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Platelet receptor expression and shedding: glycoprotein Ib-IX-V and glycoprotein VI. Transfus Med Rev 2014; 28:56-60. [PMID: 24674813 DOI: 10.1016/j.tmrv.2014.03.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/04/2014] [Accepted: 03/04/2014] [Indexed: 01/13/2023]
Abstract
Quantity, quality, and lifespan are 3 important factors in the physiology, pathology, and transfusion of human blood platelets. The aim of this review is to discuss the proteolytic regulation of key platelet-specific receptors, glycoprotein(GP)Ib and GPVI, involved in the function of platelets in hemostasis and thrombosis, and nonimmune or immune thrombocytopenia. The scope of the review encompasses the basic science of platelet receptor shedding, practical aspects related to laboratory analysis of platelet receptor expression/shedding, and clinical implications of using the proteolytic fragments as platelet-specific biomarkers in vivo in terms of platelet function and clearance. These topics can be relevant to platelet transfusion regarding both changes in platelet receptor expression occurring ex vivo during platelet storage and/or clinical use of platelets for transfusion. In this regard, quantitative analysis of platelet receptor profiles on blood samples from individuals could ultimately enable stratification of bleeding risk, discrimination between causes of thrombocytopenia due to impaired production vs enhanced clearance, and monitoring of response to treatment prior to change in platelet count.
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Abstract
Platelets are small, non-homogenous cells with distinctive surface features important to their essential role in hemostasis. The surface membrane is dynamic, and changes remarkably in lipid asymmetry and receptor expression on triggering of the activation process. There are also extensive and rapid intracellular changes in platelets as a result of biochemical activation through calcium fluxes, phospholipase activity, kinase activity, and phosphorylation mechanisms that lead to release of storage granule contents and generation of fast-acting prostaglandins, all in a matter of seconds after stimulation with a strong agonist. These characteristics make the platelet an interesting but difficult cell to study, and the explosion of knowledge over the last two decades has been fueled in large part by the application of flow cytometry techniques. Clinical applications of flow cytometry analysis of platelets have been pursued in individual specialized medical centers, but have not found widespread practice in clinical laboratories, mostly because of difficulties in standardization of techniques and the inherent biovariability in comparing normal to abnormal platelets. Despite these hurdles, it seems certain that flow cytometry analysis of platelets in pathological states will continue to evolve into more practical and robust procedures that will eventually become standard hematologic assays rather than specialized research tools.
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Affiliation(s)
- Darren H M Hickerson
- Department of Pathology and Laboratory Medicine, 241 Life Sciences Building, Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA
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Kunishima S, Shimizu T, Kora S, Kamiya T, Ozawa K. Determination of glycocalicin in platelet concentrate supernatants stored in a synthetic medium (Seto solution). Vox Sang 2000; 75:74-5. [PMID: 9779564 DOI: 10.1046/j.1423-0410.1998.7510074.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kostelijk E, Folman C, Gouwerok C, Kramer C, Verhoeven A, Korte D. Increase in Glycocalicin Levels in Platelet Concentrates Stored in Plasma or Synthetic Medium for 8 Days: Comparison with Other Platelet Activation Markers. Vox Sang 2000. [DOI: 10.1046/j.1423-0410.2000.7910021.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Milne AA, Adam DJ, Murphy WG, Ruckley CV. Effects of asymptomatic abdominal aortic aneurysm on the soluble coagulation system, platelet count and platelet activation. Eur J Vasc Endovasc Surg 1999; 17:434-7. [PMID: 10329529 DOI: 10.1053/ejvs.1998.0790] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES the aim of the study was to determine the effects of infrarenal asymptomatic abdominal aortic aneurysm (AAA) on platelet count and activation. DESIGN prospective clinical study in a University Department of Vascular Surgery. PATIENTS one hundred and five patients with AAA. Thirty-two control patients with symptomatic carotid artery stenoses. METHODS platelet count (PC), plasma glycocalicin levels, prothrombin ratio (PTR), activated partial thromboplastin time (APPT), fibrinogen and D-dimer were measured in 23 patients with AAA and 16 control patients with symptomatic carotid artery stenoses. PC alone was measured in a further 84 patients with AAA and 16 with carotid artery stenoses. RESULTS PC was below the normal range in 8/105 patients and mean PC (215x10(9)/l, S.D. 47.5) was significantly lower than that of a control population (242x10(9)/l, S.D. 16.8) and patients with carotid disease (269x10(9)/l, S.D. 57). Glycocalicin level was above the normal range in 7/23 patients and the median level (28 fg/plt) was significantly higher than that of a normal population (21.6 fg/plt) and patients with carotid disease (12.3 fg/plt). Fibrinogen levels, PTR and APPT were all within the normal range. One patient had a minimally elevated level of D-dimer. CONCLUSIONS the combination of low PC and high glycocalicin levels suggests that there is increased platelet destruction, most likely due to activation within the aneurysm sac.
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Affiliation(s)
- A A Milne
- Vascular Surgery Unit, University Department of Surgery, Royal Infirmary of Edinburgh, U.K
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Sciscione AC, Bessos H, Callan N, Blakemore K, Kickler T. Indicators of platelet turnover in thrombocytopenic infants. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1997; 104:743-5. [PMID: 9197883 DOI: 10.1111/j.1471-0528.1997.tb11990.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Glycocalicin has been found to be a marker of increased platelet turnover, while interleukin-6 may be increased in response to thrombocytopenia. We used these markers to study the pathophysiology of thrombocytopenia in newborn infants. Cord blood platelet counts were obtained from 499 infants. Thrombocytopenic infants (< 100,000/mm3) and a control group had ELISA assays for interleukin-6 and glycocalicin performed. The mean levels of glycocalicin and interleukin-6 were elevated in cord blood of thrombocytopaenic infants. Infants with intrauterine growth restriction and thrombocytopaenia had no detectable glycocalicin in their plasma, despite elevated levels of interleukin-6. This probably reflects impaired thrombopoiesis in these infants.
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Affiliation(s)
- A C Sciscione
- Department of Gynaecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Bessos H, Atkinson A, McGill A, Baillie J, Seghatchian J, Vickers M, Bishop D, Tandy N, Murphy WG. Apheresis platelet concentrates: correlation of day one levels of in vitro quality markers with corresponding levels on days two to five of storage. Thromb Res 1996; 84:367-72. [PMID: 8948064 DOI: 10.1016/s0049-3848(96)00201-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- H Bessos
- Edinburgh and South-East Scotland Blood Transfusion Service, Royal Infirmary, UK
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Huggan PJ, Milne AA, Bessos H, Atkinson A, Murphy WG. Plasma glycocalicin levels are not elevated in patients with a history of transient ischaemic event and are normal in aspirinated normal volunteers. Thromb Res 1996; 81:339-43. [PMID: 8928091 DOI: 10.1016/0049-3848(96)00005-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Glycocalicin (GC) is the soluble portion of platelet membrane protein GP1b, and may be cleaved from the platelet surface during platelet activation. Previous study has indicated that plasma glycocalicin/platelet (GC/plt) levels are elevated in patients presenting with acute stroke. The present study was undertaken to determine the GC/plt levels in patients being treated for transient ischaemic episodes, to assess whether the elevated GC/plt level in acute stroke is due to a detectable, constitutive premorbid state of platelet activation. In sixteen consecutive patients attending a vascular surgery clinic, GC levels were measured on a citrated plasma sample, and corrected for circulating platelet count. Since 15 of 16 patients were taking aspirin when seen at clinic, a control study was undertaken to assess the effect of aspirin on sequential plasma GC/plt levels measured over 10 days--5 pre and post daily aspirin for 5 days, 4 acting as non-aspirinated controls. Plasma GC/plt levels in normal plasma were 21.6 +/- 8.0 fg; mean +/- SD. In the 16 patients the GC/plt levels were 13.1 fg/plt; SD 5.4, range 2.9-24.3. All platelet counts were in the normal range in all patients involved. While a masking effect due to aspirin cannot be completely ruled out, these studies indicate that plasma GC/plt level is not useful as a predictor of acute stroke in the premorbid population.
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Affiliation(s)
- P J Huggan
- Faculty of Medicine, University of Edinburgh, Scotland
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Bessos H, Atkinson A, Murphy WG, McGill A, Robertson M, Seghatchian MJ, Vickers M, Bishop D, Tandy N. A comparison of in vitro storage markers between gamma-irradiated and non-irradiated apheresis platelet concentrates (APC). TRANSFUSION SCIENCE 1995; 16:131-4. [PMID: 10155728 DOI: 10.1016/0955-3886(95)97395-g] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- H Bessos
- Department of Transfusion Medicine, South East Scotland Regional Transfusion Centre, Royal Infirmary, Edinburgh, U.K
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Divers SG, Kannan K, Stewart RM, Betzing KW, Dempsey D, Fukuda M, Chervenak R, Holcombe RF. Quantitation of CD62, soluble CD62, and lysosome-associated membrane proteins 1 and 2 for evaluation of the quality of stored platelet concentrates. Transfusion 1995; 35:292-7. [PMID: 7535481 DOI: 10.1046/j.1537-2995.1995.35495216076.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Platelets become activated during storage, which results in secretion of granules, vesiculation of microparticles, secretion of protein, and a number of other biochemical and morphologic processes that decrease the utility of platelet concentrates stored for transfusion. STUDY DESIGN AND METHODS To evaluate the quality of stored platelet concentrates, the cell surface expression of specific activation-dependent antigens (CD62 and lysosome-associated membrane proteins 1 and 2 [LAMP-1, LAMP-2]) on platelets stored in a hospital blood bank over a 7-day period was examined. Relative microparticle counts and the expression of CD62 by microparticles, as well as platelet concentrate supernatant levels of soluble CD62, were determined. RESULTS The percentage of platelets expressing CD62 increased significantly from Day 1 to Day 5 (p < 0.05) of storage; the mean fluorescence values for CD62 did not. In contrast, the mean fluorescence values of LAMP-1 and LAMP-2 rose significantly (p < 0.01 and p < 0.05, respectively) between Days 1 and 5. Significant declines in CD62, LAMP-1, and LAMP-2 percent expression and mean fluorescence were seen on Day 6 of storage (p < 0.001). Microparticle numbers increased significantly during storage and correlated with levels of CD62 protein (free and membrane-bound) (r = 0.95 vs. Day 2, p < 0.05; r = 0.88 vs. Day 5, p < 0.05). CONCLUSION Flow cytometric evaluations of the expression of cell surface CD62, LAMP-1, and LAMP-2 are complementary tests that, especially when used in conjunction with the quantitation of CD62 protein, provided a simple and effective means of evaluating the quality of platelet concentrates stored for transfusion.
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Affiliation(s)
- S G Divers
- Department of Medicine, Louisiana State University Medical Center, Shreveport, USA
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Rivera J, Sánchez-Roig MJ, Rosillo MC, Moraleda JM, Vicente V. Stability of glycoproteins Ib/IX and IIb/IIIa during preparation and storage of platelet concentrates: detection by binding assays with epitope-defined monoclonal antibodies and physiological ligands. Vox Sang 1994; 67:166-71. [PMID: 7528455 DOI: 10.1111/j.1423-0410.1994.tb01653.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Preservation of the glycoprotein (GP) complexes Ib/IX and IIb/IIIa, because of their role as specific platelet receptors for adhesive proteins, is essential for the haemostatic efficacy of transfusions of platelet concentrates (PCs). We have combined binding assays with epitope-defined monoclonal antibodies, and with the physiological ligands von Willebrand factor and fibrinogen (Fo), to investigate the total expression and functional status of these receptors, in PCs stored for up to 9 days. Routine preparation and storage for up to 5 days have no apparent effect on the surface expression and the functional status of GPs Ib/IX and IIb/IIIa. However, after prolonged storage for up to 9 days we found a 50% decrease in the level of the total and functional GP Ib/IX content of platelets. This finding parallelled a significant rise in plasma glycocalicin, a proteolytic fragment of GP Ib. In addition, long-term storage promoted an impairment in the exposure of GP IIb/IIIa to Fo, and a 50% decrease in Fo binding capacity, without affecting the complex quantitatively. Finally, we also noticed a storage-induced increase in the platelet surface expression of GMP 140, and after 9 days of storage there was a rise in mean platelet volume, and a significant reduction in pH levels.
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Affiliation(s)
- J Rivera
- Unit of Hematology and Hemotherapy, School of Medicine, General University Hospital, Murcia, Spain
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Murphy WG, Palmer JP, Green RH. The management of haemorrhage in the refractory non-alloimmunized thrombocytopenic patient. Vox Sang 1994; 67 Suppl 3:99-103. [PMID: 7975521 DOI: 10.1111/j.1423-0410.1994.tb04553.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- W G Murphy
- South East Scotland Blood Transfusion Service, Academic Unit, Edinburgh
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Bessos H, Murphy WG, Robertson A, Vickers M, Seghatchian MJ, Tandy NP, Cutts M, Pamphilon DH. Quality of platelet concentrates irradiated with UVB light: effect of UV dose and dose rate on glycocalicin release and correlation with other markers of the platelet storage lesion. Transfus Med 1993; 3:115-21. [PMID: 8374699 DOI: 10.1111/j.1365-3148.1993.tb00048.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The amount of membrane-associated glycoprotein Ib in platelet concentrates (PCs) irradiated with a high dose of UVB light has been shown to be significantly reduced after 48 h storage. We recently corroborated this finding when we noted an increase in the supernatant levels of glycocalicin (GC, a major segment of glycoprotein Ib) in UVB-treated PCs during storage. The aim of the present study was to determine whether GC release was related to both the UV dose and the rate of dose delivery. Plateletpheresis concentrates obtained from five donors were pooled and split into five equal parts. Four of these were treated with 7500 and 15,000 mJ/cm2 UVB using two prototype UV sources with differing rates of dose delivery; namely, Baxter (BAT) and British Aerospace (BAC) cabinets, with the latter having the slower rate of delivery. On days 1 and 5 of storage, GC levels in the supernatants of PCs were determined by ELISA. Moreover, the following parameters were also assessed: platelet and WBC count; hypotonic shock response (HSR) and platelet aggregation response to ADP, ADP+collagen, ADP+arachidonic acid and ristocetin; pH; supernatant levels of lactate, glucose, von Willebrand factor (vWf) and beta-thromboglobulin (beta TG). The results revealed an association of GC release with UVB dose using both UV sources, although this was more apparent in the BAC system, in which glycocalicin release at day 5 of storage was as follows (microgram/ml, mean +/- SD): 4.8 +/- 0.3 and 9.5 +/- 3.6 at 7500 and 15,000 mJ/cm2 respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H Bessos
- Edinburgh & S.E. Scotland Blood Transfusion Service, Department of Transfusion Medicine, Royal Infirmary of Edinburgh, U.K
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Bessos H, Goldschmeding R, von dem Borne A, Atkinson A, Murphy WG. The development of a simple and quick enzyme-linked immunosorbent assay for anti-HPA1a (PLA1) antibodies. Thromb Res 1993; 69:395-400. [PMID: 8470061 DOI: 10.1016/0049-3848(93)90039-q] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- H Bessos
- Edinburgh and South East Scotland Blood Transfusion Service, Royal Infirmary
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Black IW, Chesterman CN, Hopkins AP, Lee LC, Chong BH, Walsh WF. Hematologic correlates of left atrial spontaneous echo contrast and thromboembolism in nonvalvular atrial fibrillation. J Am Coll Cardiol 1993; 21:451-7. [PMID: 8426010 DOI: 10.1016/0735-1097(93)90688-w] [Citation(s) in RCA: 146] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVES This study examined the relation between left atrial spontaneous echo contrast, hematologic variables and thrombo-embolism in patients with nonvalvular atrial fibrillation. BACKGROUND Left atrial spontaneous echo contrast is associated with left atrial stasis and thromboembolism in patients with nonvalvular atrial fibrillation. However, its hematologic determinants in patients with nonvalvular atrial fibrillation are unknown. METHODS Clinical, hematologic and echocardiographic variables were prospectively measured in 135 consecutive patients with nonvalvular atrial fibrillation undergoing transesophageal echocardiography. RESULTS Patients with left atrial spontaneous echo contrast (n = 74, 55%) had an increased fibrinogen concentration (p = 0.029), platelet count (p = 0.045), hematocrit (p = NS) and left atrial dimension (p = 0.005). Multivariate analysis showed that left atrial spontaneous echo contrast was independently related to hematocrit (odds ratio = 2.24, p = 0.002), fibrinogen concentration (odds ratio = 2.08, p = 0.008) and left atrial dimension (odds ratio = 1.90, p = 0.004) but not platelet count. It was also associated with left atrial thrombus (n = 15, p = 0.001) and with recent embolism (n = 40, p < 0.001). In 40 clinically stable outpatients without previous embolism, left atrial spontaneous echo contrast was significantly related to hematocrit (p = 0.005), fibrinogen concentration (p = 0.035) and left atrial dimension (p = 0.029) but not to coagulation factor VII, D-dimer, erythrocyte sedimentation rate, platelet count, plasma beta-thromboglobulin, plasma glycocalicin or glycocalicin index. CONCLUSIONS Left atrial spontaneous echo contrast in patients with nonvalvular atrial fibrillation is independently related to hematocrit, fibrinogen concentration and left atrial dimension, indicating a relatively hypercoagulable state in addition to stasis. These findings support the hypothesis that left atrial spontaneous echo contrast is due to erythrocyte aggregation. Hematologic factors may contribute to its association with thromboembolism.
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Affiliation(s)
- I W Black
- Department of Cardiovascular Medicine, Prince Henry Hospital, Sydney, Australia
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Ribeiro A, Swann JC, Berndt MC. Alterations of the levels of glycoproteins Ib-IX and IIb-IIIa in platelets stored at 22 degrees C. Thromb Res 1992; 66:619-27. [PMID: 1381527 DOI: 10.1016/0049-3848(92)90038-c] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Platelets stored in CLX blood bags, under normal blood banking conditions, were studied for up to 7 days to determine if changes occurred in the levels of membrane glycoproteins (GP) Ib-IX and IIb-IIIa. Radiolabeled monoclonal antibodies (MAB) were used to estimate the number of glycoprotein molecules on the surface membrane of intact platelets. GP IX and GP IIb-IIIa levels remained essentially unaltered during storage. In contrast, the content of GP Ib at day 7 decreased by 45% of the total when fresh. The aggregation response to ristocetin, which requires GP Ib, was also diminished after 7 days. Addition of protease inhibitors, leupeptin and/or aprotinin did not appear to influence the degradation of this glycoprotein. We conclude that storage at 22 degrees C had deleterious effects on the GP Ib content of platelets.
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Affiliation(s)
- A Ribeiro
- NSW Red Cross Blood Transfusion Service, Sydney, Australia
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