Associate Professor Vera Ignjatovic, Haematology Research
October 13th marks two milestones: the second World Thrombosis Day and the birthday of Rudolf Virchow, born on this day in 1821. Virchow was a German doctor who first described factors involved in thrombosis (blood clotting) and whose ideas still have value today.
World Thrombosis Day is important because blood is an essential player in the symphony orchestra of life. While the heart is busy conducting, blood is that magical instrument player that is constantly in motion and relentlessly transporting oxygen and nutrients to all parts of the body, while simultaneously directing waste products to kidneys.
Most of us have seen the way our blood clots after a scrape on our knee when we were kids. In this sense; blood clotting as part of the process of repairing injured blood vessels is useful for our survival. However, less well known is that when a blood clot forms at an inappropriate time, the consequences can be devastating. For example, did you know that the blockage of blood vessels by inappropriate clotting is a major underlying mechanism of three leading causes of cardiovascular death: heart attack, stroke and blockage of the veins as seen with deep vein thrombosis? Did you also know that children can teach researchers and doctors a lot about thrombosis?
We reveal how below.
Thrombosis is a major disorder associated with:
- death within 30 days in one in three of those affected;
- recurrence within ten years in one-in-three affected people; and
- major bleeding due to the blood thinners used to treat it; this is estimated to cost $1.72 billion annually in Australia alone.
Other data from around the world demonstrates the seriousness of this condition. In Europe, nearly half a million people die from thrombosis alone each year - more than the combined death total from AIDS, breast and prostate cancer and highway accidents combined. In the US, 100,000 to 300,000 people die due to thrombosis each year, with more than 500,000 hospitalised.
The frequency of thrombosis in children is much lower than in otherwise healthy adults: one in two thousand hospital admissions in children, compared to one in twenty adults. This suggests that healthy children are protected from thrombosis compared to adults. However, while thrombosis is rare in healthy children, it is a major cause of complications for children admitted to hospital for other reasons.
The blood clotting system develops with age, a concept known as Developmental Haemostasis. These age-specific differences in blood clotting are the likely source of protection from thrombosis in childhood. Over the past 13 years the research team at Murdoch Children's Research Institute has performed world-first studies that clearly show important differences in the blood clotting system between children and adults.
So why is our research important, you ask?
Through our research we are advancing our understanding of the mechanisms behind thrombosis and protection from clotting in children. Our findings will directly contribute to evidence-based treatments for thrombosis in both children and adults.
Our main studies have shown differences between children and adults in:
- the concentration, activity and structure of blood clotting proteins;
- characteristics and activity of platelets – the main cell type involved in forming a blood clot;
- response to blood thinners such as heparin;
- the potential to generate thrombin - the main clotting protein and the mechanism in which it is made;
- the structure of blood clots.
Understanding protection from blood clots in childhood will be an extremely important step toward novel prevention and treatment strategies for clotting disorders in both children and adults as well as in reducing the financial burden placed on governments and individuals.
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