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Ding R, Zeng Y, Wei Z, He Z, Jiang Z, Yu J, You C. The L-shape relationship between hemoglobin, albumin, lymphocyte, platelet score and the risk of diabetic retinopathy in the US population. Front Endocrinol (Lausanne) 2024; 15:1356929. [PMID: 38800491 PMCID: PMC11116578 DOI: 10.3389/fendo.2024.1356929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 04/22/2024] [Indexed: 05/29/2024] Open
Abstract
Background The primary aim of this study was to investigate the correlation between diabetic retinopathy (DR) and the HALP score (hemoglobin, albumin, lymphocyte, and platelet) in individuals with diabetes within the United States population. Methods This cross-sectional investigation was based on the National Health and Nutrition Examination Survey (NHANES) database from 2003-2018. The following module calculated the HALP score: HALP score = [lymphocytes (/L) × hemoglobin (g/L) × albumin (g/L)]/platelets (/L). By performing the receiver operating characteristic (ROC) analysis, the optimal cutoff value of HALP was ascertained. Restricted cubic splines (RCS), multivariable logistic regression analysis, sensitivity analysis, and subgroup analysis were conducted to evaluate the effect of the HALP score on DR patients. Finally, the decision curve analysis (DCA) and clinical impact curve (CIC) were conducted to estimate the predictive power and clinical utility of the HALP score with clinical indicators. Results According to the cutoff value (42.9) determined by the ROC curve, the participants were stratified into a lower HALP group (HALPlow) and a higher HALP group (HALPhigh). An L-shaped relationship between HALP score and DR risk was presented in the RCS model (P for nonlinearity <0.001). The DR risk sharply decreased with the increase of HALP, and the decline reached a plateau when HALP was more than 42.9. After fully adjustment, the multivariate logistic regression analysis found that HALPlow was an independent risk factor for DR (OR = 1.363, 95% CI: 1.111-1.671, P < 0.001). Besides, sensitivity analysis showed consistent results. Furthermore, the combination of HALP score and clinical indicators demonstrated predictive power and clinical utility, as shown by the ROC curve, DCA, and CIC. Conclusion The HALP score has an L-shaped correlation with the risk of DR, and thus, the HALP score may contribute to the timely intervention of diabetes patients.
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Affiliation(s)
- Ranran Ding
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
- Tianjin Medical University, Heping District, Tianjin, China
| | - Yusong Zeng
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
- Tianjin Medical University, Heping District, Tianjin, China
| | - Zhimei Wei
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
- Tianjin Medical University, Heping District, Tianjin, China
| | - Zitong He
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
- Tianjin Medical University, Heping District, Tianjin, China
| | - Zhixin Jiang
- Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, Tianjin Eye Institute, Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, China
| | - Jinguo Yu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Caiyun You
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
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Wei S, Pan X, Xiao Y, Chen R, Wei J. The unique association between the level of plateletcrit and the prevalence of diabetic kidney disease: a cross-sectional study. Front Endocrinol (Lausanne) 2024; 15:1345293. [PMID: 38726343 PMCID: PMC11079161 DOI: 10.3389/fendo.2024.1345293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/02/2024] [Indexed: 05/12/2024] Open
Abstract
Objective The activation of platelets in individuals with type 2 diabetes mellitus (T2DM) triggers inflammation and hemodynamic abnormalities, contributing to the development of diabetic kidney disease (DKD). Despite this, research into the relationship between plateletcrit (PCT) levels and DKD is sparse, with inconsistent conclusions drawn regarding the connection between various platelet parameters and DKD. This highlights the necessity for comprehensive, large-scale population studies. Therefore, our objective is to explore the association between PCT levels and various platelet parameters in relation to DKD. Methods In this cross-sectional study, hematological parameter data were collected from a cohort of 4,302 hospitalized Chinese patients. We analyzed the relationships between PCT, platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and DKD, along with the urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR). Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic potential of these parameters. Results DKD patients exhibited significantly higher PCT levels compared to those without DKD. Multivariate regression analysis identified elevated PCT and PLT levels as potential independent risk factors for both DKD and UACR, while lower MPV levels might serve as independent protective factors for eGFR. The areas under the ROC curve for PCT in relation to DKD and UACR (≥30 mg/g) were 0.523 and 0.526, respectively. The area under the ROC curve for PLT in relation to UACR (≥30 mg/g) was 0.523. Conclusion PCT demonstrates a weak diagnostic value for T2DM patients at risk of developing DKD and experiencing proteinuria, and PLT shows a similarly modest diagnostic utility for detecting proteinuria. These insights contribute to a deeper understanding of the complex dynamics involved in DKD. Additionally, incorporating these markers into routine clinical assessments could enhance risk stratification, facilitating early interventions and personalized management strategies.
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Affiliation(s)
- Shuwu Wei
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Xinyu Pan
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yao Xiao
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Ruishuang Chen
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Junping Wei
- Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Xie Y, Shao X, Zhang P, Zhang H, Yu J, Yao X, Fu Y, Wei J, Wu C. High Starch Induces Hematological Variations, Metabolic Changes, Oxidative Stress, Inflammatory Responses, and Histopathological Lesions in Largemouth Bass ( Micropterus salmoides). Metabolites 2024; 14:236. [PMID: 38668364 PMCID: PMC11051861 DOI: 10.3390/metabo14040236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/09/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
This study evaluated effects of high starch (20%) on hematological variations, glucose and lipid metabolism, antioxidant ability, inflammatory responses, and histopathological lesions in largemouth bass. Results showed hepatic crude lipid and triacylglycerol (TAG) contents were notably increased in fish fed high starch. High starch could increase counts of neutrophils, lymphocytes, monocytes, eosinophils, and basophils and serum contents of TAG, TBA, BUN, and LEP (p < 0.05). There were increasing trends in levels of GLUT2, glycolysis, gluconeogenesis, and LDH in fish fed high starch through the AKT/PI3K signal pathway. Meanwhile, high starch not only triggered TAG and cholesterol synthesis, but mediated cholesterol accumulation by reducing ABCG5, ABCG8, and NPC1L1. Significant increases in lipid droplets and vacuolization were also shown in hepatocytes of D3-D7 groups fed high starch. In addition, high starch could decrease levels of mitochondrial Trx2, TrxR2, and Prx3, while increasing ROS contents. Moreover, high starch could notably increase amounts of inflammatory factors (IL-1β, TNF-α, etc.) by activating NLRP3 inflammasome key molecules (GSDME, caspase 1, etc.). In conclusion, high starch could not only induce metabolic disorders via gluconeogenesis and accumulation of glycogen, TAG, and cholesterol, but could disturb redox homeostasis and cause inflammatory responses by activating the NLRP3 inflammasome in largemouth bass.
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Affiliation(s)
| | - Xianping Shao
- National-Local Joint Engineering Laboratory of Aquatic Animal Genetic Breeding and Nutrition (Zhejiang), Department of Fisheries, School of Life Science, Huzhou University, 759 East 2nd Road, Huzhou 313000, China; (Y.X.); (P.Z.); (H.Z.); (J.Y.); (X.Y.); (Y.F.); (J.W.)
| | | | | | | | | | | | | | - Chenglong Wu
- National-Local Joint Engineering Laboratory of Aquatic Animal Genetic Breeding and Nutrition (Zhejiang), Department of Fisheries, School of Life Science, Huzhou University, 759 East 2nd Road, Huzhou 313000, China; (Y.X.); (P.Z.); (H.Z.); (J.Y.); (X.Y.); (Y.F.); (J.W.)
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AlShareef AA, Alrawaili MS, Almutairi SA, Ayyad MM, Alshora W. Association of Hematological Parameters and Diabetic Neuropathy: A Retrospective Study. Diabetes Metab Syndr Obes 2024; 17:779-793. [PMID: 38371389 PMCID: PMC10874184 DOI: 10.2147/dmso.s453766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/08/2024] [Indexed: 02/20/2024] Open
Abstract
Background Diabetic neuropathy (DN) is a common complication of type 2 diabetes (T2DM) and is characterized by persistent inflammation. Hematological parameters have emerged as a novel marker for detecting chronic inflammatory conditions, including diabetes. Aim We aim to examine the association between HbA1c levels, which can indicate the presence of diabetic neuropathy, and hematological parameters to explore the possibility of using hematological parameters as a new indicator for DN in T2DM patients. Methods This was a retrospective study of 768 (483 males and 284 females) medical records of adult T2DM patients with or without neuropathy who attending the outpatient neuromuscular clinic at King Abdul-Aziz University Hospital from January 2016 to December 2021. Results The results showed significant increases in HbA1c levels (p=0.000), lymphocyte levels (p=0.028), and the neutrophil-lymphocyte ratio (NLR) (p=0.011). In the T2DM group, HBA1C levels were found to be positively correlated with age (r=0.306, p=0.000), neutrophil (NEUT) (r=0. 287, p=0.000), platelet (PLT) (r=0. 148, p=0.039), and neutrophil-lymphocyte ratio (NLR) (r=0.306193, p=0.0007), and negatively correlated with gender (r=-0.306193, p=0.0007). In the T2DMN group, HBA1C levels showed a positive correlation with hemoglobin (HB) (r=0.084, p=0.045), PLT (r=0.087, p=0.037), and PLT/mean corpuscular hemoglobin (MCH) ratio (PLT/MCH ratio) (r=0.12, p=0.004), and a negative correlation with age (r=-0.204, p=0.000), gender (r=-0.086, p=0.041), weight (WT) (r=-0.113, p=0.007), Body Surface Area (BSA) (r=-0.09, p=0.031), mean corpuscular volume (MCV) (r=-0.292, p=0.000), and MCH (r=-0.186, p=0.000). Conclusion Our study found a significant association between HbA1c, a biomarker for diabetic neuropathy, and various hematological parameters (HB, MCV, MCH, PLT, PLT/MCH ratio) in T2DMN patients. By effectively controlling and monitoring these variables, it may be feasible to prevent or delay the progression of peripheral neuropathy in diabetic patients. However, further research is needed to validate these findings.
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Affiliation(s)
- Aysha A AlShareef
- Department of Neurology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Neuromuscular Medicine Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Moafaq S Alrawaili
- Department of Neurology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Neuromuscular Medicine Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salwa Awwadh Almutairi
- Department of Neurology, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mustafa Mohammad Ayyad
- Department of Neurology, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Weam Alshora
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
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Kaur R, Mittal K, Cheema RK, Gupta S, Sood T, Kaur P. Association of blood donor characteristics with in vitro platelet storage properties. Transfus Apher Sci 2023; 62:103746. [PMID: 37286442 DOI: 10.1016/j.transci.2023.103746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/17/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE The study was planned to determine the association of blood donor characteristics with in vitro quality of platelets. MATERIAL AND METHODS In the prospective observational study, a total of 85 male whole blood donors in the age group of 18-30 and 45-65 years were enrolled using purposive sampling method. Serum total cholesterol, glycosylated hemoglobin (HbA1c), and LDH levels were performed on donor pre-donation sample. Buffy coat platelet concentrates were prepared from 450 mL quadruple blood bags. Samples from platelets were taken on day one and five of storage and biochemical properties were observed. RESULTS Median MPV was higher in platelets from older blood donors on day five (9.8 vs 9.4, p = 0.037). Median LDH levels were also higher in platelets on day one and five from older donors (Day one: 204.5 vs 147, p = <0.000; day five: 278 vs 224, p = 0.001 respectively). Platelets from donors with high HbA1c levels had lower median pH (Day one: 7.31 vs 7.37, p = 0.024) and higher median glucose levels on day one of storage (Day one: 358 vs 311, p = 0.001). Higher median lactate levels throughout the storage period were also seen in platelets from donors with higher HbA1c levels (Day one: 7 vs 5.7, p = 0.037; Day five: 16 vs 12.2, p = 0.032). Glucose consumption (108 vs 66, p = 0.025) and lactate production (9 vs 6.4, p = 0.019) was higher in platelets from donors with higher HbA1c levels. CONCLUSION In vitro platelet storage properties are affected by blood donor characteristics.
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Affiliation(s)
- Ravneet Kaur
- Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
| | - Kshitija Mittal
- Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Rajbir Kaur Cheema
- Department of Transfusion Medicine, Maharishi Markandeshwar College of Medical Sciences and Research, Sadopur, Ambala, India
| | - Seema Gupta
- Department of Biochemistry, Government Medical College and Hospital, Chandigarh, India
| | - Tanvi Sood
- Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Paramjit Kaur
- Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India
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Iqbal I, Wilairatana P, Saqib F, Nasir B, Wahid M, Latif MF, Iqbal A, Naz R, Mubarak MS. Plant Polyphenols and Their Potential Benefits on Cardiovascular Health: A Review. Molecules 2023; 28:6403. [PMID: 37687232 PMCID: PMC10490098 DOI: 10.3390/molecules28176403] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/26/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Fruits, vegetables, and other food items contain phytochemicals or secondary metabolites which may be considered non-essential nutrients but have medicinal importance. These dietary phytochemicals exhibit chemopreventive and therapeutic effects against numerous diseases. Polyphenols are secondary metabolites found in vegetables, fruits, and grains. These compounds exhibit several health benefits such as immune modulators, vasodilators, and antioxidants. This review focuses on recent studies on using dietary polyphenols to treat cardiovascular disorders, atherosclerosis, and vascular endothelium deficits. We focus on exploring the safety of highly effective polyphenols to ensure their maximum impact on cardiac abnormalities and discuss recent epidemiological evidence and intervention trials related to these properties. Kaempferol, quercetin, and resveratrol prevent oxidative stress by regulating proteins that induce oxidation in heart tissues. In addition, polyphenols modulate the tone of the endothelium of vessels by releasing nitric oxide (NO) and reducing low-density lipoprotein (LDL) oxidation to prevent atherosclerosis. In cardiomyocytes, polyphenols suppress the expression of inflammatory markers and inhibit the production of inflammation markers to exert an anti-inflammatory response. Consequently, heart diseases such as strokes, hypertension, heart failure, and ischemic heart disease could be prevented by dietary polyphenols.
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Affiliation(s)
- Iram Iqbal
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (I.I.); (M.W.); (M.F.L.); (R.N.)
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Fatima Saqib
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Bushra Nasir
- Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan;
| | - Muqeet Wahid
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (I.I.); (M.W.); (M.F.L.); (R.N.)
| | - Muhammad Farhaj Latif
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (I.I.); (M.W.); (M.F.L.); (R.N.)
| | - Ahmar Iqbal
- Department of General Surgery, Shanxi Medical University, Jinzhong 030600, China;
| | - Rabia Naz
- Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (I.I.); (M.W.); (M.F.L.); (R.N.)
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A Comprehensive Literature Review on Cardioprotective Effects of Bioactive Compounds Present in Fruits of Aristotelia chilensis Stuntz (Maqui). Molecules 2022; 27:molecules27196147. [PMID: 36234679 PMCID: PMC9571323 DOI: 10.3390/molecules27196147] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
Some fruits and vegetables, rich in bioactive compounds such as polyphenols, flavonoids, and anthocyanins, may inhibit platelet activation pathways and therefore reduce the risk of suffering from CVD when consumed regularly. Aristotelia chilensis Stuntz (Maqui) is a shrub or tree native to Chile with outstanding antioxidant activity, associated with its high content in anthocyanins, polyphenols, and flavonoids. Previous studies reveal different pharmacological properties for this berry, but its cardioprotective potential has been little studied. Despite having an abundant composition, and being rich in bioactive products with an antiplatelet role, there are few studies linking this berry with antiplatelet activity. This review summarizes and discusses relevant information on the cardioprotective potential of Maqui, based on its composition of bioactive compounds, mainly as a nutraceutical antiplatelet agent. Articles published between 2000 and 2022 in the following bibliographic databases were selected: PubMed, ScienceDirect, and Google Scholar. Our search revealed that Maqui is a promising cardiovascular target since extracts from this berry have direct effects on the reduction in cardiovascular risk factors (glucose index, obesity, diabetes, among others). Although studies on antiplatelet activity in this fruit are recent, its rich chemical composition clearly shows that the presence of chemical compounds (anthocyanins, flavonoids, phenolic acids, among others) with high antiplatelet potential can provide this berry with antiplatelet properties. These bioactive compounds have antiplatelet effects with multiple targets in the platelet, particularly, they have been related to the inhibition of thromboxane, thrombin, ADP, and GPVI receptors, or through the pathways by which these receptors stimulate platelet aggregation. Detailed studies are needed to clarify this gap in the literature, as well as to specifically evaluate the mechanism of action of Maqui extracts, due to the presence of phenolic compounds.
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Fernández-Rojas M, Rodríguez L, Trostchansky A, Fuentes E. Regulation of platelet function by natural bioactive compounds. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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An Insight into Phytochemical, Pharmacological, and Nutritional Properties of Arbutus unedo L. from Morocco. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:1794621. [PMID: 34853597 PMCID: PMC8629616 DOI: 10.1155/2021/1794621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/23/2021] [Accepted: 11/07/2021] [Indexed: 11/18/2022]
Abstract
Arbutus unedo L. (Ericaceae) is an evergreen shrub widely distributed in the Mediterranean region, particularly through the Moroccan forests. It is an important medicinal plant of great scientific interest due to its nutritional, pharmacological, and chemical properties. The objective of this review is to provide insights into traditional medicinal uses and phytochemical and pharmacological properties of A. unedo from Morocco. In Morocco, the plant has been used as a traditional medicine to treat several pathological conditions. Many phytochemical compounds have been reported in the plant, of which vitamins, carotenoids, flavonoids, polyphenols, tannins, and their derivatives are the most prevalent. Leaves and fruits of A. unedo contain the most significant number of phytochemicals among the species. Furthermore, researchers have demonstrated that A. unedo exhibited antioxidant, anticancer, antibacterial, antidiabetic, antiaggregant, and antihypertensive activities due to the presence of many biochemical compounds with health-promoting properties. According to different toxicity tests, the use of A. unedo is devoid of any significant side effects and/or toxicity. Despite its nutraceutical and health-promoting properties, Moroccan A. unedo remains underexploited mainly, and most of its traditional uses have not yet undergone scientific evidence-based research; therefore, improved knowledge about the potential value of the plant would allow understanding of its biological activity based on its phytochemical compounds that may contribute to the species preservation and valorization.
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Cyperus esculentus L. and Tetracarpidium conophorum Müll. Arg. Supplemented Diet Improved Testosterone Levels, Modulated Ectonucleotidases and Adenosine Deaminase Activities in Platelets from L-NAME-Stressed Rats. Nutrients 2021; 13:nu13103529. [PMID: 34684530 PMCID: PMC8541559 DOI: 10.3390/nu13103529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 02/07/2023] Open
Abstract
In hypertensive individuals, platelet morphology and function have been discovered to be altered, and this has been linked to the development of vascular disease, including erectile dysfunction (ED). The impact of nutritional supplementation with Cyperus esculentus (tiger nut, TN) and Tetracarpidium conophorum (walnut, WN) on androgen levels, ectonucleotidases, and adenosine deaminase (ADA) activities in platelets from L-NAME (Nω-nitro-L-arginine methyl ester hydrochloride) challenged rats were investigated. We hypothesized that these nuts may show a protective effect on platelets aggregation and possibly enhance the sex hormones, thereby reverting vasoconstriction. Wistar rats (male; 250-300 g; n = 10) were grouped into seven groups as follows: basal diet control group (I); basal diet/L-NAME/Viagra (5 mg/kg/day) as positive control group (II); ED-induced group (basal diet/L-NAME) (III); diet supplemented processed TN (20%)/L-NAME (IV); diet supplemented raw TN (20%)/L-NAME (V); diet supplemented processed WN (20%)/L-NAME (VI); and diet supplemented raw WN (20%)/L-NAME (VII). The rats were given their regular diet for 2 weeks prior to actually receiving L-NAME (40 mg/kg/day) for ten days to induce hypertension. Platelet androgen levels, ectonucleotidases, and ADA were all measured. L-NAME considerably lowers testosterone levels (54.5 ± 2.2; p < 0.05). Supplementing the TN and WN diets revealed improved testosterone levels as compared to the control (306.7 ± 5.7), but luteinizing hormone levels remained unchanged. Compared to control groups, the L-NAME-treated group showed a rise in ATP (127.5%) hydrolysis and ADA (116.7%) activity, and also a decrease in ADP (76%) and AMP (45%) hydrolysis. Both TN and WN supplemented diets resulted in substantial (p < 0.05) reversal effects. Enhanced testosterone levels and modulation of the purinergic system in platelets by TN and WN could be one of the mechanisms by which they aid in vasoconstriction control.
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Zhang P, Xue WW, Huang XB, Xu Y, Lu LN, Zheng KR, Zou HD. Prevalence and risk factors of diabetic retinopathy in patients with type 2 diabetes in Shanghai. Int J Ophthalmol 2021; 14:1066-1072. [PMID: 34282393 DOI: 10.18240/ijo.2021.07.16] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/18/2021] [Indexed: 01/02/2023] Open
Abstract
AIM To investigate the prevalence of diabetic retinopathy (DR) in residents of Shanghai and analyze the risk factors of DR. METHODS This study involved 7233 patients with diabetes in 2016. The demographic data of the participants were collected using a questionnaire survey. Physical examination, laboratory tests, and ophthalmological examinations were conducted. Two professional ophthalmologists diagnosed and graded DR by fundus examination and then combined the results with fundus images. The unconditional multivariate Logistic regression analysis was used to determine the risk factors. RESULTS In total, 6978 patients with type 2 diabetes in Shanghai with a mean age of 68.33±8.40y were recruited, including 2975 males (42.6%) and 4003 females (57.4%). Overall, 1184 patients were diagnosed with DR, with a prevalence rate of 16.97%. Regression analysis showed that duration of diabetes (OR 1.061, 95%CI 1.049-1.073), high systolic blood pressure (SBP; OR 1.071, 95%CI 1.037-1.106), increased glycosylated hemoglobin level (OR 1.234, 95%CI 1.162-1.311), high blood glucose level (OR 1.061, 95%CI 1.023-1.099), increased neutrophil-to-lymphocyte ratio (NLR; OR 1.132, 95%CI 1.053-1.217) and mean platelet volume (MPV; OR 1.077, 95%CI 1.016-1.142) were risk factors of DR. Conversely, hematocrit (HCT; OR 0.971, 95%CI 0.954-0.988) and mean corpuscular volume (MCV; OR 0.980, 95%CI 0.965-0.994) were protective factors. CONCLUSION The prevalence rate of DR in Shanghai is 16.97%. The duration of diabetes, high SBP, increased glycosylated hemoglobin, NLR, and MPV were determined as risk factors of DR.
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Affiliation(s)
- Pei Zhang
- Department of Ophthalmology, Shanghai Gonghui Hospital, Shanghai 200041, China
| | - Wen-Wen Xue
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Xiao-Bo Huang
- Department of Ophthalmology, the Second Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
| | - Yi Xu
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Li-Na Lu
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China
| | - Kai-Rong Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Hai-Dong Zou
- Department of Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200040, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
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Sharifi-Rad J, Quispe C, Shaheen S, El Haouari M, Azzini E, Butnariu M, Sarac I, Pentea M, Ramírez-Alarcón K, Martorell M, Kumar M, Docea AO, Cruz-Martins N, Calina D. Flavonoids as potential anti-platelet aggregation agents: from biochemistry to health promoting abilities. Crit Rev Food Sci Nutr 2021; 62:8045-8058. [PMID: 33983094 DOI: 10.1080/10408398.2021.1924612] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cardiovascular ailments are the number one cause of mortalities throughout the globe with 17.9 million deaths per year. Platelet activation and aggregation play a crucial role in the pathogenesis of arterial diseases, including acute coronary syndrome, acute myocardial infarction, cerebrovascular transient ischemia, unstable angina, among others. Flavonoids-rich plant extracts are gaining interest for treating the heart-related problems due to safe nature of these herbal extracts. Consumption of plant-food-derived bioactives, particularly flavonoids, has shown antithrombotic, and cardiovascular protective effects due to its anti-platelet activity. Preclinical and clinical trials have proven that flavonoid-rich plant extracts are protective against the cardiac ailments through anti-platelet aggregation activity. This review aims to highlight the anti-platelet aggregation potential of flavonoids with a key emphasis on the therapeutic efficacy in humans. The mechanism of flavonoids in preventing and treating cardiovascular diseases is also highlighted based on preclinical and clinical experimental trials. Further studies are the need of time for exploring the exact molecular mechanism of flavonoids as anti-platelet aggregation agents for treating heart-related problems.
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Affiliation(s)
- Javad Sharifi-Rad
- Phytochemistry Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Facultad de Medicina, Universidad del Azuay, Cuenca, Ecuador
| | - Cristina Quispe
- Facultad de Ciencias de la Salud, Universidad Arturo Prat, Iquique, Chile
| | | | - Mohammed El Haouari
- Centre Régional des Métiers de l'Education et de la Formation/Région: Fès-Meknès (Antenne de Taza), Taza Gare, Morocco.,Laboratoire Matériaux, Substances Naturelles, Environnement et Modélisation (LMSNEM), Faculté Polydisciplinaire de Taza, Université Sidi Mohamed Ben Abdellah, Taza Gare, Morocco
| | - Elena Azzini
- Centre for Research on Food and Nutrition, Council for Agricultural Research and Economics (CREA), Rome, Italy
| | - Monica Butnariu
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, Timis, Romania
| | - Ioan Sarac
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, Timis, Romania
| | - Marius Pentea
- Banat's University of Agricultural Sciences and Veterinary Medicine "King Michael I of Romania" from Timisoara, Timis, Romania
| | - Karina Ramírez-Alarcón
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile
| | - Miquel Martorell
- Department of Nutrition and Dietetics, Faculty of Pharmacy, University of Concepcion, Concepcion, Chile.,Unidad de Desarrollo Tecnológico, UDT, Universidad de Concepción, Concepción, Chile
| | - Manoj Kumar
- Chemical and Biochemical Processing Division, ICAR - Central Institute for Research on Cotton Technology, Mumbai, India
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Natália Cruz-Martins
- Faculty of Medicine, University of Porto, Porto, Portugal.,Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal.,Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, Craiova, Romania
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13
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Sato Y, Yoshihisa A, Watanabe K, Hotsuki Y, Kimishima Y, Yokokawa T, Misaka T, Sato T, Kaneshiro T, Oikawa M, Kobayashi A, Takeishi Y. Association between platelet distribution width and prognosis in patients with heart failure. PLoS One 2020; 15:e0244608. [PMID: 33373413 PMCID: PMC7771660 DOI: 10.1371/journal.pone.0244608] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/11/2020] [Indexed: 11/18/2022] Open
Abstract
Background The prognostic impact of platelet distribution width (PDW), which is a specific marker of platelet activation, has been unclear in patients with heart failure (HF). Methods and results We conducted a prospective observational study enrolling 1,746 hospitalized patients with HF. Patients were divided into tertiles based on levels of PDW: 1st (PDW < 15.9 fL, n = 586), 2nd (PDW 15.9–16.8 fL, n = 617), and 3rd (PDW ≥ 16.9, n = 543) tertiles. We compared baseline patients’ characteristics and post-discharge prognosis: all-cause death; cardiac death; and cardiac events. The 3rd tertile showed the highest age and levels of B-type natriuretic peptide compared to other tertiles (1st, 2nd, and 3rd tertiles; age, 69.0, 68.0, and 70.0 years old, P = 0.038; B-type natriuretic peptide, 235.2, 171.9, and 241.0 pg/mL, P < 0.001). Left ventricular ejection fraction was equivalent among the tertiles. In the Kaplan-Meier analysis, rates of all endpoints were the highest in the 3rd tertile (log-rank P < 0.001, respectively). The Cox proportional hazard analysis revealed that the 3rd tertile was associated with adverse prognosis (all-cause death, hazard ratio [HR] 1.716, P < 0.001; cardiac death, HR 1.919, P < 0.001; cardiac event, HR 1.401, P = 0.002). Conclusions High PDW is a novel predictor of adverse prognosis in patients with HF.
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Affiliation(s)
- Yu Sato
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan
- * E-mail:
| | - Koichiro Watanabe
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yu Hotsuki
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yusuke Kimishima
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tetsuro Yokokawa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tomofumi Misaka
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan
| | - Takamasa Sato
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takashi Kaneshiro
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masayoshi Oikawa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Kobayashi
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
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14
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Ciumărnean L, Milaciu MV, Runcan O, Vesa ȘC, Răchișan AL, Negrean V, Perné MG, Donca VI, Alexescu TG, Para I, Dogaru G. The Effects of Flavonoids in Cardiovascular Diseases. Molecules 2020; 25:E4320. [PMID: 32967119 PMCID: PMC7571023 DOI: 10.3390/molecules25184320] [Citation(s) in RCA: 146] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/13/2020] [Accepted: 09/18/2020] [Indexed: 12/14/2022] Open
Abstract
Flavonoids are metabolites of plants and fungus. Flavonoid research has been paid special attention to in recent times after the observation of their beneficial effects on the cardiovascular system. These favorable effects are exerted by flavonoids mainly due to their antioxidant properties, which result from the ability to decrease the oxidation of low-density lipoproteins, thus improving the lipid profiles. The other positive effect exerted on the cardiovascular system is the ability of flavonoids to produce vasodilation and regulate the apoptotic processes in the endothelium. Researchers suggested that these effects, including their anti-inflammatory function, are consequences of flavonoids' potent antioxidant properties, but recent studies have shown multiple signaling pathways linked to them, thus suggesting that there are more mechanisms involved in the beneficial effect of the flavonoids on the human body. This review aims to present the latest data on the classification of these substances, their main mechanisms of action in the human body, and the beneficial effects on the physiological and pathological status of the cardiovascular system.
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Affiliation(s)
- Lorena Ciumărnean
- Department 5—Internal Medicine, 4th Medical Clinic, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (L.C.); (M.V.M.); (M.-G.P.); (V.N.); (T.-G.A.); (I.P.)
| | - Mircea Vasile Milaciu
- Department 5—Internal Medicine, 4th Medical Clinic, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (L.C.); (M.V.M.); (M.-G.P.); (V.N.); (T.-G.A.); (I.P.)
| | - Octavia Runcan
- Regional Institute of Gastroenterology and Hepatology ‘Octavian Fodor’ Cluj-Napoca, 400162 Cluj-Napoca, Romania;
| | - Ștefan Cristian Vesa
- Department 2—Functional Sciences, Discipline of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania
| | - Andreea Liana Răchișan
- Department of Pediatrics, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400177 Cluj-Napoca, Romania
| | - Vasile Negrean
- Department 5—Internal Medicine, 4th Medical Clinic, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (L.C.); (M.V.M.); (M.-G.P.); (V.N.); (T.-G.A.); (I.P.)
| | - Mirela-Georgiana Perné
- Department 5—Internal Medicine, 4th Medical Clinic, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (L.C.); (M.V.M.); (M.-G.P.); (V.N.); (T.-G.A.); (I.P.)
| | - Valer Ioan Donca
- Department of Geriatrics-Gerontology, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania;
| | - Teodora-Gabriela Alexescu
- Department 5—Internal Medicine, 4th Medical Clinic, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (L.C.); (M.V.M.); (M.-G.P.); (V.N.); (T.-G.A.); (I.P.)
| | - Ioana Para
- Department 5—Internal Medicine, 4th Medical Clinic, Faculty of Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (L.C.); (M.V.M.); (M.-G.P.); (V.N.); (T.-G.A.); (I.P.)
| | - Gabriela Dogaru
- Department of Physical Medicine & Rehabilitation, “Iuliu Hațieganu” University of Medicine and Pharmacy, Louis Pasteur Street 6, 400349 Cluj-Napoca, Romania;
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15
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Boussofara A, Laroussi L, Baccouche H, Bennour E, Kasbaoui S, Triki H, Zied IEH, Kammoun I, Halima AB, Addad F, Marrakchi S, Romdhane NB, Kachboura S. ImpaCt of aspirin regimen on THrombin generation in diabEtic patients with acute coronary syndrome: CARTHaGE-ACS trial. Eur J Clin Pharmacol 2020; 77:517-526. [PMID: 32761372 DOI: 10.1007/s00228-020-02969-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Diabetes is associated with a high rate of events after acute coronary syndrome. It was recently reported that once-daily aspirin might not provide stable biological efficacy in patients with diabetes. AIMS We sought to compare the biological efficacy of aspirin given once a day versus aspirin divided twice per day in a population of diabetic patients with non-ST elevation acute coronary syndrome (NSTE-ACS) as assessed by the thrombin generation test. METHODS We performed an open-label single-blind randomized study including 59 consecutive diabetic patients admitted for NSTE-ACS. Patients were randomly treated with aspirin 100 mg once a day (GA100; n = 20), aspirin 160 mg once a day (GA160; n = 19) or aspirin 100 mg twice a day (G2A100; n = 20). The primary endpoint was endogenous thrombin potential (ETP) at discharge and after 6 months. RESULTS The mean age of our patients was 61.5 ± 9 years, and 73% were male. The baseline characteristics were comparable between the three groups. In the GA100 group, there was no significant effect on ETP variation at 6 months (1150.46 ± 504.84 vs. 1087.63 ± 454.18; p = 0.794). An increase in aspirin dose with a second daily administration of 100 mg was associated with a significant reduction in ETP at 6 months (1004.87 ± 196.2 vs. 1233.63 ± 333.5; p = 0.003). A nonsignificant decrease in ETP was seen in the GA160 group (from 1173.8 ± 388.07 to 1053.64 ± 269.93 at 6 months, p = 0.117). CONCLUSION Only the twice-daily aspirin regimen led to better control of hypercoagulability in NSTE-ACS diabetic patients. However, no thrombin generation normalization was reported.
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Affiliation(s)
- Amine Boussofara
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
| | - Lobna Laroussi
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia. .,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia. .,, Residence Diar Ons apartment B 2 1, Riadh El Andalos, 2058, Ariana, Tunisia.
| | - Hela Baccouche
- Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia.,Department of Hematology, Rabta Hospital, Tunis, Tunisia
| | - Emna Bennour
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
| | - Sami Kasbaoui
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
| | - Hbib Triki
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
| | - Ibn El Haj Zied
- Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia.,Taher Maamouri Hospital, Nabeul, Tunisia
| | - Ikram Kammoun
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
| | - Afef Ben Halima
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
| | - Faouzi Addad
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
| | - Sonia Marrakchi
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
| | - Neila Ben Romdhane
- Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia.,Department of Hematology, Rabta Hospital, Tunis, Tunisia
| | - Salem Kachboura
- Department of Cardiology, Abderrahmen Mami Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis- Tunis University El Manar, Tunis, Tunisia
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16
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Zhou AM, Xiang YJ, Liu EQ, Cai CH, Wu YH, Yang LB, Zeng CL. Salvianolic acid a inhibits platelet activation and aggregation in patients with type 2 diabetes mellitus. BMC Cardiovasc Disord 2020; 20:15. [PMID: 31931718 PMCID: PMC6956554 DOI: 10.1186/s12872-019-01316-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 12/19/2019] [Indexed: 02/07/2023] Open
Abstract
Background Platelets in patients with type 2 diabetes mellitus (DM2) are characterized by increased activation and aggregation, which tends to be associated with a high morbidity and mortality due to cardiovascular disease (CVD). Moreover, a large proportion of DM2 patients show an inadequate response to standard antiplatelet treatments, contributing to recurrent cardiovascular events. In our previous study, we indicated that Salvianolic acid A (SAA) presents an antiplatelet effect in healthy volunteers. However, whether it can inhibit “activated platelets” with a pathologic status has not been explored. Therefore, this study was designed to investigate the antiplatelet effect of SAA and its diabetic complication-related difference in DM2. Methods Forty patients diagnosed with DM2 from January 2018 to April 2018 were recruited. Fibrinogen-binding (PAC-1) and P-selectin (CD62p) flow cytometry reagents were measured under resting and stimulated conditions by flow cytometry, while agonist-induced platelet aggregation was conducted by light transmission aggregometry. Before all these measurements were conducted, all platelet samples were preincubated with a vehicle or SAA for 10 min. Additionally, the diabetic complication-related difference in the antiplatelet effect of SAA was further studied in enrolled patients. Results The expressions of PAC-1 and CD62p were elevated in DM2, as well as the maximal platelet aggregation. In addition, SAA decreased the expressions of PAC-1 and CD62p, which were enhanced by ADP and thrombin (all P < 0.01). It also reduced the platelet aggregation induced by ADP (P < 0.001) and thrombin (P < 0.05). Comparing the antiplatelet effect of SAA on DM2, with and without diabetic complications, no statistically significant difference was found (all P > 0.05). Conclusions The present study demonstrated that SAA can inhibit platelet activation and aggregation in patients with DM2, and the inhibition did not abate for the existence of diabetic complications.
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Affiliation(s)
- Ai-Ming Zhou
- The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - Yi-Jia Xiang
- Department of Cardiology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, 323000, Zhejiang, China
| | - En-Qian Liu
- Zhejiang University School of Medicine, Hangzhou, 310029, Zhejiang, China
| | - Chang-Hong Cai
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, Zhejiang, China
| | - Yong-Hui Wu
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, Zhejiang, China
| | - Le-Bing Yang
- The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, 323000, Zhejiang, China
| | - Chun-Lai Zeng
- Department of Cardiology, Lishui Hospital, Zhejiang University School of Medicine, Lishui, 323000, Zhejiang, China.
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17
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El Haouari M. Platelet Oxidative Stress and its Relationship with Cardiovascular Diseases in Type 2 Diabetes Mellitus Patients. Curr Med Chem 2019; 26:4145-4165. [PMID: 28982316 DOI: 10.2174/0929867324666171005114456] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 06/07/2017] [Accepted: 06/07/2017] [Indexed: 01/01/2023]
Abstract
Enhanced platelet activation and thrombosis are linked to various cardiovascular diseases (CVD). Among other mechanisms, oxidative stress seems to play a pivotal role in platelet hyperactivity. Indeed, upon stimulation by physiological agonists, human platelets generate and release several types of reactive oxygen species (ROS) such as O2 -, H2O2 or OH-, further amplifying the platelet activation response via various signalling pathways, including, formation of isoprostanes, Ca2+ mobilization and NO inactivation. Furthermore, excessive platelet ROS generation, incorporation of free radicals from environment and/or depletion of antioxidants induce pro-oxidant, pro-inflammatory and platelet hyperaggregability effects, leading to the incidence of cardiovascular events. Here, we review the current knowledge regarding the effect of oxidative stress on platelet signaling pathways and its implication in CVD such as type 2 diabetes mellitus. We also summarize the role of natural antioxidants included in vegetables, fruits and medicinal herbs in reducing platelet function via an oxidative stress-mediated mechanism.
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Affiliation(s)
- Mohammed El Haouari
- Centre Regional des Metiers de l'Education et de la Formation de Taza (CRMEF - Taza), B.P: 1178 - Taza Gare, Morocco
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18
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Rosado JA, Diez-Bello R, Salido GM, Jardin I. Fine-tuning of microRNAs in Type 2 Diabetes Mellitus. Curr Med Chem 2019; 26:4102-4118. [PMID: 29210640 DOI: 10.2174/0929867325666171205163944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 11/23/2017] [Accepted: 11/23/2017] [Indexed: 12/13/2022]
Abstract
Type 2 diabetes mellitus is a metabolic disease widely spread across industrialized countries. Sedentary lifestyle and unhealthy alimentary habits lead to obesity, boosting both glucose and fatty acid in the bloodstream and eventually, insulin resistance, pancreas inflammation and faulty insulin production or secretion, all of them very well-defined hallmarks of type 2 diabetes mellitus. miRNAs are small sequences of non-coding RNA that may regulate several processes within the cells, fine-tuning protein expression, with an unexpected and subtle precision and in time-frames ranging from minutes to days. Since the discovery of miRNA and their possible implication in pathologies, several groups aimed to find a relationship between type 2 diabetes mellitus and miRNAs. Here we discuss the pattern of expression of different miRNAs in cultured cells, animal models and diabetic patients. We summarize the role of the most important miRNAs involved in pancreas growth and development, insulin secretion and liver, skeletal muscle or adipocyte insulin resistance in the context of type 2 diabetes mellitus.
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Affiliation(s)
- Juan A Rosado
- Institute of Molecular Pathology Biomarkers & Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Caceres, Spain
| | - Raquel Diez-Bello
- Institute of Molecular Pathology Biomarkers & Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Caceres, Spain
| | - Ginés M Salido
- Institute of Molecular Pathology Biomarkers & Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Caceres, Spain
| | - Isaac Jardin
- Institute of Molecular Pathology Biomarkers & Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Caceres, Spain
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19
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Mothibe ME, Kahler-Venter CP, Osuch E. Evaluation of the in vitro effects of commercial herbal preparations significant in African traditional medicine on platelets. Altern Ther Health Med 2019; 19:224. [PMID: 31438931 PMCID: PMC6704509 DOI: 10.1186/s12906-019-2644-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 08/19/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND Commercial herbal medicines (CHMs) marketed as immune boosters are gaining wide popularity in South Africa, in the absence of control and regulatory guidelines. These commercially packaged and labelled herbal preparations, acquired in various retail outlets, are used without consulting either a conventional health provider or a traditional health practitioner. Although they are indicated for immune-boosting purposes, they might exert many other beneficial and unwanted effects on physiological systems. Platelets are crucial in haemostasis and important for the immunological system. The aim was to investigate the effect of the CHMs used to strengthen the immune system on the activity of human platelets. METHODS Six CHMs commonly used as African traditional medicines in Pretoria, South Africa, were tested for their effects on healthy, isolated human platelets, using a bioluminescence method. The tested herbal medicines were Intlamba Zifo™, Maphilisa™ Herbal medicine, Matla™ African medicine for all diseases, Ngoma™ Herbal Tonic Immune Booster, Stametta™ Body Healing Liquid, and Vuka Uphile™ Immune Booster and serial-diluted standards of each from 10 to 10,000 times. The luminol-enhanced luminescence activity of the platelets was measured after incubation with the herbal medicines and activation with phorbol myristate acetate (PMA) or N-formyl-methionyl-leucyl-phenylalanine (fMLP). RESULTS Five herbal medicines, namely Intlamba Zifo™, Maphilisa™ Herbal medicine, Matla™ African medicine for all diseases, Stametta™ Body Healing Liquid, and Vuka Uphile™ Immune Booster exerted comparable weak inhibitory effects on both PMA and fMLP-induced platelets, which were concentration dependent at high doses, and inversely related to concentration at low doses. Intlamba Zifo™, Matla™ African medicine for all diseases, Stametta™ Body Healing Liquid, and Vuka Uphile™ exhibited weak, but non-systematic stimulatory effects at low doses, which were not statistically significant. Ngoma™ Herbal Tonic Immune Booster had weak, inhibitory effects at high doses and weak stimulatory effects that were inversely related to concentration at low doses. CONCLUSION The findings suggest a potential beneficial role of the CHMs in the suppression of platelets' reactivity and in enhancing the immune system. Caution, however, should be exercised as platelet inhibition and stimulation predispose to the risk of bleeding and thrombosis, respectively.
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20
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Abdel-Moneim A, Mahmoud B, Nabil A, Negeem Z. Correlation between oxidative stress and hematological profile abnormalities in diabetic nephropathy. Diabetes Metab Syndr 2019; 13:2365-2373. [PMID: 31405645 DOI: 10.1016/j.dsx.2019.06.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/10/2019] [Indexed: 11/17/2022]
Abstract
AIMS Diabetes patients with renal impairment commonly have a degree of hematological abnormalities than those non-diabetics with chronic kidney disease. The present study aimed to clarify the association between oxidative stress and hematological abnormalities with the progression of diabetic nephropathy. METHODS A total of 20 healthy subjects and 100 patients were enrolled in the study. Eligible renal dysfunction patients were classified according to biochemical markers into five groups (20 patients); diabetic patients, pre-renal failure patients, diabetic pre-renal failure patients, renal failure patients, and diabetic renal failure patients. RESULTS Erythrocytes and platelets count, hemoglobin and hematocrit levels revealed a significant decrease in all renal dysfunction groups, while leukocytes count, red cell distribution width, platelet distribution width, and mean platelet volume showed significant increases in diabetic and renal dysfunction groups as compared to the healthy control. Nitric oxide level increased significantly, while reduced glutathione showed a marked decrease in diabetic and all renal dysfunction groups compared to the healthy control. CONCLUSION Nitric oxide and reduced glutathione were associated with the inflammatory status in diabetic renal dysfunction patients which reflected by elevation in leukocytes and neutrophils count, red cell distribution width as well as the reduction in values of erythrocytes, platelets count, hemoglobin and hematocrit. Therefore, hematological indices can play a role in predict the progression of diabetic nephropathy.
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Affiliation(s)
- Adel Abdel-Moneim
- Molecular Physiology Division, Faculty of Science, Beni-Suef University, Egypt.
| | - Basant Mahmoud
- Biochemistry Division, Faculty of Science, Beni-Suef University, Egypt
| | - Ahmad Nabil
- Biotechnology Department, Faculty of Postgraduate Studies for Advanced Science, Beni-Suef University, Egypt
| | - Zinab Negeem
- Biotechnology Department, Faculty of Postgraduate Studies for Advanced Science, Beni-Suef University, Egypt
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21
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Ji S, Zhang J, Fan X, Wang X, Ning X, Zhang B, Shi H, Yan H. The relationship between mean platelet volume and diabetic retinopathy: a systematic review and meta-analysis. Diabetol Metab Syndr 2019; 11:25. [PMID: 30911336 PMCID: PMC6417244 DOI: 10.1186/s13098-019-0420-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 03/02/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is one of the most common diseases causing blindness in the world, and most patients are already in advanced stage. Recent years, many studies reported mean platelet volume (MPV) may be associated with development of DR, but there was no consistent conclusion reached. METHODS Literature was retrieved by formally searching PubMed, Embase, Cochrane library and Scopus and by hand searching of reference lists of related articles. Finally, a total of 14 literatures included, and Review manager 5.3 and STATA 14.0 statistical software were utilized for processing. RESULTS Meta-analysis showed that MPV values in DR were significantly higher than health controls [SMD (95% CI) = 0.92 (0.60-1.24)] and type 2 diabetes mellitus without diabetic retinopathy (T2DM without DR) [SMD (95% CI) = 0.36 (0.19-0.53)]. Subgroup analysis indicated that MPV level in proliferative diabetic retinopathy (PDR) patients was higher than T2DM without DR patients [SMD (95% CI) = 0.48 (0.28, 0.68)], but this difference didn't appear in non-proliferative diabetic retinopathy (NPDR). CONCLUSIONS The study demonstrated that increased MPV level was significant associated with the development of DR, and it might reflect the severity of DR, which could be provided to monitor development and progression of DR clinically.
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Affiliation(s)
- ShuaiFei Ji
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xian, 710038 Shaanxi People’s Republic of China
| | - Jie Zhang
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xian, 710038 Shaanxi People’s Republic of China
| | - XiuDe Fan
- Department of Infectious Diseases, First Affiliated Hospital of Xian Jiaotong University, Xian, 710061 Shaanxi People’s Republic of China
| | - XiQiang Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xian Jiaotong University, Xian, 710061 Shaanxi People’s Republic of China
| | - XiaoNa Ning
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xian, 710038 Shaanxi People’s Republic of China
| | - BaBo Zhang
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xian, 710038 Shaanxi People’s Republic of China
| | - Heng Shi
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xian, 710038 Shaanxi People’s Republic of China
| | - Hong Yan
- Department of Ophthalmology, Tangdu Hospital, the Fourth Military Medical University, Xian, 710038 Shaanxi People’s Republic of China
- Department of Ophthalmology, Xi’an No. 4 Hospital, Shaanxi Eye Hospital, Affiliated Guangren Hospital School of Medicine, Xi’an Jiaotong University, Xian, 710004 Shaanxi China
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Luo WJ, Zhang WF. The relationship of blood cell-associated inflammatory indices and diabetic retinopathy: a Meta-analysis and systematic review. Int J Ophthalmol 2019; 12:312-323. [PMID: 30809490 DOI: 10.18240/ijo.2019.02.20] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 08/02/2018] [Indexed: 12/17/2022] Open
Abstract
AIM To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume (MPV), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and the presence and severity of diabetic retinopathy (DR). METHODS We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference (SMD) calculated with confidence interval (CI) of 95% was used to estimate the values of those indices. RESULTS A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus (T2DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR (SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.
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Affiliation(s)
- Wen-Juan Luo
- Department of Ophthalmology, Lanzhou University Second Hospital, Lanzhou 730000, Gansu Province, China
| | - Wen-Fang Zhang
- Department of Ophthalmology, Lanzhou University Second Hospital, Lanzhou 730000, Gansu Province, China
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Mendes BB, Oliveira ACR, Alcântara KCD. Comparison of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in normoglycemic and hyperglycemic subjects. EINSTEIN-SAO PAULO 2019; 17:eAO4403. [PMID: 30652737 PMCID: PMC6333213 DOI: 10.31744/einstein_journal/2019ao4403] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 06/24/2018] [Indexed: 01/22/2023] Open
Abstract
Objective: To compare the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as possible parameters of systemic inflammation in hyperglycemic and normoglycemic subjects. Methods: A retrospective, cross-sectional study of data collected from patients tested for fasting blood glucose, glycated hemoglobin (HbA1c) and blood count on the same day, between July and December 2016. Patients were divided into hyperglycemic and normoglycemic, and matched by age and sex. The data were analyzed using Epi Info™, version 7.2.1.0, for the Windows® platform. Results: We enrolled 278 subjects, 139 hyperglycemic and 139 normoglycemic. The absolute number of leukocytes and neutrophils was higher in the Hyperglycemic Group (p=0.006 and p=0.004, respectively). There was no difference in the neutrophil-to-lymphocyte ratio between the Hyperglycemic Group and the Normoglycemic Group (2.1 versus 2.0; p=0.264), and both neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios showed no differences between those with HbA1c ≥7% (n=127, p=0.778) and those with HbA1c <7% (n=12, p=0.490). In contrast, the platelet-to-lymphocyte ratio was lower in the Hyperglycemic Group (117.8 versus 129.6; p=0.007). Conclusion: Hyperglycemic subjects had a neutrophil-to-lymphocyte ratio similar to that of normoglycemic subjects, but had a lower platelet-to-lymphocyte ratio. Future prospective studies will be useful to determine the importance and prognostic value of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in the hyperglycemic state.
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24
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Lopez JJ, El Haouari M, Jardin I, Alonso N, Regodon S, Diez-Bello R, Redondo PC, Rosado JA. Flavonoids and Platelet-Derived Thrombotic Disorders. Curr Med Chem 2019; 26:7035-7047. [DOI: 10.2174/0929867325666180417170218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 12/14/2017] [Accepted: 12/14/2017] [Indexed: 01/12/2023]
Abstract
:
Thrombotic disorders are characterized by an increase in the probability of the
formation of unnecessary thrombi that might be due to the activation of the coagulation cascade
or the circulating platelets. Platelets or thrombocytes play an essential role in hemostasis
but abnormal platelet function leads to the development of a number of cardiovascular
complications, including thrombotic disorders. Under pathological conditions, platelets are
associated with the development of different thrombotic disorders, including atherosclerosis,
arterial thrombosis and stroke, deep venous thrombosis and pulmonary embolism; therefore,
platelets are the target of a number of anti-thrombotic strategies. Flavonoids, a large group
of polyphenols ubiquitously expressed in fruits and vegetables that have attracted considerable
attention because of their benefits in human health, including the reduction of the risk
of cardiovascular disease. Flavonoids have been reported to reduce platelet activity by attenuating
agonist-induced GPIIb/IIIa receptor activation, mobilization of intracellular free
Ca2+, granule exocytosis, as well as activation of different signaling molecules such as mitogen-
activated protein kinases or phospholipases. This review summarizes the current studies
concerning the modulation of platelet activation by flavonoids, giving especial attention to
those events associated to thrombotic disorders.
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Affiliation(s)
- Jose J. Lopez
- Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Cáceres, Spain
| | - Mohammed El Haouari
- Faculté Polydisciplinaire de Taza, Laboratoire des Matériaux, Substances Naturelles, Environnement et Modélisation (LMSNEM), Université Sidi Mohamed Ben Abdellah, B.P. 1223, Taza Gare, Morocco
| | - Isaac Jardin
- Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Cáceres, Spain
| | - Nieves Alonso
- Department of Hematology, Hospital Infanta Cristina, 06006 Badajoz, Spain
| | - Sergio Regodon
- Department of Animal Medicine, University of Extremadura, 10003-Cáceres, Spain
| | - Raquel Diez-Bello
- Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Cáceres, Spain
| | - Pedro C. Redondo
- Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Cáceres, Spain
| | - Juan A. Rosado
- Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003-Cáceres, Spain
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Bontekoe IJ, Meer PF, Verhoeven AJ, Korte D. Platelet storage properties are associated with donor age:in vitroquality of platelets from young donors and older donors with and without Type 2 diabetes. Vox Sang 2018; 114:129-136. [DOI: 10.1111/vox.12739] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/08/2018] [Accepted: 11/13/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Ido J. Bontekoe
- Department of Product and Process Development Sanquin Blood Bank Amsterdam the Netherlands
| | - Pieter F. Meer
- Department of Product and Process Development Sanquin Blood Bank Amsterdam the Netherlands
- Center for Clinical Transfusion Research Sanquin Leiden the Netherlands
| | | | - Dirk Korte
- Department of Product and Process Development Sanquin Blood Bank Amsterdam the Netherlands
- Department of Blood Cell Research Sanquin Research Amsterdam the Netherlands
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Abstract
The diminished capacity for wound healing in patients with diabetes contributes to morbidity through ulceration and recurrent infections, loss of function and decreased workplace productivity, increased hospitalisation rates, and rising health-care costs. These are due to diabetes' effects on signalling molecules, cellular cascades, different cell populations, and the vasculature. The function of multiple immune system components including cellular response, blood factors, and vascular tone are all negatively impacted by diabetes. The purpose of this paper is to review the current understanding of immune and vascular dysfunction contributing to impaired wound healing mechanisms in the diabetic population. Normal wound healing mechanisms are reviewed followed by diabetic aberrations to immune and inflammatory function and atherogenesis and angiopathy. DECLARATION OF INTEREST The authors have no financial or personal relationships to people or organisations that could potentially and inappropriately influence their work and conclusions.
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Affiliation(s)
- A S Ahmed
- Baylor College of Medicine, 1 Baylor Plaza, Houston, Texas 77030
| | - E L Antonsen
- Baylor College of Medicine, 1 Baylor Plaza, Houston, Texas 77030.,Department of Medicine - Section of Emergency Medicine, 1 Baylor Plaza, Houston, Texas.,Department of Medicine - Section of Space Medicine, 1 Baylor Plaza, Houston, Texas
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27
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Oshima S, Higuchi T, Okada S, Takahashi O. The Relationship Between Mean Platelet Volume and Fasting Plasma Glucose and HbA1c Levels in a Large Cohort of Unselected Health Check-Up Participants. J Clin Med Res 2018; 10:345-350. [PMID: 29511424 PMCID: PMC5827920 DOI: 10.14740/jocmr3361w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 02/06/2018] [Indexed: 11/19/2022] Open
Abstract
Background Larger platelets are more active and mean platelet volume (MPV) is an indicator of platelet activation and an independent risk factor of cardiovascular diseases. While MPV is reported to be higher in diabetic patients, the relationship between MPV and glycemic parameters in general population remains inconclusive. Methods In this cross-sectional study, we studied relationship between MPV and fasting plasma glucose (FPG) and HbA1c levels in 38,204 unselected participants of general health check-up aged 20 years or older in the year of 2014 who were considered to be representative of the general population. Individuals with known diabetes, coronary artery disease and/or cerebrovascular disease who were on drug therapy and those with platelet counts below 100 × 109/L or above 400 × 109/L were excluded. Results The mean age of the individuals was 52.3 ± 12.1 years and 46.1% were male. There were positive associations between MPV and both FPG (r = 0.066; P < 0.001) and HbA1c (r = 0.025; P < 0.001) levels when all individuals were analyzed as a whole. While the association was only marginal in individuals with HbA1c levels below 6.5% (r = 0.009; P = 0.068), it was significant in those with HbA1c ≥ 6.5% (r = 0.138; P < 0.001). When the individuals were categorized into four groups according to the HbA1c values: HbA1c < 5.5%, 5.5% ≤ HbA1c < 6.0%, 6.0% ≤ HbA1c < 6.5%, and HbA1c ≥ 6.5%, the mean MPV was virtually same among groups with HbA1c level < 6.5% and that of the individuals with HbA1c ≥ 6.5 was significantly higher than groups with lower HbA1c levels. Multivariate analyses adjusted with age and sex showed the same results. Conclusion FPG and HbA1c appeared to be associated with MPV in unselected health check-up participants; however, the association between glycemic state and MPV was apparent only in individuals with impaired glycemic control and only marginal in those with normal glycemic control. The clinical significance of the associations warrants further study.
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Affiliation(s)
- Shinichiro Oshima
- Department of Internal Medicine, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - Takakazu Higuchi
- Division of Hematology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan.,Dokkyo Medical University Saitama Medical Center, 2-1-50, Minami-Koshigaya, Koshigaya 343-8555, Japan
| | - Sadamu Okada
- Division of Hematology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - Osamu Takahashi
- Center for Clinical Epidemiology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
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Tsimerman G, Roguin A, Bachar A, Melamed E, Brenner B, Aharon A. Involvement of microparticles in diabetic vascular complications. Thromb Haemost 2017; 106:310-21. [DOI: 10.1160/th10-11-0712] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Accepted: 05/16/2011] [Indexed: 11/05/2022]
Abstract
SummaryType 2 diabetes mellitus (T2DM) is associated with increased coagulability and vascular complications. Circulating microparticles (MPs) are involved in thrombosis, inflammation, and angiogenesis. However, the role of MPs in T2DM vascular complications is unclear. We characterised the cell origin and pro-coagulant profiles of MPs obtained from 41 healthy controls and 123 T2DM patients with coronary artery disease, retinopathy and foot ulcers. The effects of MPs on endothelial cell coagulability and tube formation were evaluated. Patients with severe diabetic foot ulcers expressed the highest levels of MPs originated from platelet and endothelial cells and negatively-charged phospholipidbearing MPs. MP coagulability, calculated from MP tissue factor (TF) and TF pathway inhibitor (TFPI) ratio, was low in healthy controls and in diabetic retinopathy patients (<0.7) but high in patients with coronary artery disease and foot ulcers (>1.8, p≥0.002). MPs of all T2DM patients induced a more than two-fold increase in endothelial cell TF (antigen and gene expression) but did not affect TFPI levels. Tube networks were longest and most stable in endothelial cells that were incubated with MPs of healthy controls, whereas no tube formation occurred in MPs of diabetic patients with coronary artery disease. MPs of diabetic retinopathy and diabetic foot ulcer patients induced branched tube networks that were unstable and collapsed over time. This study demonstrates that MP characteristics are related to the specific type of vascular complications and may serve as a bio-marker for the procoagulant state and vascular pathology in patients with T2DM.
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29
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Unsworth AJ, Bye AP, Tannetta DS, Desborough MJR, Kriek N, Sage T, Allan HE, Crescente M, Yaqoob P, Warner TD, Jones CI, Gibbins JM. Farnesoid X Receptor and Liver X Receptor Ligands Initiate Formation of Coated Platelets. Arterioscler Thromb Vasc Biol 2017; 37:1482-1493. [PMID: 28619996 PMCID: PMC5526435 DOI: 10.1161/atvbaha.117.309135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 05/30/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The liver X receptors (LXRs) and farnesoid X receptor (FXR) have been identified in human platelets. Ligands of these receptors have been shown to have nongenomic inhibitory effects on platelet activation by platelet agonists. This, however, seems contradictory with the platelet hyper-reactivity that is associated with several pathological conditions that are associated with increased circulating levels of molecules that are LXR and FXR ligands, such as hyperlipidemia, type 2 diabetes mellitus, and obesity. APPROACH AND RESULTS We, therefore, investigated whether ligands for the LXR and FXR receptors were capable of priming platelets to the activated state without stimulation by platelet agonists. Treatment of platelets with ligands for LXR and FXR converted platelets to the procoagulant state, with increases in phosphatidylserine exposure, platelet swelling, reduced membrane integrity, depolarization of the mitochondrial membrane, and microparticle release observed. Additionally, platelets also displayed features associated with coated platelets such as P-selectin exposure, fibrinogen binding, fibrin generation that is supported by increased serine protease activity, and inhibition of integrin αIIbβ3. LXR and FXR ligand-induced formation of coated platelets was found to be dependent on both reactive oxygen species and intracellular calcium mobilization, and for FXR ligands, this process was found to be dependent on cyclophilin D. CONCLUSIONS We conclude that treatment with LXR and FXR ligands initiates coated platelet formation, which is thought to support coagulation but results in desensitization to platelet stimuli through inhibition of αIIbβ3 consistent with their ability to inhibit platelet function and stable thrombus formation in vivo.
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Affiliation(s)
- Amanda J Unsworth
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Alexander P Bye
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Dionne S Tannetta
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Michael J R Desborough
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Neline Kriek
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Tanya Sage
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Harriet E Allan
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Marilena Crescente
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Parveen Yaqoob
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Timothy D Warner
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Chris I Jones
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.)
| | - Jonathan M Gibbins
- From the Institute of Cardiovascular and Metabolic Research, School of Biological Sciences (A.J.U., A.P.B., N.K., T.S., M.C., C.I.J., J.M.G.) and Department of Food and Nutritional Sciences (D.S.T., P.Y.), University of Reading, United Kingdom; Oxford Haemophilia and Thrombosis Centre, Oxford Biomedical Research Centre, Churchill Hospital, United Kingdom (M.J.R.D.); Nuffield Division of Clinical Laboratory Sciences, University of Oxford, United Kingdom (M.J.R.D.); and Blizard Institute, Barts & the London School of Medicine & Dentistry, United Kingdom (H.E.A., M.C., T.D.W.).
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30
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Faggio C, Sureda A, Morabito S, Sanches-Silva A, Mocan A, Nabavi SF, Nabavi SM. Flavonoids and platelet aggregation: A brief review. Eur J Pharmacol 2017; 807:91-101. [DOI: 10.1016/j.ejphar.2017.04.009] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 04/04/2017] [Accepted: 04/10/2017] [Indexed: 12/11/2022]
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Hyperglycaemia-induced reciprocal changes in miR-30c and PAI-1 expression in platelets. Sci Rep 2016; 6:36687. [PMID: 27819307 PMCID: PMC5098184 DOI: 10.1038/srep36687] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 10/18/2016] [Indexed: 02/01/2023] Open
Abstract
Type 2 diabetic mellitus (DM2) is associated with accelerated thrombotic complications and is characterized by high levels of plasminogen activator inhibitor-1 (PAI-1). Recent studies show that human platelets have high levels of miR-30c and synthesize considerable active PAI-1. The underlying mechanism of how PAI-1 expression is upregulated in DM2 is poorly understood. We now report that hyperglycaemia-induced repression of miR-30c increases PAI-1 expression and thrombus formation in DM2. Bioinformatic analysis and identification of miRNA targets were assessed using luciferase assays, quantitative real-time PCR and western blots invitro and in vivo. The changes in miR-30c and PAI-1 levels were identified in platelets from healthy and diabetic individuals. We found that miR-30c directly targeted the 3′ UTR of PAI-1 and negatively regulated its expression. miR-30c was negatively correlated with glucose and HbA1c levels in DM2. In HFD-fed diabetic mice, increasing miR-30c expression by lenti-miR-30c significantly decreased the PAI-1 expression and prolonged the time to occlusion in an arterial thrombosis model. Platelet depletion/reinfusion experiments generating mice with selective ablation of PAI-1 demonstrate a major contribution by platelet-derived PAI-1 in the treatment of lenti-miR-30c to thrombus formation. These results provide important implications regarding the regulation of fibrinolysis by platelet miRNA under diabetic mellitus.
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Akinyemi AJ, Thomé GR, Morsch VM, Bottari NB, Baldissarelli J, de Oliveira LS, Goularte JF, Belló-Klein A, Oboh G, Schetinger MRC. Dietary Supplementation of Ginger and Turmeric Rhizomes Modulates Platelets Ectonucleotidase and Adenosine Deaminase Activities in Normotensive and Hypertensive Rats. Phytother Res 2016; 30:1156-63. [PMID: 27151061 DOI: 10.1002/ptr.5621] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 03/13/2016] [Accepted: 03/15/2016] [Indexed: 01/15/2023]
Abstract
Hypertension is associated with platelet alterations that could contribute to the development of cardiovascular complications. Several studies have reported antiplatelet aggregation properties of ginger (Zingiber officinale) and turmeric (Curcuma longa) with limited scientific basis. Hence, this study assessed the effect of dietary supplementation of these rhizomes on platelet ectonucleotidase and adenosine deaminase (ADA) activities in Nω-nitro-l-arginine methyl ester hydrochloride (l-NAME) induced hypertensive rats. Animals were divided into seven groups (n = 10): normotensive control rats; induced (l-NAME hypertensive) rats; hypertensive rats treated with atenolol (10 mg/kg/day); normotensive and hypertensive rats treated with 4% supplementation of turmeric or ginger, respectively. After 14 days of pre-treatment, the animals were induced with hypertension by oral administration of l-NAME (40 mg/kg/day). The results revealed a significant (p < 0.05) increase in platelet ADA activity and ATP hydrolysis with a concomitant decrease in ADP and AMP hydrolysis of l-NAME hypertensive rats when compared with the control. However, dietary supplementation with turmeric or ginger efficiently prevented these alterations by modulating the hydrolysis of ATP, ADP and AMP with a concomitant decrease in ADA activity. Thus, these activities could suggest some possible mechanism of the rhizomes against hypertension-derived complications associated to platelet hyperactivity. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ayodele Jacob Akinyemi
- Functional Foods and Nutraceuticals Unit, Department of Biochemistry, Federal University of Technology Akure, Private Mail Bag 704, Akure, 340001, Nigeria
- Department of Biochemistry, Afe Babalola University, Private Mail Bag 5454, Ado-Ekiti, Nigeria
- Programa de Pós Graduação em Ciências Biológicas: Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Campus Universitário, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
| | - Gustavo Roberto Thomé
- Programa de Pós Graduação em Ciências Biológicas: Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Campus Universitário, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
| | - Vera Maria Morsch
- Programa de Pós Graduação em Ciências Biológicas: Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Campus Universitário, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
| | - Nathieli B Bottari
- Programa de Pós Graduação em Ciências Biológicas: Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Campus Universitário, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
| | - Jucimara Baldissarelli
- Programa de Pós Graduação em Ciências Biológicas: Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Campus Universitário, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
| | - Lizielle Souza de Oliveira
- Programa de Pós Graduação em Ciências Biológicas: Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Campus Universitário, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
| | - Jeferson Ferraz Goularte
- Health Basic Sciences Institute, Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Adriane Belló-Klein
- Health Basic Sciences Institute, Department of Physiology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ganiyu Oboh
- Functional Foods and Nutraceuticals Unit, Department of Biochemistry, Federal University of Technology Akure, Private Mail Bag 704, Akure, 340001, Nigeria
| | - Maria Rosa Chitolina Schetinger
- Programa de Pós Graduação em Ciências Biológicas: Bioquímica Toxicológica, Centro de Ciências Naturais e Exatas, Universidade Federal de Santa Maria, Campus Universitário, Camobi, CEP 97105-900, Santa Maria, RS, Brazil
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Xu Z, Xu W, Song Y, Zhang B, Li F, Liu Y. Blockade of store-operated calcium entry alleviates high glucose-induced neurotoxicity via inhibiting apoptosis in rat neurons. Chem Biol Interact 2016; 254:63-72. [PMID: 27234048 DOI: 10.1016/j.cbi.2016.05.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 05/08/2016] [Accepted: 05/19/2016] [Indexed: 10/21/2022]
Abstract
Altered store-operated calcium entry (SOCE) has been suggested to be involved in many diabetic complications. However, the association of altered SOCE and diabetic neuronal damage remains unclear. This study aimed to investigate the effects of altered SOCE on primary cultured rat neuron injury induced by high glucose. Our data demonstrated that high glucose increased rat neuron injury and upregulated the expression of store-operated calcium channel (SOC). Inhibition of SOCE by a pharmacological inhibitor and siRNA knockdown of stromal interaction molecule 1 weakened the intracellular calcium overload, restored mitochondrial membrane potential, downregulated cytochrome C release and inhibited cell apoptosis. As well, treatment with the calcium chelator BAPTA-AM prevented cell apoptosis by ameliorating the high glucose-increased intracellular calcium level. These findings suggest that SOCE blockade may alleviate high glucose-induced neuronal damage by inhibiting apoptosis. SOCE might be a promising therapeutic target in diabetic neurotoxicity.
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Affiliation(s)
- Zhenkuan Xu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute of Shandong University, Jinan, Shandong Province 250012, PR China.
| | - Wenzhe Xu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute of Shandong University, Jinan, Shandong Province 250012, PR China.
| | - Yan Song
- Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute of Shandong University, Jinan, Shandong Province 250012, PR China.
| | - Bin Zhang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute of Shandong University, Jinan, Shandong Province 250012, PR China.
| | - Feng Li
- Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute of Shandong University, Jinan, Shandong Province 250012, PR China.
| | - Yuguang Liu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Brain Science Research Institute of Shandong University, Jinan, Shandong Province 250012, PR China.
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El Haouari M, Rosado JA. Medicinal Plants with Antiplatelet Activity. Phytother Res 2016; 30:1059-71. [PMID: 27062716 DOI: 10.1002/ptr.5619] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 02/29/2016] [Accepted: 03/12/2016] [Indexed: 12/25/2022]
Abstract
Blood platelets play an essential role in the hemostasis and wound-healing processes. However, platelet hyperactivity is associated to the development and the complications of several cardiovascular diseases. In this sense, the search for potent and safer antiplatelet agents is of great interest. This article provides an overview of experimental studies performed on medicinal plants with antiplatelet activity available through literature with particular emphasis on the bioactive constituents, the parts used, and the various platelet signaling pathways modulated by medicinal plants. From this review, it was suggested that medicinal plants with antiplatelet activity mainly belong to the family of Asteraceae, Rutaceae, Fabaceae, Lamiaceae, Zygophyllaceae, Rhamnaceae, Liliaceae, and Zingiberaceae. The antiplatelet effect is attributed to the presence of bioactive compounds such as polyphenols, flavonoids, coumarins, terpenoids, and other substances which correct platelet abnormalities by interfering with different platelet signalization pathways including inhibition of the ADP pathway, suppression of TXA2 formation, reduction of intracellular Ca(2+) mobilization, and phosphoinositide breakdown, among others. The identification and/or structure modification of the plant constituents and the understanding of their action mechanisms will be helpful in the development of new antiplatelet agents based on medicinal plants which could contribute to the prevention of thromboembolic-related disorders by inhibiting platelet aggregation. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Mohammed El Haouari
- Centre Régional des Métiers de l'Education et de la Formation de Taza (CRMEF - Taza), B.P. 1178, Taza Gare, Morocco.,Faculté Polydisciplinaire de Taza, Laboratoire des Matériaux, Substances Naturelles, Environnement et Modélisation (LMSNEM), Université Sidi Mohamed Ben Abdellah, B.P. 1223, Taza Gare, Morocco
| | - Juan A Rosado
- Department of Physiology (Cell Physiology Research Group), University of Extremadura, 10003, Cáceres, Spain
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Abstract
Store-operated Ca(2+) entry (SOCE) is mediated by the store-operated Ca(2+) channel (SOC) that opens upon depletion of internal Ca(2+) stores following activation of G protein-coupled receptors or receptor tyrosine kinases. Over the past two decades, the physiological and pathological relevance of SOCE has been extensively studied. Recently, accumulating evidence suggests associations of altered SOCE with diabetic complications. This review focuses on the implication of SOCE as it pertains to various complications resulting from diabetes. We summarize recent findings by us and others on the involvement of abnormal SOCE in the development of diabetic complications, such as diabetic nephropathy and diabetic vasculopathy. The underlying mechanisms that mediate the diabetes-associated alterations of SOCE are also discussed. The SOCE pathway may be considered as a potential therapeutic target for diabetes-associated diseases.
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Affiliation(s)
- Sarika Chaudhari
- Department of Integrative Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth 76107, TX, USA
| | - Rong Ma
- Department of Integrative Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth 76107, TX, USA
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Effect of acetylsalicylic acid on platelet activation and oxidative profile in a set of Brazilian patients with type 2 diabetes mellitus. Blood Coagul Fibrinolysis 2015; 26:123-30. [PMID: 25325344 DOI: 10.1097/mbc.0000000000000199] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Type 2 diabetes mellitus (DM2) is a metabolic disorder associated with hyperactivation of platelets, increased formation of platelet microparticles (PMPs) and oxidative stress that are related to cardiovascular complications. Acetylsalicylic acid (ASA) is an antiplatelet agent used in the prevention of atherothrombosis. The aim of this study was to evaluate the effect of ASA by means of platelet activation and oxidative profile. We collected blood samples of 81 patients with DM2 before and during ASA treatment. These samples were analyzed to determine the levels of 2,3-dinor thromboxane-B2 (2,3-dinor-TXB2), PMPs, thiobarbituric acid reactive species (TBARS) and 3-(4,5-dimethylthiazol-2yl)-2,5-diphenyltetrazolium bromide (MTT). Moreover, the relationship between the levels of 2,3-dinor-TXB2 with some clinical and laboratory variables such as glycated hemoglobin, platelet count, D dimer, low-density lipoprotein cholesterol and glycoprotein IIb/IIIa and cyclooxygenase-1 polymorphisms was evaluated. ASA intake did not change the levels of PMP, TBARS and MTT. Although a significant decrease in the levels of 2,3 dinorTXB2 (P < 0.001) in patients under ASA has been observed, an equal and satisfactory response to this drug was not found. However, the presence of PIA2 allele in GPIIIa gene may be associated with a better response to ASA intake in these patients, whereas other clinical and laboratory variables showed no association with this drug use. These findings are consistent with previous reports in the literature that patients with DM2 do not benefit in an equal way from the use of ASA for primary prevention of atherothrombotic events.
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Zaccardi F, Rocca B, Pitocco D, Tanese L, Rizzi A, Ghirlanda G. Platelet mean volume, distribution width, and count in type 2 diabetes, impaired fasting glucose, and metabolic syndrome: a meta-analysis. Diabetes Metab Res Rev 2015; 31:402-10. [PMID: 25421610 DOI: 10.1002/dmrr.2625] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 11/09/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND Platelet activation contributes to cardiovascular disease (CVD), the main complication of type 2 diabetes mellitus (T2DM) and pre-diabetic conditions. Mean platelet volume is an easy-to-measure platelet parameter that has been associated with CVD. We sought to assess mean platelet volume, platelet distribution width, and platelet count in T2DM, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and metabolic syndrome. METHODS Web-based literature search (PubMed, EMBASE, and Web of Science) of studies published in English through June 2014 was performed to select case-control and cross-sectional studies that reported data on mean platelet volume, platelet distribution width, or platelet count in cases (subjects with T2DM, IFG, IGT, or metabolic syndrome) and noncases. Descriptive and quantitative information was extracted, and within-study standardized mean difference was estimated from means and standard deviations. Standardized mean differences across studies were synthesized using a random random-effects model, and subgroup analyses were performed on pre-specified study-level characteristics. RESULTS Thirty-nine studies were included. Compared with controls, mean platelet volume was significantly higher in T2DM (standardized mean difference, 95% confidence interval: 0.70, 0.50-0.91; N = 24,245), IFG (0.14, 0.02-0.26; N = 17,389) but not in metabolic syndrome (0.15, -0.24 to 0.55; N = 14,990). Platelet distribution width was wider in T2DM (0.93, 0.09-1.76; N = 471). Platelet count resulted higher in IFG (0.18, 0.12-0.24; N = 3960) and metabolic syndrome (0.39, 0.01-0.78; N = 4070). Only two studies included IGT. CONCLUSIONS Available data suggest that T2DM subjects tend to have higher mean platelet volume and platelet distribution width values, but nondifferent platelet count as compared with subjects without T2DM. Whether and how these morphometric changes contribute to CVD of T2DM or can be used as CVD biomarker awaits further investigation.
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Affiliation(s)
- Francesco Zaccardi
- Internal Medicine and Diabetes Care Unit, Catholic University School of Medicine, Rome, Italy; Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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Lang F, Gawaz M, Borst O. The serum- & glucocorticoid-inducible kinase in the regulation of platelet function. Acta Physiol (Oxf) 2015; 213:181-90. [PMID: 24947805 DOI: 10.1111/apha.12334] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 06/02/2014] [Accepted: 06/15/2014] [Indexed: 12/23/2022]
Abstract
The serum- and glucocorticoid-inducible kinase 1 (SGK1) is expressed in megakaryocytes and circulating platelets. In megakaryocytes, SGK1 activates transcription factor nuclear factor kappa-B (NF-κB), which in turn stimulates expression of Orai1, a Ca(2+) channel protein accomplishing store-operated Ca(2+) enrty (SOCE). SGK1 enhances SOCE and several Ca(2+) -sensitive platelet functions, including degranulation, integrin αII b β3 activation, phosphatidylserine exposure, aggregation and thrombus formation. As shown in other cell types, stimulators of SGK1 expression include ischaemia, oxidative stress, hyperglycaemia, advanced glycation end products (AGEs) and a variety of hormones such as glucocorticoids, mineralocorticoids, transforming growth factor beta (TGFβ), interleukin 6 (IL-6), platelet-derived growth factor (PDGF), thrombin and endothelin. Thus, SGK1-sensitive Ca(2+) signalling may contribute to altered platelet function in several clinical conditions including inflammation, metabolic syndrome, diabetes mellitus and chronic renal failure. Nevertheless, further studies are needed defining the contribution of altered SGK1 expression and activity to physiology and pathophysiology of platelets.
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Affiliation(s)
- F. Lang
- Department of Physiology; University of Tübingen; Tübingen Germany
| | - M. Gawaz
- Department of Cardiology & Cardiovascular Medicine; University of Tübingen; Tübingen Germany
| | - O. Borst
- Department of Physiology; University of Tübingen; Tübingen Germany
- Department of Cardiology & Cardiovascular Medicine; University of Tübingen; Tübingen Germany
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Rao AK, Freishtat RJ, Jalagadugula G, Singh A, Mao G, Wiles A, Cheung P, Boden G. Alterations in insulin-signaling and coagulation pathways in platelets during hyperglycemia-hyperinsulinemia in healthy non-diabetic subject. Thromb Res 2014; 134:704-10. [PMID: 25042561 PMCID: PMC4148207 DOI: 10.1016/j.thromres.2014.06.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Diabetes mellitus (DM) is a prothrombotic and proinflammatory state. Hyperglycemia (HG) is encountered even in patients without DM. We have shown that combined HG and hyperinsulinemia (HI) in healthy non-diabetic subjects increased circulating tissue factor (TF) and thrombin generation. To understand the changes in platelet and monocyte pathways induced by combined HG and HI in healthy non-diabetic state, we performed whole genome expression profiling of leukocyte-depleted platelets and monocytes before and after 24 hours of combined HG (glucose ~200mg/dL) and HI by glucose infusion clamp in a healthy non-diabetic subject. RESULTS We defined time-dependent differential mRNA expression (24 versus 0 hour fold change (FC) ≥ 2) common to platelets and monocytes. Ingenuity Pathways Analysis revealed alterations in canonical insulin receptor signaling and coagulation pathways. A preliminary group of 9 differentially expressed genes was selected for qRT-PCR confirmation. Platelet 24 hour sample was compared to the 0 hour sample plus 4 controls. Five transcripts in platelets and 6 in monocytes were confirmed. Platelet GSK3B and PTPN1 were upregulated, and STXBP4 was downregulated in insulin signaling, and F3 and TFPI were upregulated in coagulation pathways. Monocyte, PIK3C3, PTPN11 and TFPI were downregulated. Platelet GSKβ3 and PTPN11 protein and TF antigen in platelets and monocytes was increased. CONCLUSIONS Even in non-diabetic state, HG+HI for 24 hours induces changes in platelets and monocytes. They suggest downregulation of insulin signaling and upregulation of TF. Further studies are needed to elucidate cellular alterations leading to the prothrombotic and proinflammatory state in DM.
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Affiliation(s)
- A Koneti Rao
- Sol Sherry Thrombosis Research Center, Temple University School of Medicine, Philadelphia, PA, USA; Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA.
| | - Robert J Freishtat
- Division of Emergency Medicine, Children's National Medical Center, Washington, DC, USA
| | - Gauthami Jalagadugula
- Sol Sherry Thrombosis Research Center, Temple University School of Medicine, Philadelphia, PA, USA
| | - Anamika Singh
- Sol Sherry Thrombosis Research Center, Temple University School of Medicine, Philadelphia, PA, USA
| | - Guangfen Mao
- Sol Sherry Thrombosis Research Center, Temple University School of Medicine, Philadelphia, PA, USA
| | - Andrew Wiles
- Division of Emergency Medicine, Children's National Medical Center, Washington, DC, USA
| | - Peter Cheung
- General Clinical Research Center, Temple University School of Medicine, Philadelphia, PA, USA
| | - Guenther Boden
- Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA; General Clinical Research Center, Temple University School of Medicine, Philadelphia, PA, USA
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Rozalski M, Kassassir H, Siewiera K, Klepacka A, Sychowski R, Watala C. Platelet activation patterns are different in mouse models of diabetes and chronic inhibition of nitric oxide synthesis. Thromb Res 2014; 133:1097-104. [DOI: 10.1016/j.thromres.2014.03.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/26/2014] [Accepted: 03/26/2014] [Indexed: 01/05/2023]
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Rocca B, Dragani A, Pagliaccia F. Identifying determinants of variability to tailor aspirin therapy. Expert Rev Cardiovasc Ther 2014; 11:365-79. [DOI: 10.1586/erc.12.144] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Abstract
Atherothrombotic complications are important causes of morbidity and mortality in diabetic patients. Diabetes has been considered to be a prothrombotic status. Several factors contribute to the prothrombotic condition, such as increasing coagulation, impaired fibrinolysis, endothelial dysfunction, and platelet hyperreactivity. Among the factors that contribute to the prothrombotic status in diabetes, altered platelet function plays a crucial role. Although understanding platelet function abnormalities in diabetes still remains as a challenge, more attention should be focused on platelet function for effective management and the prediction of atherothrombotic events in diabetic patients. This review will provide an overview on the current status of knowledge of platelet function abnormalities and clinical marker of platelet hyperreactivity in patients with diabetes.
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Affiliation(s)
- Jin Hwa Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Hak Yeon Bae
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
| | - Sang Yong Kim
- Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea
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Lang F, Münzer P, Gawaz M, Borst O. Regulation of STIM1/Orai1-dependent Ca2+ signalling in platelets. Thromb Haemost 2013; 110:925-30. [PMID: 23846758 DOI: 10.1160/th13-02-0176] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 05/19/2013] [Indexed: 01/20/2023]
Abstract
Platelet secretion and aggregation as well as thrombus formation of blood platelets critically depend on increase of cytosolic Ca2+ concentration ([Ca2+]i) mainly resulting from intracellular Ca2+ release followed by store operated Ca2+ entry (SOCE) through Ca2+ release activated channels (CRAC). SOCE is in part accomplished by the pore forming unit Orai and its regulator stromal interaction molecule (STIM). Orai1 and STIM1 transcription is stimulated by NF-κB (nuclear factor kappa B). Serum- and glucocorticoid-inducible kinase 1 (SGK1) up-regulates NF-κB-activity in megakaryocytes and thus Orai1-expression and SOCE in platelets. SGK1 is thus a powerful regulator of platelet Ca2+-signalling and thrombus formation and presumably participates in the regulation of platelet activation by a variety of hormones as well as clinical conditions (e.g. type 2 diabetes or metabolic syndrome) associated with platelet hyperaggregability and increased risk of thromboocclusive events. SOCE in platelets is further regulated by scaffolding protein Homer and chaperone protein cyclophilin A (CyPA). Additional potential regulators of Orai1/STIM1 and thus SOCE in platelets include AMP activated kinase (AMPK), protein kinase A (PKA), reactive oxygen species, lipid rafts, pH and mitochondrial Ca2+ buffering. Future studies are required defining the significance of those mechanisms for platelet Orai1 abundance and function, for SOCE into platelets and for platelet function in cardiovascular diseases.
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Affiliation(s)
- F Lang
- Florian Lang, MD, Department of Physiology, University of Tübingen, Gmelinstr. 5, 72076 Tübingen, Germany, Tel.: +49 7071 29 72194, Fax: +49 7071 29 5618, E-mail:
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Wieschhaus AJ, Le Breton GC, Chishti AH. Headpiece domain of dematin regulates calcium mobilization and signaling in platelets. J Biol Chem 2012; 287:41218-31. [PMID: 23060452 DOI: 10.1074/jbc.m112.364679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Dematin is a broadly expressed membrane cytoskeletal protein that has been well characterized in erythrocytes and to a lesser extent in non-erythroid cells. However, dematin's function in platelets is not known. Here, we show that dematin is abundantly expressed in both human and mouse platelets. Platelets harvested from the dematin headpiece knock-out (HPKO) mouse model exhibit a striking defect in the mobilization of calcium in response to multiple agonists of platelet activation. The reduced calcium mobilization in HPKO platelets is associated with concomitant inhibition of platelet aggregation and granule secretion. Integrin α(IIb)β(3) activation in response to agonists is attenuated in the HPKO platelets. The mutant platelets show nearly normal spreading on fibrinogen and an unaltered basal cAMP level; however, the clot retraction was compromised in the mutant mice. Immunofluorescence analysis indicated that dematin is present both at the dense tubular system and plasma membrane fractions of platelets. Proteomic analysis of dematin-associated proteins in human platelets identified inositol 1,4,5-trisphosphate 3-kinase isoform B (IP3KB) as a binding partner, which was confirmed by immunoprecipitation analysis. IP3KB, a dense tubular system protein, is a major regulator of calcium homeostasis. Loss of the dematin headpiece resulted in a decrease of IP3KB at the membrane and increased levels of IP3KB in the cytosol. Collectively, these findings unveil dematin as a novel regulator of internal calcium mobilization in platelets affecting multiple signaling and cytoskeletal functions. Implications of a conserved role of dematin in the regulation of calcium homeostasis in other cell types will be discussed.
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Affiliation(s)
- Adam J Wieschhaus
- Department of Molecular Physiology and Pharmacology, Tufts University School of Medicine, Boston, Massachusetts 02111, USA
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Moderate Red Wine and Grape Juice Consumption Modulates the Hydrolysis of the Adenine Nucleotides and Decreases Platelet Aggregation in Streptozotocin-Induced Diabetic Rats. Cell Biochem Biophys 2012; 65:129-43. [DOI: 10.1007/s12013-012-9407-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Alexandru N, Popov D, Georgescu A. Intraplatelet oxidative/nitrative stress: inductors, consequences, and control. Trends Cardiovasc Med 2012; 20:232-8. [PMID: 22293024 DOI: 10.1016/j.tcm.2011.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This article provides an overview of the current knowledge on intraplatelet oxidative/nitrative stress, an abnormality associated with platelet activation and hyper-reactivity. The first issue discussed is related to induction of platelet endogenous stress by the molecules present within the circulating (extracellular) milieu that bathes these cells. The second issue concerns the intraplatelet oxidative/nitrative stress associated with specific pathologies or clinical procedures and action of particular molecules and platelet agonists as well as of the specialized intraplatelet milieu and its redox system; the biomarkers of endogenous oxidative/nitrative stress are also briefly outlined. Next, the association between intraplatelet oxidative/nitrative stress and the risk factors of the metabolic syndrome is presented. Then, the most recent strategies aimed at the control/regulation of platelet endogenous oxidative/nitrative stress, such as exploitation of circulating extracellular reactive oxygen species scavengers, manipulation of platelet molecules, and the use of antioxidants, are discussed. Finally, the results of studies on platelet-dependent redox mechanisms, which deserve immediate attention for potential clinical exploitation, are illustrated.
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Affiliation(s)
- Nicoleta Alexandru
- Petru Poni Institute of Macromolecular Chemistry, 700487 Iasi, Romania. @icbp.ro
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Variability in the responsiveness to low-dose aspirin: pharmacological and disease-related mechanisms. THROMBOSIS 2012; 2012:376721. [PMID: 22288010 PMCID: PMC3263649 DOI: 10.1155/2012/376721] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 10/04/2011] [Indexed: 01/21/2023]
Abstract
The main pharmacological aspects of pharmacodynamics (PD) and pharmacokinetics (PK) of aspirin as antiplatelet agent were unravelled between the late sixties and the eighties, and low-dose aspirin given once daily has been shown to be a mainstay in the current treatment and prevention of cardiovascular disorders. Nevertheless, several PD and PK aspects of aspirin in selected clinical conditions have recently emerged and deserve future clinical attention. In 1994, the term "aspirin resistance" was used for the first time, but, until now, no consensus exists on definition, standardized assay, underlying mechanisms, clinical impact, and possible efficacy of alternative therapeutic interventions. At variance with an undefined aspirin-resistant status, in the last 5 years, the concept of variability in response to aspirin due to specific pathophysiological mechanisms and based on PK and/or PD of the drug has emerged. This growing evidence highlights the existence and possible clinical relevance of an interindividual variability of pharmacological aspirin response and calls for new, large studies to test new low-dose aspirin-based regimens which may ameliorate platelet acetylation, reduce variability in drug responsiveness, and improve clinical efficacy on selected populations.
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Alexandru N, Popov D, Georgescu A. Platelet dysfunction in vascular pathologies and how can it be treated. Thromb Res 2011; 129:116-26. [PMID: 22035630 DOI: 10.1016/j.thromres.2011.09.026] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 09/19/2011] [Accepted: 09/22/2011] [Indexed: 12/17/2022]
Abstract
Cardiovascular diseases are one of the leading causes of morbidity and mortality in industrialized countries, and although many processes play a role in the development of vascular disease, thrombosis is the primary event that precipitates stroke and acute coronary syndromes. The blood platelets are of significant importance in medicine. These cells are involved in many physiological processes, particularly haemostasis through their ability to aggregate and form clots in response to activation. In addition, these dynamic cells display activities that extend beyond thrombosis, including an important role in initiating and sustaining vascular inflammation. The expansion of knowledge from basic and clinical research has highlighted the critical position of platelets in several inflammatory diseases such as arthritis and atherosclerosis. Platelets are emerging as important mediators of inflammation and provide important signals to mediate phenotype of other blood and vascular cells. The important role of platelets in arterial thrombosis and the onset of acute myocardial infarction after atherosclerotic plaque rupture make inhibition of platelet aggregation a critical step in preventing thrombotic events associated with stroke, heart attack, and peripheral arterial thrombosis. However, the use of platelet inhibitors for thrombosis prevention must seek a delicate balance between inhibiting platelet activation and an associated increased bleeding risk. The aim of this review is to up-date the knowledge on platelets physiology and dysfunction in pathologies, such as diabetes mellitus, hypercholesterolemia, and hypertension, emphasizing the link between platelets and the inflammation-related atherosclerosis. The review evaluates the opportunities offered by the novel platelet inhibitors to efficiently alleviate the thrombotic events.
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