interleukin-8 and Thrombophilia

The hypercoagulable state associated with malignancy is well described. However, the mechanisms by which tumors cause this hypercoagulable state are yet to be fully understood. This review summarizes the available literature of human and animal studies examining NETs and cancer-associated thrombosis. The methods for detecting and quantifying NET formation are growing but are not yet standardized in practice. Furthermore, it is important to distinguish between measuring neutrophil activation and NET formation, as the former can be present without the latter. Citrullination of histones by peptidylarginine deiminase 4 (PAD4) is considered one of the key pathways leading to NET formation. Cancer cells can prime neutrophils toward NET formation through the release of soluble mediators, such as interleukin-8, and activation of platelets, and may cause excess NET formation. Dismantling NETs through exogenous deoxyribonuclease has been shown to degrade NETs and reduce thrombus formation in vitro but may simultaneously release prothrombotic NET components, such as DNA and histones. Inhibiting PAD4 is far from clinical trials, but animal models show promising results with a potentially favorable safety profile. Interestingly, results from animal studies suggest that several therapies approved for other indications, such as interleukin-1 receptor blockade and JAK inhibition, may mitigate excessive NET formation or the prothrombotic effects of NETs in cancer. It is yet to be determined if inhibition of NET formation reduces cancer-associated thrombosis also in the clinical setting.

Topics: Animals; Deoxyribonucleases; DNA; Extracellular Traps; Histones; Humans; Interleukin-8; Neoplasms; Neutrophils; Protein-Arginine Deiminases; Receptors, Interleukin-1; Thrombophilia; Thrombosis

Immunological status, levels of pro-inflammatory cytokines of non-specific resistance and tumor expression factor have been studied in patients with cervical dysplasia or cancer versus stage. Slight and moderate dysplasia involved virtually no changes in interleukin-8 (Il-8) and tumor necrotic factor TNF-alpha concentrations whereas those of Il-1 alpha and Il-1 beta were 5 times as high. Monocyte-dependent expression of tissue factor was similar to that in healthy women. In cases of advanced dysplasia and cervical carcinoma, monocyte-dependent expression of tissue factor and production of Il-1 alpha, Il-1 beta, Il-8 and TNF-alpha were significantly enhanced. Patients with cervical carcinoma stage II and III revealed signs of depression of the cellular component of immunity as well as non-specific resistance. Hence, increased concentrations of cytokines induce monocyte-dependent expression of tissue factor in advanced dysplasia and cervical carcinoma by triggering-on of hypercoaggulation.

Topics: Adult; Cytokines; Female; Gene Expression Regulation, Neoplastic; Humans; Interleukin-1; Interleukin-8; Middle Aged; Neoplasm Staging; Thrombophilia; Thromboplastin; Tumor Necrosis Factor-alpha; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms

Thrombosis is a life-threatening complication that occurs in a subset of patients with heparin-induced thrombocytopenia (HITT). The pathogenic mechanisms underlying the variable occurrence of thrombosis in HITT is poorly understood. It was hypothesized that monocyte activation leading to tissue factor expression may play a role in promoting a thrombogenic state in HITT. This study demonstrates that a human platelet factor 4 (PF4)/heparin-specific murine monoclonal antibody (KKO) binds to peripheral blood-derived human monocytes in a PF4-dependent manner. KKO and antibodies from patients with HITT induce monocytes to synthesize and secrete interleukin-8 and induce cell-surface procoagulant activity, which is abrogated following treatment with antihuman tissue factor antibody. The findings suggest a novel mechanism by which PF4/heparin antibodies may promote a hypercoagulable state in patients with HITT. (Blood. 2001;98:1252-1254)

Topics: Antibodies, Monoclonal; Autoantibodies; Coagulants; Heparin; Humans; Interleukin-8; Monocytes; Platelet Factor 4; Thrombocytopenia; Thrombophilia; Thromboplastin; Thrombosis