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Service et Laboratoire central d'hématologie
Accueil > Recherche > Axes de recherche > Pr Lorenzo Alberio

Laboratory members



Professor Lorenzo Alberio

MD, Associate Professor University of Lausanne
Physician in chief, Service and Main laboratory of Haematology

Tél. +41 21 314 0171
Email contact

        

  

SPÉCIALISATIONS

Hématologie clinique (FMH) et de laboratoire (FAMH)

Médecine interne (FMH)

  

DOMAINES D’INTÉRÊTS ACADÉMIQUE ET/OU CLINIQUE

Hématologie générale, hémostase et thrombose, méthodes cytométrie de flux

  

ÉDUCATION ET FORMATION

Professeur associé UNIL : 2014

Professeur associé UNIBE : 2009

Venia docendi UNIBE : 2004

FAMH hématologie (incl. analyses ADN/ARN) : 2002

FMH hématologie : 1999

FMH médecine interne : 1996

Doctorat en médecine : 1993

Diplôme de médecine : 1990

  

INSTITUTIONS DE FORMATION & EXPÉRIENCES PRÉCÉDENTES

Université de Berne, Faculté de médecine

Ente Ospedaliero Cantonale, Ticino

Inselspital, Hôpital universitaire, Berne

University of Oklahoma, Health Sciences Center, Oklahoma City, USA

Université de Strasbourg, UMR S949 INSERM, Établissement Français du Sang, Strasbourg, F

  

LANGUES PARLÉES

Français, Anglais, Allemand, Italien,


Research topics

PROCOAGULANT COAT PLATELETS

At sites of vascular injury platelets become exposed to collagen and thrombin, the strongest physiologic platelet agonists. We have described and characterized a fraction of platelets that, upon combined activation by collagen and thrombin, become highly efficient in sustaining thrombin generation (Blood 2000;95:1694). These platelets retain on their surface a COAT of several alpha-granule proteins, such as fibrinogen, von Willebrand factor, and procoagulant factor V by a transglutaminase- and serotonin-dependent mechanism (Nature 2002;415:175). Recent work of our group has shown that:

  1. A diminished ability to generate COAT platelets leads to a clinically relevant bleeding diathesis (Cytometry Part B Clin Cytom 2014;86:397). This novel observation highlights the physiological relevance of platelet procoagulant activity besides aggregation.

  2. The in vivo administration of DDAVP (desmopressin) selectively enhances COAT platelet generation (Blood 2014;123:1905). This is a novel mechanism explaining the beneficial hemostatic action of DDAVP in platelet disorders.

  3. Intracellular signaling strikingly diverges starting about 2 minutes after platelet activation by collagen and thrombin (Thromb Haemost 2017; doi: 10.1160/TH16-09-0711).

Current interests of our group are the further dissection of signaling mechanisms underlying and modulating COAT platelet generation, and the role of COAT platelets in hematological diseases, such as paroxysmal nocturnal hemoglobinuria (PNH), myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN), and heparin-induced thrombocytopenia (HIT).

 

  

  

HEPARIN-INDUCED THROMBOCYTOPENIA (HIT)

  

HIT represents a fascinating hemostatic paradox (thrombocytopenic anticoagulated patients develop a life-threatening prothrombotic state) and a challenging clinical problem. Over the years our group has investigated mechanistic, diagnostic, and therapeutic aspects of HIT (Thromb Haemost 2004;91:276; JTH 2009;7:1649; Blood 2009;113:2402). In particular, we have developed a Bayesian diagnostic approach in order to reach a rapid exclusion or confirmation of suspected HIT (Haematologica 2012;97:89). Current interests are the development of a rapid functional assay for HIT and the dissection of platelet intracellular signaling events induced by anti-PF4/heparin-antibodies, specifically their ability to generate procoagulant COAT platelets.

  

  

  

IN VIVO EFFECT OF RIVAROXABAN ON THROMBIN GENERATION

  

Rivaroxaban (RVX) belongs to a new class of direct oral anticoagulants (DOAC) and works by specifically inhibiting clotting factor Xa. RVX has predictable pharmacokinetics and pharmacodynamics, even in obese patients (Br J Clin Pharmacol 2017, doi: 10.1111/bcp.13243) and therefore there is no need for laboratory monitoring. Nevertheless, the anticoagulant effect of a given RVX concentration in a specific patient is not known. We have recently observed that in obese patients taking RVX the ex vivo anticoagulant action measured by thrombin generation (TG) according to calibrated automated thrombogram (CAT) does not predict the in vivo anticoagulant effect (manuscript submitted). Our current interest is to assess coagulation with global hemostasis tests (CAT and Thrombodynamics) to investigate the anticoagulant effect of similar plasma concentrations of RVX in obese patients before and after bariatric surgery. Our investigations will bring new insights on the knowledge of anticoagulation by DOAC in obese patients and on the characterization of new tools to assess hypercoagulability.


Selected publications