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Sandeep B, Xiao Z, Zhao F, Feng Q, Gao K. Role of Platelets in Acute Lung Injury After Extracorporeal Circulation in Cardiac Surgery Patients: A Systemic Review. Curr Probl Cardiol 2022; 47:101088. [PMID: 34936908 DOI: 10.1016/j.cpcardiol.2021.101088] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 11/15/2022]
Abstract
In vitro circulation (cardiopulmonary bypass, CPB) has been widely used in heart surgery. In the past, it was believed that the reduction of platelet count and impaired platelet function during cardiac surgery were the main causes of acute lung injury (ALI). ALI is a life-threatening clinical syndrome in critically ill patients due to an uncontrolled systemic inflammatory response resulting from direct injury to the lung or indirect injury in the setting of a systemic process. Platelets have an emerging and incompletely understood role in a myriad of ALI after extracorporeal circulation in cardiac surgery patients. An electronic literature search was performed using Pubmed, Scopus and Cinahl investigating ALI, pathogenesis, and role of platelets, treatment and management for ALI patients. Many studies have shown that in vitro circulation is a nonphysiological process that can lead to a decrease in the number of platelets and impaired platelet function, as well as varying degrees of lung damage. The relationship between the effects of in vitro circulation on platelets and acute lung injury is still controversial. This review article discusses the role of platelets in lung injury after cardiopulmonary bypass and resent development in the management of ALI.
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Affiliation(s)
- Bhushan Sandeep
- Department of Cardiothoracic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Zongwei Xiao
- Department of Cardiothoracic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Fengying Zhao
- Department of Intensive Care Unit, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Qianru Feng
- Department of Intensive Care Unit, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Ke Gao
- Department of Cardiothoracic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan, China.
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Brezinov OP, Sevilya Z, Yahud E, Rahkovich M, Kogan Y, Marincheva G, Kakzanov Y, Lev E, Laish-Farkash A. Comparison of Immature Platelet Fraction and Factors Associated with Inflammation, Thrombosis and Platelet Reactivity Between Left and Right Atria in Patients with Atrial Fibrillation. J Atr Fibrillation 2021; 13:2459. [PMID: 34950336 DOI: 10.4022/jafib.2459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/25/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022]
Abstract
Background Recent trials found poor temporal relationship between atrial fibrillation (AF) episodes and strokes. Thus, stroke in AF patients probably involves more mechanisms than cardiac embolism. We compared factors of inflammation, thrombosis and platelet reactivity between left (LA) and right atria (RA) and femoral vein (FV) in patients with AF. Methods Blood samples were collected from patients undergoing AF-ablation from the FV, RA and LA for neutrophil to lymphocyte ratio (NLR), immature platelet fraction (IPF) and count (IPC), CD40 ligand, P-selectin and E-Selectin. IPF was measured by an autoanalyzer; CD40 ligand, P-selectin, and E-Selectin were measured by ELISA and NLR was calculated from complete blood counts. Results Sixty-seven patients were included (age 65±10y, 63% male, CHA2DS2-VASc score 2.8±1.8, LA volume index 40±24 mL/m2, 63% paroxysmal AF). There was no difference between FV, RA and LA regarding NLR and CD40 ligand. Factors associated with platelets activity: P-selectin, IPC and IPF% were higher in RA vs LA (60.3 IQR 49.0-76.4 ng/ml vs. 59.3 IQR 49.0-74.7, respectively, p=0.03 for P-selectin, 7.5 IQR 5.2-10 103/μL vs. 7.1 IQR 5-9.8, p<0.01 for IPC, and 3.6 IQR 2.7-5.0 % vs. 3.6 IQR 2.6-4.8, p<0.01 for IPF%). Similar trends were for E-selectin (41.2 IQR 31.1-51.2 ng/mL vs. 38.7 IQR 27.9-50.4 p=0.09). Similar significant differences were found in patients with CHA2DS2-VASC≥2 but not in patients with low score. Conclusions Patients with AF, especially those with CHA2DS2-VASc≥2, have higher markers of thrombogenicity in RA compared to LA. There was no difference in inflammatory properties between the atria.
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Affiliation(s)
- Olga Perelshtein Brezinov
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ziv Sevilya
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Ella Yahud
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Michael Rahkovich
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yonatan Kogan
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Gergana Marincheva
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Yana Kakzanov
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Eli Lev
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Avishag Laish-Farkash
- Department of Cardiology, Assuta Ashdod Medical Center, Ashdod.,The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Sandeep B, Xiao Z, Zhao F, Feng Q, Gao K. Role of Platelets in Acute Lung Injury After Extracorporeal Circulation in Cardiac Surgery Patients: A Systemic Review. Curr Probl Cardiol 2021. [DOI: https://doi.org/10.1016/j.cpcardiol.2021.101088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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The Role and Molecular Mechanism of P2Y12 Receptors in the Pathogenesis of Atherosclerotic Cardiovascular Diseases. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11199078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The P2Y receptor family is a class of G protein-coupled receptors activated primarily by adenosine triphosphate (ATP), adenosine diphosphate (ADP), uridine triphosphate (UTP) and uridine diphosphate (UDP). The P2Y12 receptor is expressed on platelets which mediates platelet aggregation and morphological changes. At the same time, during the process of vascular remodeling and atherosclerosis, ADP can also promote the migration and proliferation of vascular smooth muscle and endothelial cells through P2Y12 receptor activating. Furthermore, P2Y12 is involved in many signal transductions processes, such as intimal hyperplasia, monocyte infiltration and so on, which play an important role in immune inflammation and brain injury. In order to solve the diseases induced by P2Y12 receptor, inhibitors such as ticagrelor, clopidogrel were widely used for cardiovascular diseases. However, there were some problems, such as limited antithrombotic effect, remain unsolved. This article summarizes the role and molecular mechanism of P2Y12 receptors in the pathogenesis of cardiovascular-related diseases, providing in-depth expounding on the molecular mechanism of P2Y12 receptor inhibitors and contributing to the treatment of diseases based on P2Y12 receptors.
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Smith CW. Release of α-granule contents during platelet activation. Platelets 2021; 33:491-502. [PMID: 34569425 DOI: 10.1080/09537104.2021.1913576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Upon activation, platelets release a plethora of factors which help to mediate their dynamic functions in hemostasis, inflammation, wound healing, tumor metastasis and angiogenesis. The majority of these bioactive molecules are released from α-granules, which are unique to platelets, and contain an incredibly diverse repertoire of cargo including; integral membrane proteins, pro-coagulant molecules, chemokines, mitogenic, growth and angiogenic factors, adhesion proteins, and microbicidal proteins. Clinically, activation of circulating platelets has increasingly been associated with various disease states. Biomarkers indicating the level of platelet activation in patients can therefore be useful tools to evaluate risk factors to predict future complications and determine treatment strategies or evaluate antiplatelet therapy. The irreversible nature of α-granule secretion makes it ideally suited as a marker of platelet activation. This review outlines the release and contents of platelet α-granules, as well as the membrane bound, and soluble α-granule cargo proteins that can be used as biomarkers of platelet activation.
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Affiliation(s)
- Christopher W Smith
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, B15 2TT, Birmingham, UK
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