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We investigated the in vitro effect of various members of the genus Legionella on human peripheral mononuclear cells. All the strains tested induced the generation of strong procoagulant activity (tissue factor) when incubated for a prolonged period of time with pure mononuclear cell suspensions. This effect was dependent on the number of bacteria. The production of mononuclear cell procoagulant activity was also observed after the addition of bacteria to citrated whole blood. Escherichia coli 0111:B4 showed similar activity, but Staphylococcus aureus was much less effective. These findings suggest that the presence of endotoxin-like substance(s) in the outer cell wall of Legionellae could contribute to the stimulation of mononuclear cells. The production of tissue factor, a potent trigger of blood clotting, by these cells could help us to understand the mechanism(s) responsible for the activation of intravascular coagulation associated with severe legionellosis.

The in vitro effect of a virulent and a nonvirulent strain of Leptospira interrogans serotype icterohaemorrhagiae on human peripheral mononuclear cells was investigated. After addition of bacteria to citrated whole blood the production of mononuclear cell procoagulant activity (tissue factor) was observed. Indeed mononuclear cells isolated from whole blood bacteria mixtures after prolonged incubation shortened the recalcification time of normal plasma. The virulent strain induced a significantly higher procoagulant activity than nonvirulent and this effect was dependent on the number of bacteria. The production of tissue factor, a potent trigger of blood coagulation, by Leptospira icterohaemorrhagiae could help to understand the mechanism(s) responsible for the activation of intravascular coagulation associated with leptospirosis.

The in vitro effect of a purified endotoxin preparation from culture fluids of Shigella sonnei, phase I (purified free endotoxin, PFE) and of three endotoxin preparations chemically extracted from the intact parent cells on human blood mononuclear leucocytes and platelets was investigated. PFE, like cell-extracted preparations, caused generation of strong procoagulant activity (tissue factor) by human mononuclear cells. PFE-stimulated cells, however, developed significantly greater activity than cells stimulated by the other endotoxins. they had about 4-fold more activity. Neither free nor cell-extracted preparations induced aggregation in human citrated or heparinized platelet-rich plasma (PRP) or unmasking of platelet factor 3 (PF3). These findings suggest that free endotoxin from Shigella sonnei, phase I resembles endotoxin extracted from cells by conventional procedures in their interaction with human platelets and mononuclear leucocytes. In view of the possible contribution of free endotoxin to endotoxemia in human and experimental gram-negative sepsis, our data that free endotoxin stimulates human mononuclear leucocytes to produce a potent trigger of blood coagulation (tissue factor) may be relevant to the understanding of the mechanism(s) responsible for the initiation of intravascular coagulation in severe human infections.

The in vitro effect of a virulent and a non virulent strain of Leptospira interrogans serotype icterohaemorrhagiae on human peripheral mononuclear cells was investigated. After addition of bacteria to citrated whole blood the production of mononuclear cell procoagulant activity (tissue factor) was observed. Indeed mononuclear cells isolated from whole blood-bacteria mixtures after prolonged incubation shortened the recalcification time of normal plasma. The virulent strain induced a significantly higher procoagulant activity than non virulent and this effect was dependent on the number of bacteria. The production of tissue factor, a potent trigger of blood clotting, by Leptospira icterohaemorrhagiae could help to understand the mechanism(s) responsible for the activation of intravascular coagulation sometimes associated with leptospirosis.

Lipoglycans represent a special type of lipopoly-saccharide that differs in structure from the well-known gram-negative bacteria lipopolysaccharide. After briefly describing their most important characteristics, the authors take into consideration the in vitro interaction between lipoglycans from Acholeplasma granularum, Acholeplasma oculi, and Acholeplasma axanthum and human leukocytes in terms of production of procoagulant activity. The results obtained show that the examined lipoglycans possess, similarly to lipopolysaccharides, the capacity to induce the production of procoagulant activity, thromboplastin-like, from human mononuclear cells. However, the pathophysiological significance of this endotoxin-like activity remains to be established.

The production of procoagulant activity, tissue factor-like, by human mononuclear phagocytes stimulated by Legionella microorganisms is here hypothesized as a key moment in the pathogenesis of Legionella prosthetic valve endocarditis.