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High mobility group box 1 derived mainly from platelet microparticles exacerbates microvascular obstruction in no reflow

  • Xinyi Zhao
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Ministry of Education, Heilongjiang Province, Harbin, China
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  • Jianbin Han
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Ministry of Education, Heilongjiang Province, Harbin, China
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  • Lijin Zhou
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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  • Jinjin Zhao
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Ministry of Education, Heilongjiang Province, Harbin, China
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  • Meijiao Huang
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Ministry of Education, Heilongjiang Province, Harbin, China
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  • Yueqing Wang
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Ministry of Education, Heilongjiang Province, Harbin, China
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  • Junjie Kou
    Correspondence
    Corresponding authors at: Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Ministry of Education, Heilongjiang Province, Harbin, China
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  • Yan Kou
    Correspondence
    Corresponding authors at: Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
    Affiliations
    Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China

    The Key Laboratory of Myocardial Ischemia, Ministry of Education, Heilongjiang Province, Harbin, China
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  • Jiaqi Jin
    Correspondence
    Correspondence to: J. Jin, Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
    Affiliations
    The Key Laboratory of Myocardial Ischemia, Ministry of Education, Heilongjiang Province, Harbin, China

    Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Published:December 17, 2022DOI:https://doi.org/10.1016/j.thromres.2022.12.003

      Abstract

      Introduction

      No reflow manifests coronary microvascular injury caused by continuous severe myocardial ischemia and reperfusion. Microvascular obstruction (MVO) has emerged as one fundamental mechanism of no reflow. However, the underlying pathophysiology remains incompletely defined. Herein, we explore the contribution of high mobility group box 1 (HMGB1), derived mainly from platelet microparticles exacerbating MVO in no reflow.

      Materials and methods

      44 STEMI patients undergoing successful primary percutaneous coronary intervention (PCI) were included in our study. Plasma HMGB1 levels in both the peripheral artery (PA) and infarct-related coronary artery (IRA) were measured by ELISA. Flow cytometry and confocal microscopy assessed the level of HMGB1+ platelet derived microparticles (PMPs) and platelet activation. Flow cytometry and western blot evaluated the procoagulant activity (PCA) and the release of inflammatory factors of human microvascular endothelial cells (HCEMCs).

      Results

      HMGB1 levels were significantly higher in the IRA in no-reflow patients. The levels of HMGB1+ PMPs were considerably higher in the IRA of patients with no reflow and were strongly associated with platelet activation. Moreover, our results show that HMGB1 interacts with human microvascular endothelial cells primarily through TLR4, inducing HCMEC proinflammatory, procoagulant phenotype, and monocyte recruitment, accelerating microvascular obstruction and facilitating the development of no reflow.

      Conclusion

      Our results illustrate a novel mechanism by which HMGB1, derived mainly from PMPs, plays a crucial role in the pathogenesis of no-reflow, revealing a novel therapeutic target.

      Keywords

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