id	author	title	date	pages	extension	mime	words	sentence	flesch	summary	cache	txt
fnp-3395	Chiang, Kate Chander; Raghavan, Ravi; Gupta, Ajay	SARS-CoV-2 vaccination induced cerebral venous sinus thrombosis: Do megakaryocytes, platelets and lipid mediators make up the orchestra?	2021		.htm	application/xhtml+xml	4091	280	39	We propose that antiplatelet agents targeting thromboxane A2 receptor signaling such as low-dose aspirin merit consideration for chemoprophylaxis when administering the adenovirus based COVID-19 vaccines to young adults at risk of thrombosis provided there are no contraindications. B. Predilection of cerebral venous sinuses for thrombosis following vaccination Recent studies have demonstrated that arterial, venous and sinusoidal endothelial cells in the brain uniquely express markers of the lymphatic endothelium including podoplanin.37 Podoplanin (D2-40) serves as a ligand for CLEC2 receptors on platelets.38 Thromboxane A2-dependent CLEC2 signaling leads to platelet activation (Figure 1), while a TxA2 receptor antagonist nearly abolished CLEC2 signaling and platelet activation.38 TxA2-dependent CLEC2 signaling promotes release of exosomes and microvesicles from platelets, leading to activation of CLEC5A and TLR2 receptors respectively on neutrophils, neutrophil activation and release of neutrophil extracellular traps (NETs) (Figure 1).39 Neutrophil activation, more than platelet activation, is associated with thrombotic complications in COVID-19.13,18,40 As proposed above, the expression of podoplanin by cerebral venous sinuses may be responsible for the predilection of brain vascular bed to thromboinflammation and CVST as a complication of COVID-19 vaccines.	cache/fnp-3395.htm	txt/fnp-3395.txt