What is it about?

Soon after the onset of the COVID-19 pandemic, it was noted that enhanced blood clotting (thrombosis or embolism) frequently occurred as life-threatening complication in severely ill patients. This complex disorder involves an intense inflammatory response and a strong stimulation of blood clotting, and was named therefore “thromboinflammation”. Children show rarely severe COVID-19 complicated by thromboinflammation. Already 500 million years ago, the natural protein α2-macroglobulin (α2-M) was present in living organisms, and it was conserved up to now in many species including humans, which suggests that it is important. It is known that children have a much higher level of α2-M in their blood than adults. This higher level α2-M is assumed to compensate rare genetic deficiencies (i.e., lack of antithrombotic proteins) which may cause thrombosis in adults, but usually not in children. By a unique mechanism α2-M is capable to trap and neutralize a vast spectrum of functional proteins, including several proteins thought to be involved in COVID-19 thromboinflammation. This led the authors to the hypothesis that children may be protected by the ancient protein α2-M

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Why is it important?

Understanding, why in the COVID-19 pandemic children tend to do much better than adults, might open new way in diagnosis and treatment.

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This page is a summary of: COVID‐19‐associated coagulopathy—Hypothesis: Are children protected due to enhanced thrombin inhibition by higher α2‐Macroglobulin macroglobulin (α2‐M)?, Journal of Thrombosis and Haemostasis, September 2020, Elsevier, DOI: 10.1111/jth.15013.
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