Increased production of procoagulant activity (tissue factor) by human peripheral blood monocytes after Intralipid® infusion

Abstract

Intralipid® can produce functional and structural changes in the mononuclear phagocyte system. We have investigated the effect of Intralipid® on the capacity of peripheral blood human monocytes to produce procoagulant activity when incubated in short term cultures. Twenty-three patients were studied before and after a single infusion of Intralipid® 10%. Procoagulant activity was measured on isolated mononuclear cells after incubation (4 h at 37°C) with and without endotoxin, using a one-stage clotting assay. Mononuclear cells obtained after Intralipid® infusion produced significantly increased procoagulant activity as compared to their pre-infusion control samples (p < 0.005). Similar results were obtained when freshly collected whole blood was incubated with and without endotoxin (4 h at 37°C) and procoagulant activity was measured on subsequently isolated mononuclear cells (p < 0.005). In all instances procoagulant activity was identified as tissue factor. Patients in the need of Intralipid® are often at increased risk for thromboembolic complications and/or disseminated intravascular coagulation because of malignant disease, surgery or infection and there is evidence that the procoagulant activity of mononuclear phagocytes could play a major role in these processes. Our findings suggest that Intralipid® might cause a further accentuation of the thrombotic tendency as a result of increased procoagulant activity.