Venous thromboembolism (VTE) remains the third most common cause of mortality among all cardiovascular diseases. Innate inflammatory mechanisms contribute to the pathogenesis of VTE. Toll-like receptors (TLRs) play pivotal roles in the innate immune system by detecting “danger signals”. Endogenous RNA has been identified as a potent procoagulant factor in thrombosis and may possibly act through TLR3. To investigate how eRNA mediate procoagulant effects through endothelial TLR3 in venous thrombosis. The FeCl 3 model was used to induce venous thrombosis in WT or TLR3 deficient (-/-) mice. A specific fluorescent probe for RNA (Syto RNA Select), RNase1, poly(I:C) or RNA extracted from murine endothelial cells (eRNA) were injected to mice. HUVECs were treated with poly(I:C) or eRNA extracted from HEK 293 cells in the presence of a TLR3 antagonist. Gene expression and signaling pathways activated were analyzed using western blot and real-time quantitative PCR. Turbidimetric measurement of plasma clot formation was performed by incubating HUVECs treated with poly(I:C) or eRNA with human plasma. We found that FeCl 3 promoted RNA release in vivo and increased the RNA content within the thrombus. RNase1 treatment reduced thrombus size compared to control mice. In contrast, eRNA and poly(I:C) treatment increased thrombus size in WT mice whereas no modifications were observed in TLR3-/- mice. Hence, poly(I:C) and eRNA treatments bolstered neutrophil infiltration in WT but not in TLR3-/- mice. In vitro, eRNA stimulated the release of CXCL5 in WT but not in TLR3-/- endothelial cells. In addition, eRNA enhanced plasma clot formation by downregulating thrombomodulin mRNA expression. These effects are mediated through NFkB activation. These results suggest that eRNA through TLR3 enhances neutrophil recruitment and clot formation leading to venous thrombosis.
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