2026 80th Anniversary
International Convention of PSK

D+12
October 21-23, 2026

Abstracts

P5-4

Expanding the coagulopathy paradigm: a convergent, RTX-independent red blood cell activation strategy by diverse Salmonella serovars

  • Hyobin Jeon1, Soeun Kim1, Eunha Lee1, Han Young Chung*1
  • 1College of Pharmacy, Chungnam National University

Red blood cells (RBCs) are emerging as active drivers of infection-associated coagulopathy. While recent studies established that pore-forming RTX toxins from enterohemorrhagic Escherichia coli mediate RBC-dependent thrombosis, it remains unclear if this procoagulant shift is strictly RTX-dependent. Salmonella species frequently cause systemic infections complicated by intravascular coagulation, yet inherently lack classical RTX toxins. Here, we demonstrate that diverse Salmonella serovars employ a universally conserved, RTX-independent pathway to orchestrate RBC procoagulant activation in vitro. Regardless of invasiveness or typhoidal nature, non-typhoidal (SL1344, LT2, Virchow) and typhoidal (Ty2) strains universally induced a substantial intracellular calcium influx in human RBCs at sub-hemolytic levels. This triggered downstream caspase-3 and scramblase activation while suppressing flippase, leading to robust phosphatidylserine (PS) externalization. These biochemical alterations drove a profound morphological transition from normal biconcave discocytes to pathologic echinocytes and spherocytes. Consequently, the PS-exposing RBC membranes provided a catalytic surface that significantly accelerated thrombin generation. Although the specific bacterial effector remains unidentified, our findings reveal that RBC remodeling is a convergent pathogenic strategy exploited across the Salmonella genus, broadening the paradigm of pathogen-induced coagulopathy beyond RTX toxins. 


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