Discover the groundbreaking synergy between red blood cells and tranexamic acid that’s revolutionizing our approach to inhibiting fibrinolysis in tropical medicine.
– by James
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Synergism of red blood cells and tranexamic acid in the inhibition of fibrinolysis.
Raska et al., J Thromb Haemost 2023
DOI: 10.1016/j.jtha.2023.11.009
Enhanced Anti-fibrinolytic Effect of Tranexamic Acid with Red Blood Cells
The study investigates the interaction between red blood cells (RBCs) and tranexamic acid (TXA) in preventing fibrinolysis, which is relevant for treating post-partum haemorrhage (PPH). PPH is a major cause of maternal mortality, and the WOMAN trial has previously shown that TXA can reduce PPH deaths. The ongoing WOMAN-2 trial is further exploring TXA’s preventive potential in anemic women.
Key findings include:
- The anti-fibrinolytic potency of TXA (4-128 μM) is increased by 10-40% v/v RBCs.
- Global fibrinolysis assays indicate that the combined effect of RBCs and TXA on inhibiting fibrinolysis is approximately 15% greater than their individual effects.
- TXA consistently adds the same level of inhibition to the effect of RBCs on plasminogen activation, regardless of the RBC count in the clot.
- TXA thickens fibrin fibers, which hinders plasminogen activation, while RBCs create finer fibers that are more resistant to plasmin.
This research is important as it suggests that TXA’s effectiveness in preventing PPH could be enhanced in anemic patients due to the interaction with RBCs. This could contribute to the development of more effective treatments for PPH, particularly in women with anaemia.
The study contributes to the current literature by elucidating the synergistic effects of RBCs and TXA on fibrinolysis, which could inform clinical practices and improve outcomes for patients at risk of PPH.