The intestinal microbiome potentially affects thrombin generation in human subjects

Date

2019

Authors

Mohammed, Yassene
Kootte, Ruud S.
Kopatz, Wil F.
Borchers, Christoph H.
Büller, Harry R.
Versteeg, Henri H.
Nieuwdorp, Max
van Mens, Thijs E.

Journal Title

Journal ISSN

Volume Title

Publisher

Journal of Thrombosis and Haemostasis

Abstract

Background: The intestinal microbiome plays a versatile role in the etiology of arterial thrombosis. In venous thrombosis, driven chiefly by plasma coagulation, no such role has yet been established. We hypothesized that the intestinal microbiome composition affects coagulation in humans. Methods: We used healthy donor fecal microbiota transplant (FMT) to experimentally change the microbiome composition in metabolic syndrome patients. Thirty‐five subjects were randomized in a blinded fashion to healthy donor FMT or autologous FMT as a control in a 2:1 ratio. We measured thrombin generation at baseline and after 6 weeks using automated calibrated thrombinography, and we determined plasma abundance of 32 coagulation related proteins using a targeted mass spectrometry‐based quantitative proteomics assay with heavy labeled internal standards. Results: Healthy donor FMT prolonged the thrombinography lag time (median delta 0.0 versus 0.25 minutes, P = .039). The other thrombinography parameters showed no significant difference. Unsupervised cluster analysis suggested overall downregulation of coagulation related plasma proteins in subject clusters containing predominantly subjects that had a metabolic response to healthy donor FMT. FMT treatment status itself showed no clear clustering pattern with up‐ or downregulation, however, and proteins did not cluster according to an apparent biological grouping. Discussion: A single healthy donor FMT tends to modestly suppress the onset thrombin generation in metabolic syndrome patients, representing initial proof‐of‐principle that the intestinal microbiota composition might affect the coagulation system in humans. The findings merit external validation as a role for intestinal microbiota in coagulation can have clinically important implications.

Description

Keywords

coagulation, fecal microbiota transplant, intestinal microbiome, metabolic syndrome, thrombin generation, thrombosis

Citation

Mohammed, Y., Kootte, R. S., Kopatz, W. F., Borchers, C. H., Büller, H. R., Versteeg, H. H., Nieuwdorp, M., & van Mens, T. E. (2019). The intestinal microbiome potentially affects thrombin generation in human subjects. Journal of Thrombosis and Haemostasis, 18(3), 642-650. https://doi.org/10.1111/jth.14699.