binding microvesicles, but they no longer associated with TF. Past PM exposure was never associated with activated partial thromboplastin time (aPTT), prothrombin time (PT), or factor (F) VII, FVIII, FXII or D-dimers. Residential distance to a major road was only marginally correlated with procoagulant changes in FVIII and thrombin generation.
  
  
  CONCLUSIONS
  Increases in the number of microvesicles and in their procoagulant properties, rather than increases in coagulation factors per se, seem to contribute to the risk of VTE, developing during prolonged exposure to air pollutants.
authors: Center for Molecular and Vascular Biology, Unit of Lung Toxicology, University of Leuven, Leuven, Belgium.
authors: J
authors: J
authors: Emmerechts
authors: L
authors: L
authors: Jacobs
authors: S
authors: S
authors: Van Kerckhoven
authors: S
authors: S
authors: Loyen
authors: C
authors: C
authors: Mathieu
authors: F
authors: F
authors: Fierens
authors: B
authors: B
authors: Nemery
authors: T S
authors: TS
authors: Nawrot
authors: Marc F
authors: MF
authors: Hoylaerts
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D055252:Cell-Derived Microparticles / Q000502:physiology*; D003920:Diabetes Mellitus / Q000097:blood; D006801:Humans; D007249:Inflammation; D019851:Thrombophilia / Q000209:etiology; D054556:Venous Thromboembolism / Q000209:etiology