Modification of human platelet function by a diet enriched in saturated or polyunsaturated fat

Genetic and nongenetic drivers of platelet reactivity in healthy Tanzanian individuals

BACKGROUND

Platelets play a key role in hemostasis, inflammation, and cardiovascular diseases. Platelet reactivity is highly variable between individuals. The drivers of this variability in populations from Sub-Saharan Africa remain largely unknown.

OBJECTIVES

We aimed to investigate the nongenetic and genetic determinants of platelet reactivity in healthy adults living in a rapidly urbanizing area in Northern Tanzania.

METHODS

Platelet activation and reactivity were measured by platelet P-selectin expression and the binding of fibrinogen in unstimulated blood and after ex vivo stimulation with adenosine diphosphate and PAR-1 and PAR-4 ligands. We then analyzed the associations of platelet parameters with host genetic and nongenetic factors, environmental factors, plasma inflammatory markers, and plasma metabolites.

RESULTS

Only a few associations were found between platelet reactivity parameters and plasma inflammatory markers and nongenetic host and environmental factors. In contrast, untargeted plasma metabolomics revealed a large number of associations with food-derived metabolites, including phytochemicals that were previously reported to inhibit platelet reactivity. Genome-wide single-nucleotide polymorphism genotyping identified 2 novel single-nucleotide polymorphisms (rs903650 and rs4789332) that were associated with platelet reactivity at the genome-wide level (P < 5 × 10-8) as well as a number of variants in the PAR4 gene (F2RL3) that were associated with PAR4-induced reactivity.

CONCLUSION

Our study uncovered factors that determine variation in platelet reactivity in a population in East Africa that is rapidly transitioning to an urban lifestyle, including the importance of genetic ancestry and the gradual abandoning of the traditional East African diet.

Postprandial Triglyceride-Rich Lipoproteins from Type 2 Diabetic Women Stimulate Platelet Activation Regardless of the Fat Source in the Meal

SCOPE

The aim of this study is to examine whether postprandial (PP) triglyceride-rich lipoproteins (TGRL) secreted after a moderate fat intake would activate platelets differently according to their fatty acid (FA) composition.

METHODS AND RESULTS

In a parallel single-blind randomized trial, 30 women with type 2 diabetes are assigned a breakfast containing 20 g lipids from butter versus hazelnut-cocoa spread (HCS) rich in palm oil. Blood samples are collected at fasting and 4 h PP. FA composition of fasting and PP TGRL and their effects on the activation of platelets from healthy blood donors are assessed. Both breakfasts similarly increase plasma ApoB-48, plasma, and TGRL triglycerides (p < 0.05). TGRL mean diameter increases after both breakfasts and is greater after the butter breakfast. Both breakfasts are rich in palmitic acid, and the HCS breakfast contains 45% oleic acid. TGRL FA composition reflects the dietary FA composition. Pre-incubation of platelets with fasting and PP TGRL increases collagen-stimulated aggregation (p < 0.01 vs control). Fasting and PP TGRL similarly increase agonist-induced thromboxane B₂ concentrations, and this effect is concentration-dependent for PP TGRL.

CONCLUSION

PP TGRL from type 2 diabetic women after a palm-oil spread versus butter-based mixed meal induce similar acute in vitro platelet activation.

Dietary interventions (plant sterols, stanols, omega-3 fatty acids, soy protein and dietary fibers) for familial hypercholesterolaemia

BACKGROUND

A cholesterol-lowering diet and several other dietary interventions have been suggested as a management approach either independently or as an adjuvant to drug therapy in children and adults with familial hypercholesterolaemia (FH). However, a consensus has yet to be reached on the most appropriate dietary treatment. Plant sterols are commonly used in FH although patients may know them by other names like phytosterols or stanols.

OBJECTIVES

To examine whether a cholesterol-lowering diet is more effective in reducing ischaemic heart disease and lowering cholesterol than no dietary intervention in children and adults with familial hypercholesterolaemia. Further, to compare the efficacy of supplementing a cholesterol-lowering diet with either omega-3 fatty acids, soya proteins, plant sterols or plant stanols.

SEARCH METHODS

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Inborn Errors of Metabolism Trials Register, which is compiled from electronic searches of the Cochrane Central Register of Controlled Trials (CENTRAL) (updated with each new issue of The Cochrane Library), quarterly searches of MEDLINE and the prospective handsearching of one journal - Journal of Inherited Metabolic Disease. Most recent search of the Group's Inborn Errors of Metabolism Trials Register: 22 August 2013. We also searched PubMed to 05 February 2012.

SELECTION CRITERIA

Randomised controlled trials, both published and unpublished, where a cholesterol-lowering diet in children and adults with familial hypercholesterolaemia has been compared to other forms of dietary treatment or to no dietary intervention were included.

DATA COLLECTION AND ANALYSIS

Two authors independently assessed the trial eligibility and risk of bias and one extracted the data, with independent verification of data extraction by a colleague.

MAIN RESULTS

In the 2014 update of the review, 15 trials have been included, with a total of 453 participants across seven comparison groups. The included trials had either a low or unclear risk of bias for most of the parameters used for risk assessment. Only short-term outcomes could be assessed due to the short duration of follow up in the included trials. None of the primary outcomes, (incidence of ischaemic heart disease, number of deaths and age at death) were evaluated in any of the included trials. No significant differences were noted for the majority of secondary outcomes for any of the planned comparisons. However, a significant difference was found for the following comparisons and outcomes: for the comparison between plant sterols and cholesterol-lowering diet (in favour of plant sterols), total cholesterol levels, mean difference 0.30 mmol/l (95% confidence interval 0.12 to 0.48); decreased serum LDL cholesterol, mean difference -0.60 mmol/l (95% CI -0.89 to -0.31). Fasting serum HDL cholesterol levels were elevated, mean difference -0.04 mmol/l (95% CI -0.11 to 0.03) and serum triglyceride concentration was reduced, mean difference -0.03 mmol/l (95% CI -0.15 to -0.09), although these changes were not statistically significant. Similarly, guar gum when given as an add on therapy to bezafibrate reduced total cholesterol and LDL levels as compared to bezafibrate alone.

AUTHORS' CONCLUSIONS

No conclusions can be made about the effectiveness of a cholesterol-lowering diet, or any of the other dietary interventions suggested for familial hypercholesterolaemia, for the primary outcomes: evidence and incidence of ischaemic heart disease, number of deaths and age at death,due to the lack of data on these. Large, parallel, randomised controlled trials are needed to investigate the effectiveness of a cholesterol-lowering diet and the addition of omega-3 fatty acids, plant sterols or stanols, soya protein, dietary fibers to a cholesterol-lowering diet.

Dietary treatment for familial hypercholesterolaemia

BACKGROUND

A cholesterol-lowering diet and several other dietary interventions have been suggested as a management approach either independently or as an adjuvant to drug therapy in children and adults with familial hypercholesterolemia. However, a consensus has yet to be reached on the most appropriate dietary treatment.

OBJECTIVES

To examine whether a cholesterol-lowering diet is more effective in reducing ischaemic heart disease and lowering cholesterol than no dietary intervention in children and adults with familial hypercholesterolaemia. Further, to compare the efficacy of supplementing a cholesterol-lowering diet with either omega-3 fatty acids, soya proteins, plant sterols or plant stanols.

SEARCH STRATEGY

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Inborn Errors of Metabolism Trials Register.Most recent search of the Group's Inborn Errors of Metabolism Trials Register: 09 October 2009.We also searched PubMed till 01 June 2008.

SELECTION CRITERIA

Randomised controlled trials, both published and unpublished, where a cholesterol-lowering diet in children and adults with familial hypercholesterolaemia has been compared to other forms of dietary treatment or to no dietary intervention were included.

DATA COLLECTION AND ANALYSIS

Two authors independently assessed the trial eligibility and methodological quality and one extracted the data, with independent verification of data extraction by a colleague.

MAIN RESULTS

In the present update, four new trials have been added making eleven trials with a total of 331 participants eligible for inclusion. Only short-term outcomes could be assessed due to the short duration of follow up in the included studies. None of the primary outcomes, (incidence of ischaemic heart disease, number of deaths and age at death) were evaluated in any of the included studies. No significant difference was noted for the majority of secondary outcomes for any of the planned comparisons. However, a significant difference was found only for the following comparison and outcome: total cholesterol levels for the comparison between plant sterols and cholesterol-lowering diet, mean difference 0.70 (95% confidence interval 0.19 to 1.21).

AUTHORS' CONCLUSIONS

No conclusions can be made about the effectiveness of a cholesterol-lowering diet, or any of the other dietary interventions suggested for familial hypercholesterolaemia, due to the lack of adequate data. Large, parallel, randomised controlled trials are needed to investigate the effectiveness of a cholesterol-lowering diet and the addition of omega-3 fatty acids, plant sterols or stanols, soya protein to a cholesterol-lowering diet.

Dietary treatment for familial hypercholesterolaemia

BACKGROUND

Familial hypercholesterolaemia is an inherited disorder characterised by a raised blood cholesterol, the presence of xanthomatosis and premature ischaemic heart disease. The aim of treatment is the reduction of blood LDL cholesterol concentrations in order to reduce the risk of ischaemic heart disease. Current treatment is based on a cholesterol lowering diet alone or in combination with drug therapy. Many of the drugs found to be effective in treating adults with this disease are not licensed for use in children, therefore diet is the main treatment of children with familial hypercholesterolaemia. In addition to the cholesterol-lowering diet, several other dietary interventions have been suggested and consensus has yet to be reached on the most appropriate dietary treatment for children and adults with familial hypercholesterolaemia.

OBJECTIVES

To examine the evidence that in children and adults with familial hypercholesterolaemia, a cholesterol lowering diet is more effective at lowering cholesterol and reducing incidence of ischaemic heart disease than no intervention or than other dietary interventions.

SEARCH STRATEGY

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Trials Register, a specialist trials register which comprises references identified from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Additional studies were identified from handsearching the Journal of Inherited Metabolic Disease (from inception, 1978 to 2000) and from the reference lists of identified studies.

SELECTION CRITERIA

Randomised controlled trials (RCTs), both published and unpublished, where a cholesterol lowering diet in children and adults with familial hypercholesterolaemia has been compared to other forms of dietary treatment or to no dietary intervention. Trials which include patients with familial hypercholesterolaemia alongside patients with non-familial hypercholesterolaemia were only included if the group of familial patients was well defined and the results for these patients were available.

DATA COLLECTION AND ANALYSIS

Two reviewers independently assessed the trial eligibility and methodological quality and one reviewer extracted the data, with independent verification of data extraction by a colleague.

MAIN RESULTS

Only short term outcomes could be assessed in this review due to the length of the five eligible studies. Compliance to treatment, quality of life, mortality and evidence of ischaemic or atheromatous disease were not assessed in the studies identified. No differences were found between the cholesterol-lowering diet and all other diets for all of the short term outcomes assessed.

REVIEWER'S CONCLUSIONS

No conclusions can be made about the effectiveness of the cholesterol-lowering diet, or any of the other dietary interventions suggested for familial hypercholesterolaemia, due to the lack of adequate data. A large, parallel, randomised controlled trial is needed to investigate the effectiveness of the cholesterol-lowering diet and other dietary interventions for FH. It is also possible that data from trials including subjects with both familial and non-familial hypercholesterolaemia could alter the results of future updates of this review and until further evidence is available current dietary treatment of FH should continue to be observed and monitored with care.

Dietary canola oil alters hematological indices and blood lipids in neonatal piglets fed formula

This study was undertaken to determine the effects of canola oil on platelet characteristics, blood lipids and growth in exclusively formula-fed piglets. Piglets were fed from birth to 10 or 18 d with formula containing 51% energy from fat, with 100% fat as canola or soybean oil; 26% soybean, 59% high oleic acid sunflower and 12% flax oil (canola mimic); or 26% canola (canola blend) or soybean (soybean blend) with high oleic acid sunflower, palm and coconut oil. The canola mimic provided similar carbon chain 16 and 18 fatty acids without the sterol or 20:1 and erucic acid (22:1) of canola oil. The oil blends provided formula resembling infant formulas but with higher 16:0 and lower unsaturated fatty acid levels than in canola or soybean oil. Body weight, weight gain and heart and liver weight were not different after 10 or 18 d feeding canola when compared to soybean oil alone or blended oil formulas. Piglets fed formulas with 100% canola oil had lower platelet counts than piglets fed formula soybean oil or the canola oil mimic. Platelet counts were lower, and platelet distribution width and volume were higher, when formulas with 100% canola or soybean rather than the blended oil formulas were fed. The results show that formula fat composition influences the developing hematological system and that canola oil suppresses the normal developmental increase in platelet count in piglets by a mechanism apparently unrelated to the formula 16:0, 18:1, 18:2(n-6) or 18:3(n-3), or plasma phospholipid 20:4(n-6) or 20:5(n-3).

Retinal and optic nerve head ischemic disorders and atherosclerosis: role of serotonin

Ischemic disorders of the retina and optic nerve head (OPH) constitute a common cause of visual loss in the middle-aged and elderly population. These disorders have a high association with atherosclerosis. This review has considered the various aspects of atherosclerosis and its role, as well as that of serotonin, in the development of ischemic disorders of the retina and ONH. It is known that when platelets aggregate on an atheromatous plaque, serotonin is one of the agents released. Studies in experimental atherosclerotic monkeys have shown that, although serotonin has no effect on ocular vasculature in normal monkeys, in atherosclerotic monkeys it produces vasopasm of the central retinal artery (CRA) and/or posterior ciliary artery (PCA) in various combinations but not vasopasm of the arterioles in the retina; vasospasm of the CRA and/or PCA(s) can consequently cause transient, complete occlusion or impaired blood flow in these arteries. It is postulated that in some atherosclerotic individuals this mechanism may play an important role in the development of ischemic disorders of the retina and ONH, including amaurosis fugax, (CRA) occlusion and anterior ischemic optic neuropathy, and possibly also glaucomatous optic neuropathy, particularly in normal tension glaucoma. Studies have also shown that dietary treatment of atherosclerosis abolishes or markedly improves the serotonin induced vasoconstriction within a few months. All these considerations may have important implications for our understanding of the pathogenesis and management of these blinding disorders.

A comparison of human and killer whale platelet fatty acid composition

Activation of blood platelets and their subsequent aggregation results from the interactions of several complex metabolic pathways. Considered to be of critical importance are the platelet lipids. Subsequent to platelet activation, several membrane lipids undergo hydrolysis and the free fatty acids are metabolized to prostanoids which mediate platelet function in response to vascular injury. It is conceivable then, that differences in platelet membrane fatty acid content could result in significant differences in platelet responses to aggregatory stimuli, especially between species. The objective of this study was to identify specific differences in fatty acid content between human and killer whale platelets. Blood was collected, washed platelets were prepared, and platelet fatty acids were extracted. Methyl esters of the extracted fatty acids were analyzed by gas chromatography and reported as relative concentrations. Analysis of the data revealed significant differences between the two species for several relevant fatty acids, i.e. 16:0 (P < 0.05), and 18:0, 18:1, 18:2, and 20:4 (P < 0.001). The differences in platelet fatty acid composition and concentration may explain at least some of the differences in platelet function which have previously been identified between these species.

Dietary saturated, monounsaturated, n-6 and n-3 fatty acids, and cholesterol influence platelet fatty acids in the exclusively formula-fed piglet

Platelet lipid composition is important to normal platelet morphology and function, and is influenced by dietary fatty acids and cholesterol. The fatty acid composition and cholesterol content of infant formulas differs from those of human milk, but the possible effects on platelet lipids in young infants is not known. This was studied in piglets fed from birth to 18 d of age with one of eight formulas differing in saturated fatty acid chain length, or content of 18:1, 20:5n-3 plus 22:6n-3, or cholesterol. A reference group of piglets fed sow milk was also studied. Sow milk has a fatty acid composition and cholesterol content similar to that of human milk. Piglets fed formulas high in 18:1 (34.9-40.8% wt fatty acids) and low in 16.0 (< or = 6.5% wt fatty acids) had lower platelet counts and greater platelet size than piglets fed sow milk (40.4% 18:1, 30.7% 16:0). Piglets fed formulas high in 16:0 (27-29.6%) and 18:1 (40-40.6%), or low in both 16:0 (5.9-6.1%) and 18:1 (10.8-11.2%), had similar platelet counts and size to piglets fed sow milk. Platelet phospholipid % 20:4n-6 was lower in all the groups of piglets fed formula than in the group fed sow milk. Addition of fish oil with 20:5n-3 plus 22:6n-3 to the formula further decreased platelet phospholipid 20:4n-6. Addition of cholesterol to the formula increased the platelet phospholipid % 20:4n-6 and platelet volume.

Effects of platelets from men with risk factors for atherosclerosis on endothelial cell proliferation and prostacyclin production in vitro

The hypothesis that variations in platelet size or composition might affect some endothelial cell (EC) functions was tested. Large and small platelets stimulated cell proliferation and prostacyclin production to the same extent at the same amount of protein. Endothelial cells exposed to platelet factors from healthy men at statistically high risk of cardiovascular disease (n = 30) manifested significantly less DNA synthesis than did EC exposed to platelet factors from men at statistically low risk (n = 30) (p = 0.007). There was no difference in prostacyclin production between the groups. Nor were there any difference in EC or smooth muscle cell (SMC) proliferation or in prostacyclin production between cells exposed to platelet factors from smokers and those exposed to platelet factors from non-smokers. In stepwise regression of the results for high risk groups, with thymidine incorporation as the dependent variable, including diastolic blood pressure, s-triglycerides and s-cholesterol, s-triglycerides were inversely correlated to thymidine incorporation. We suggest that the decreased endothelial cell DNA synthesis after exposure to platelet factors from high risk individuals may imply a decreased capability for damage repair in the vascular wall, and that the differences in platelet effects on EC proliferation may be due to differences in lipids, especially triglycerides.

Formation of prostanoids and hydroxy fatty acids by stimulated peritoneal mast cells: role of the dietary fat type in rat

To study the influence of membrane fatty acid composition on the formation of prostanoids and hydroxy fatty acids by rat peritoneal mast cells (MC), animals were fed three different types of fatty acids: mackerel oil (MO), abundant in n-3 fatty acids; sunflower seed oil (SO), rich in linoleic acid; and hydrogenated coconut oil (HCO), mainly containing saturated fatty acids. The presence of n-3 fatty acids in the diet resulted in the incorporation of 20:5(n-3), 22:5(n-3) and 22:6(n-3) in MC phospholipids. A decrease of arachidonic acid, 20:4(n-6), was observed in MC-phospholipids of the MO-fed animals. Furthermore, increasing the relative amounts of 18:2(n-6) in the diet (SO group) led to an increased incorporation of linoleic acid, 18:2(n-6) in MC phospholipids when compared to both other dietary groups. The changes in MC phospholipid fatty acid composition were (partly) reflected in the formation of prostanoids and hydroxy fatty acids upon stimulation with the calcium ionophore A23187. The decrease in arachidonic acid content in MC phospholipids of MO-fed rats resulted in a decreased formation of PGD2 when compared to both other groups. Also, the increased amounts of 18:2(n-6) in MC phospholipids of SO-fed rats resulted in an increased formation of 9- and 13-HODE upon stimulation. The results show that modifications in the fatty acid composition of the diet influences MC membrane fatty acid composition which ultimately results in changes in prostanoid and hydroxy fatty acid synthesis by MC upon stimulation with the calcium ionophore A23187.

Minimal sequence requirement of thrombin receptor agonist peptide

A site-specific proteolytically generated neoamino terminus of the thrombin receptor having a sequence SFLLRNPNDKYEPF- has been reported to be a functional ligand of the receptor. This discovery raises question on the precise structural requirements of the "tethered ligand" responsible for receptor activation and signal transduction. By examining the agonist activity of a panel of synthetic sequence analogues of thrombin receptor agonist peptides (TRAP) on human platelet aggregation, we determined that the minimal sequence of the human platelet thrombin receptor ligand is SFLL-amide (TRAP1-4, EC50 = 300 uM). An extension of TRAP1-4 by an additional Arg-Asn segment yielded the most potent agonist among the series (TRAP1-6, EC50 = 1.3 microM). Based on the structure-activity relationships, we hypothesized a model of the ligand-binding site of the human platelet thrombin receptor that accommodates a hexapeptide structure. TRAP1-6, when administered intravenously, induced marked intravascular platelet aggregation in the anesthetized guinea pigs.

A comparison of human and porcine platelet fatty acid composition

1. Human and pig platelets were analyzed for lipid composition by gas chromatography. 2. In comparing the two species' platelets, we noted significant differences in several lipid concentrations, some of which involved major lipid constituents. 3. The lipids for which there are significant differences in composition may contribute to those variations in platelet responses to stimulation demonstrated to exist between species.

Effect of ethanol on low density lipoprotein and platelet composition

The present study was designed to investigate the effect of ethanol (EtOH) dose on low density lipoprotein (LDL) and platelet composition. Male squirrel monkeys were divided into three groups designated Control, Low, and High EtOH, and fed isocaloric liquid diets containing 0%, 12%, and 24% of calories as EtOH, respectively. After four months of treatment, monkeys fed the 12% alcohol dose had LDL and platelet cholesterol concentrations similar to Controls. By contrast, platelet membranes from High EtOH animals contained significantly more cholesterol which was associated with higher levels of plasma LDL cholesterol and apolipoprotein B. Blood platelet count, size, and mass were similar for all groups and circulating platelet aggregates were absent in the two alcohol cohorts. Despite elevations in platelet cholesterol mass and thromboxane A2 (TXA2) precursor, phospholipid arachidonate, platelet responsiveness, measured as thromboxane formed in response to a collagen challenge in vitro, and the cholesterol/phospholipid molar ratio, were not significantly altered by high dose alcohol. Normal platelet activity in High EtOH monkeys may have resulted from a significant increase in the platelet phospholipid polyunsaturated/saturated fatty acid ratio and a non-significant increase in platelet phospholipid mass, both of which would have a fluidizing effect on platelet membranes. Our data indicate that low EtOH intake has no effect on platelet composition and function while unfavorable platelet cholesterol enrichment following consumption of high dose ethanol may arise from elevations in plasma LDL.(ABSTRACT TRUNCATED AT 250 WORDS)

Species variation in the atherogenic profile of monkeys: relationship between dietary fats, lipoproteins, and platelet aggregation

Because lipoproteins and platelet aggregation have been implicated in atherogenesis, relative differences in the response of these variables to dietary fat saturation were compared in three species of monkeys differing in their susceptibility to atherosclerosis (cebus, rhesus, and squirrel monkeys). Both long-term (8-12 years) and short-term (8 weeks) responses to diets containing 31% fat calories were examined in the same monkeys. As expected, long-term feeding of coconut oil by comparison to corn oil produced significantly higher plasma concentrations of total cholesterol, LDL cholesterol, apoB, and triglycerides, as well as higher ratios of LDL/HDL cholesterol and apo B/apo A-I. These responses were characteristic of all species with cebus being most responsive and rhesus the least. The short-term plasma cholesterol response to animal fats (butter, lard, beef tallow) was significantly less than that to coconut oil. When fish oil was substituted for two-thirds of either corn oil or coconut oil, exceptional decreases occurred in plasma cholesterol and triglycerides, as well as in HDL cholesterol and apo A-I concentrations despite the fact that the fish oil diets contained more saturated fat and less polyenes than the corn oil diet. Platelet aggregation tended to increase with saturated fat consumption and greatly decreased with fish oil intake in all monkeys, although cebus monkeys were ten-fold more resistant to platelet aggregation than the other two species. The molecular species of platelet phosphatidylcholine (PC) varied with both the dietary fat fed and species of monkey. An inverse correlation (r = -0.60; p less than 0.001) was found between changes in one such PC molecular species (18:0-20:4) induced by diet and the platelet aggregation threshold. These results demonstrate that the lipemic and platelet responses to dietary saturated fat depend upon both the type of fat (i.e., the specific combination of dietary fatty acids, including the chain length of saturated fatty acids and the degree of polyunsaturation) and the species of monkey (genetic component) in which the response is elicited.

A comparison of human and canine platelet fatty acid composition

1. Human and canine platelets were analysed for lipid composition by gas chromatography. 2. In comparing the two species' platelets, there were several lipids for which there were significant differences in lipid concentration. 3. The results indicate that human and canine platelets are quite similar in platelet lipid composition; however, the lipids for which there are significant differences may contribute to variations between species in platelet responses to stimulation.

Platelets and aging. II--Plasma lipoproteins and fatty acid profiles

Lipid composition of both plasma and platelets were investigated in sixteen old (78-94 years) and eight young (25-35 years) subjects. No age-related change was noted in plasma total and HDL cholesterol whereas a slightly increase of triglycerides was observed in the elderly population. Level of apo AI tended to decrease while apo AII decreased significantly in the elderly. These results led to a higher apo AI/apo AII ratio in elder subjects. However, no difference was detected in the level of apo B. In contrast, several modifications appeared in fatty acid composition of plasma lipids. Primarily, monounsaturated fatty acids content was increased while level of linoleic acid (and arachidonic acid in phospholipids) decreased in each class of plasma lipids of elderly subjects. In platelets from the elderly, we found an enhancement of monounsaturated fatty acids in phosphatidyl-inositol (PI), -ethanolamine (PE) and -choline (PC). The decrease of linoleic acid was detected in PC while the reduction of AA was noted in PE. These results indicate that modifications of fatty acid composition in both plasma and platelet lipids appeared with aging. They might be linked to the enhanced platelet activation in vivo observed in elderly people.

Influence of saturated and unsaturated fats on platelet fatty acids in cholesterol-fed rabbits

Feeding natural fats varying in contents of palmitate (16:0), stearate (18:0), oleate (18:1), and linoleate (18:2) to rabbits resulted in modulation of platelet phospholipid fatty acyl composition. Rabbits were fed high fat semipurified diets containing 2% corn oil (CO) + 18% CO, cocoa butter (CB) or milkfat (M) for periods of up to 300 d. Platelet phospholipid linoleate contents corresponded to diet levels with 18:2 highest in CO-fed rabbits and following the sequence CO greater than CB greater than M. Stearate was highest in CB-fed rabbits, corresponding to high 18:0 levels in CB, but palmitate levels were not affected by diet. Both CB and M-fed rabbits were higher than CO-fed rabbits in oleate. Though CO is highest in 18:2, the accepted 20:4 precursor, arachidonate was highest in M-fed rabbits. Adding cholesterol (0.2%) to the diets did not affect platelet phospholipid fatty acyl composition except to elevate 20:4 in M-fed rabbits. CO-fed rabbits showed uniquely high levels of tetracosadienoate (24:2). Fatty acyl composition data were essentially constant between 200 and 300 d on diet. Phospholipid fatty acyl unsaturation was apparently homeostatically controlled as mole percent unsaturate to saturate ratios were independent of diet. The observed homeostasis resulted in minimal diet influences on platelet membrane fluidity and ADP or collagen stimulated platelet aggregation. Platelet fluidity, determined by fluorescence polarization, was a function of oleate and linoleate contents of the cells. Cholesterol feeding generally lowered platelet fluidity and altered the dependence of fluidity on fatty acyl composition.

Fatty acid composition of platelets and of plasma lipid esters in relation to platelet function in patients with ischaemic heart disease

Serum lipoproteins, fatty acids in plasma lipid esters and in platelet phospholipids were assessed in 64 patients with ischaemic heart disease (IHD) and in 67 controls. Hyperlipoproteinemia (HLP) (VLDL triglycerides greater than 1.4 mmol/l and/or LDL cholesterol greater than 5.2 mmol/l) was found in 64% of the patients. In the plasma lipid esters the relative concentrations of saturated and monounsaturated fatty acids as well as dihomo-gammalinolenic acid were higher in the IHD patients whereas the linoleic acid concentrations were lower. The altered fatty acid pattern was apparent both in patients with and without HLP. In the platelet phospholipids there was a relative increase of oleic acid and a decrease of stearic acid. The relative content of eicosapentaenoic acid was slightly reduced whereas the linoleic acid concentrations were unchanged compared to the controls. Platelet aggregation induced by ADP and collagen was enhanced in the IHD patients. The lowest threshold value for ADP-induced aggregation was found in the normolipidemic patients. Since there were almost no differences in the relative contents of the long-chain polyunsaturated fatty acids in the platelet phospholipids between patients and controls it is concluded that mechanisms other than the prostaglandin-mediated pathway may contribute to the increased platelet aggregation in IHD patients.

Acute postprandial lipaemia does not influence the in vivo activity of human platelets

Platelet function and serum lipid studies were conducted on nine healthy male subjects before and two hours after three separate meals, two of which were rich in fat: saturated fat (SF) or polyunsaturated fat (PUF), and a third control meal which contained no fat. Platelet activity was assessed by determination of in vivo platelet aggregate formation, and plasma levels of the platelet specific proteins platelet factor 4 (PF4) and beta-thromboglobulin (beta-TG). Serum triglyceride levels increased significantly after both fat containing meals but were unaffected by the fat free meal. Serum cholesterol levels were not affected by any of the three meals. Platelet function tests could not detect any alteration of in vivo platelet activity in terms of platelet aggregate formation or plasma concentrations of PF4 and beta-TG. These results are at variance with previously published studies that used less specific assays of platelet activity and which suggested platelet activation shortly after meals rich in SF.

Effects of dietary lipids on behaviour, lipid biosynthesis and lipid composition, in rat platelets

Rats of either sex were fed for 18 and 34 weeks respectively diets containing 40% (by weight) lipids with polyunsaturated fatty acids representing 1.34% or 13.2% of total calories. Platelet reactivity to thrombin, platelet fatty acid composition and incorporation of [14C]acetate into platelet lipids were investigated. Diets rich in saturated fatty acids markedly increased platelet sensitivity to thrombin. The concentration of 20:3 and 22:3 of the (n - 9) series and of 20:3 and 22:5 of the (n - 6) series were increased at the expense of 18:2 and 22:4 of the (n - 6) family in platelet lipids. 20:4 (n - 6) was unchanged. The fatty acid changes were more pronounced in male rats and after 34 weeks. [14C]Acetate incorporation into total platelet lipids and particularly into choline phosphoglycerides and ceramides was lower in animals fed saturated fats. This diet reduced the synthesis of 16:0 and of 22:4(n - 6) in platelet total fatty acids, while that of 22:3(n - 9) was markedly enhanced. This study showed that long-term feeding of high-saturated-low-polyunsaturated fat diets in rats induced marked changes in platelet lipid synthesis and composition, in both sexes. The lipid synthesis modification appears to be more pronounced in males than in females. The changes in the fatty acids 20:3(n - 9), 22:3(n - 9) and 22:4(n - 6) appeared to be closely related to platelet behaviour. The balance between the content and synthesis of these last fatty acids might be of significance for the effect of diet on thrombogenesis.

Platelet membrane fatty acids in thrombocytosis due to myeloproliferative disorders

The fatty acid composition of platelet membranes has been analysed in patients with thrombocytosis due to myeloproliferative disorders, who had not taken any drugs. A significant increase in palmitic and oleic acid, together with a decrease in stearic, linoleic and arachidonic acids was observed. The fatty acid pattern of platelet membranes was also analysed in patients during treatment with ASA (acetylsalicylic acid). ASA ingestion completely normalizes the platelet content of palmitic acid and partially that of stearic and arachidonic acid, whereas it has no effect on the level of linoleic acid and raises that of oleic acid. The altered pattern of fatty acids observed in patients may interfere with platelet function by decreasing membrane fluidity. Treatment of patients with ASA seems to act on platelet membranes by partially normalizing the fatty acid composition.

Protein-stimulated enrichment of human platelet membranes in linoleylphosphatidylcholines. Effect upon adenylate cyclase and fluidity

In order to study the effect of linoleyl enrichment of platelet membranes upon adenylate cyclase activity and membrane fluidity, manipulations of platelet phospholipids are carried out with phosphatidylcholine-loaded high-density lipoproteins (HDL) or phospholipid-exchange protein and phospholipid-cholesterol mixed vesicles. Incubation with HDL does not appear to be valuable for this purpose. On the other hand, phospholipid-exchange protein and mixed vesicles can be used successfully. Phospholipid-exchange protein stimulated 3-fold the spontaneous exchange of 2-linoleylphosphatidylcholine between the vesicles and the platelets. Linoleyl enrichment of platelets by dilinoleylphosphatidylcholine is about 25% and by 2-linoleylphosphatidylcholine is about 45-50%. The unsaturation index remains constant when the enrichment is performed using dilinoleylphosphatidylcholine but it increases with 2-linoleylphosphatidylcholine. Basal and prostaglandin E1-stimulated adenylate cyclase activities are not modified by dilinoleylphosphatidylcholine, while they increase significantly in the case of 2-linoleylphosphatidylcholine. There is no significant variation in diphenyl hexatriene fluorescence polarization parameters, either with dilinoleylphosphatidylcholine or with 2-linoleylphosphatidylcholine.

Further observations on the effects of dietary fatty acid composition on platelet reactivity and blood coagulation in man and the influence of methodology on findings

Eight human subjects were fed diets enriched in saturated fat (SF), or polyunsaturated fat (PUF) and after each dietary regimen the plasma heparinthrombin clotting time (HTCT) was determined. The HTCT of citrated plasma indicated reduced heparin-neutralizing activity (HNA) after PUF feeding compared with SF feeding. Platelet factor 4 (PF4) levels in the citrated plasma samples demonstrated an inverse correlation with the HTCT (r = 0.62). Experiments with purified PF4 indicated that the PF4 present in citrated plasma could only account for approximately 10% of the HNA. Plasma prepared in a manner which minimized in vitro release of platelet constituents contained significantly less PF4 after PUF feeding and indicated that most of the PF4 found in citrated plasma resulted from in vitro release. The factor Xa inhibitory activity of citrated plasma was not significantly altered by either of the dietary regimens.

The effect of hypercholesterolaemia on the lipid composition and ability of human platelets to accumulate cyclic AMP

Washed human platelets from seventeen hypercholesterolaemic subjects were compared to those from seventeen age and sex matched controls with respect to lipid composition and ability to accumulate cyclic AMP. No significant difference in platelet lipid composition was found in terms of total cholesterol, phospholipid or the ratio of cholesterol to phospholipid. There was no significant different in basal levels of platelet cyclic AMP between the two groups. Platelets from hypercholesterolaemic subjects showed an impaired ability to accumulate cyclic AMP compared with controls when challenged with prostaglandins (PG) I2, D2 and E1. The platelet inhibitory actions of PGI2, PGD2 and PGE1, which are mediated by cyclic AMP are thought to be important mechanisms for the control of platelet-platelet and platelet-vessel wall interaction. Thus, an impaired response to these three prostaglandins may be relevant to our understanding of the role played by the platelet in mediating vessel wall pathology caused by hypercholesterolaemia.

Effect of dietary fat on the fluidity of platelet membranes

Dietary fat type was reflected in the phospholipid fatty acid composition of the plasma membrane of rabbit platelets and apparently controlled the fluidity of these membranes. Rabbits were maintained for 6 months on diets that varied in stearic and polyunsaturated fatty acids and thus had different potentials for thrombosis. Microviscosities at 37 C, calculated from the arisotropy of fluorescence from the probe 1,6-diphenyl-1,3,5-hexatriene, were 3.5, 3.4, 2.8 and 2.2 poise for platelet membranes isolated from rabbits whose only source of dietary fat was cocoa butter, milkfat, coconut oil, or corn oil, respectively. The relative findings of the membrane isolates were correlated with the polyunsaturated fatty acid contents of the membrane phospholipids.

Circulating platelet aggregates in an adult population sample. Relationships with the main coronary risk factors and cardiovascular diseases

We have determined the reversible circulating platelet aggregates (CPA) in a sample taken from the general population (414 consecutive individuals of both sexes, aged 20--60 years), examined during the initial screening of a multifactor primary prevention trial for coronary heart disease. Our findings show that in the overall population, less than 10% of circulating platelets occur as reversible aggregates. No differences were observed with regard to sex, age or presence of non-acute cardiovascular disease. No significant correlations were found between the extent of CPA and the main coronary risk factors.

The protective effects of dietary fish oil on focal cerebral infarction

The protective effect of the (n-3) fatty acids in menhaden fish oil on acute cerebral ischemia was investigated in cats. Cerebral ischemia was produced by ligation of the left middle cerebral artery of cats fed either a basal diet of feline cat chow or the basal diet supplemented with 8% of the calories as menhaden oil for 18-24 days. Fatty acids esters of 20:5 (n-3) were increased and the 18:2 (n-6) decreased in the heart and liver of cats fed supplemental fish oil, but the brain lipid showed no effect of the diet. We found that the neurological deficit and the volume of brain infarction in the group treated with fish oil was less than that of the control group. The present findings suggest that moderate dietary supplements of fish oil may be beneficial in the prophylactic treatment of ischemic cerebral vascular disease.