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Tujara Z, Reta W, Tadesse E, Dereje I, Tesfa M. Assessment of Erythrocyte Osmotic Fragility and Its Determinants, and Comparison of Hematological Indices Among Type 2 Diabetes Mellitus Patients on Follow-Up at Jimma Medical Center, Southwest Ethiopia. J Blood Med 2024; 15:9-19. [PMID: 38283856 PMCID: PMC10812138 DOI: 10.2147/jbm.s445620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/18/2024] [Indexed: 01/30/2024] Open
Abstract
Background Diabetes Mellitus (DM) is one of the most prevalent non-communicable diseases worldwide. Approximately 9.3% of the general population was estimated to have DM globally in 2019. Erythrocyte osmotic fragility (EOF) in hyperglycemic patients is expected to increase and determine the rate of erythrocyte hemolysis. Purpose This study aimed to assess erythrocyte osmotic fragility (EOF) and its determinants and to compare hematological indices among T2DM patients on follow-up at the Jimma Medical Center (JMC), Jimma, Southwest Ethiopia. Methods A facility-based cross-sectional study involving 124 participants (each 62) of T2DM patients and controls was conducted from October to November 2020 using a structured questionnaire. 5 mL of venous blood was drawn to assess OF, complete blood count, and blood glucose levels. EOF was investigated using a series hypotonic solution of NaCl. The supernatant of the centrifuged sample was transferred to cuvette test tubes, and the hemolysis stage was read on a spectrophotometer. The collected data were coded and entered into Epi-data Version 3.1. The analysis was performed using SPSS Version 23. Results Compared with non-diabetic controls, patients with T2DM had significantly increased EOF. FBG >126mg/dl (AOR=7.741, 95% CI: 1.562-38.360), PPBG >200 mg/dl (AOR=7.576, 95% CI: 1.519-37.791), RDW (AOR=4.558, 95% CI: 1.136-18.284) were significantly associated with abnormal EOF. A statistically significant increase in total white blood cells and absolute neutrophil counts (P < 0.001) were observed in T2DM patients. From RBC indices, red blood cell distribution width (RDW) and mean corpuscular volume (MCV) were significantly increased in T2DM patients (P < 0.001). Conclusion This study suggests that EOF was greater in patients with T2DM than in non-diabetic controls and was determined by FBG, PPBG, and RDW. The study also demonstrated that hematological index alterations were higher in T2DM subjects than in non-diabetic controls.
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Affiliation(s)
- Zenebe Tujara
- Department of Medicine, College of Health sciences, Salale University, Fiche, Oromia, Ethiopia
| | - Wondu Reta
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Eyasu Tadesse
- Department of Biomedical Sciences, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia
| | - Ifa Dereje
- Department of Medicine, College of Health sciences, Salale University, Fiche, Oromia, Ethiopia
| | - Mekonnen Tesfa
- Department of Medicine, College of Health sciences, Salale University, Fiche, Oromia, Ethiopia
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Li L, Wang S, Han K, Qi X, Ma S, Li L, Yin J, Li D, Li X, Qian J. Quantifying Shear-induced Margination and Adhesion of Platelets in Microvascular Blood Flow. J Mol Biol 2023; 435:167824. [PMID: 36108775 DOI: 10.1016/j.jmb.2022.167824] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 02/04/2023]
Abstract
Platelet margination and adhesion are two critical and closely related steps in thrombus formation. Using dissipative particle dynamics (DPD) method that seamlessly models blood cells, blood plasma, and vessel walls with functionalized surfaces, we quantify the shear-induced margination and adhesion of platelets in microvascular blood flow. The results show that the occurrence of shear-induced RBC-platelet collisions has a remarkable influence on the degree of platelet margination. We characterize the lateral motion of individual platelets by a mean square displacement analysis of platelet trajectories, and find that the wall-induced lift force and the shear-induced displacement in wall-bounded flow cause the variation in near-wall platelet distribution. We then investigate the platelet adhesive dynamics under different flow conditions, by conducting DPD simulations of blood flow in a microtube with fibrinogen-coated wall surfaces. We find that the platelet adhesion is enhanced with the increase of fibrinogen concentration level but decreased with the increase of shear rate. These results are consistent with available experimental results. In addition, we demonstrate that the adherent platelets have a negative impact on the margination dynamics of the circulating platelets, which is mainly due to the climbing effect induced by the adherent ones. Taken together, these findings provide useful insights into the platelet margination and adhesion dynamics, which may facilitate the understanding of the predominant processes governing the initial stage of thrombus formation.
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Affiliation(s)
- Lujuan Li
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; Department of Engineering Mechanics, Zhejiang University, Hangzhou, China
| | - Shuo Wang
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; Department of Engineering Mechanics, Zhejiang University, Hangzhou, China
| | - Keqin Han
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; Department of Engineering Mechanics, Zhejiang University, Hangzhou, China
| | - Xiaojing Qi
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; Department of Engineering Mechanics, Zhejiang University, Hangzhou, China
| | - Shuhao Ma
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; Department of Engineering Mechanics, Zhejiang University, Hangzhou, China
| | - Li Li
- Department of Endocrinology and Metabolism, Ningbo First Hospital, Ningbo, China
| | - Jun Yin
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; School of Mechanical Engineering, Zhejiang University, Hangzhou, China
| | - Dechang Li
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; Department of Engineering Mechanics, Zhejiang University, Hangzhou, China.
| | - Xuejin Li
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; Department of Engineering Mechanics, Zhejiang University, Hangzhou, China; The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| | - Jin Qian
- State Key Laboratory of Fluid Power and Mechatronic Systems, Zhejiang University, Hangzhou, China; Department of Engineering Mechanics, Zhejiang University, Hangzhou, China.
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Abstract
The complement and hemostatic systems are complex systems, and both involve enzymatic cascades, regulators, and cell components-platelets, endothelial cells, and immune cells. The two systems are ancestrally related and are defense mechanisms that limit infection by pathogens and halt bleeding at the site of vascular injury. Recent research has uncovered multiple functional interactions between complement and hemostasis. On one side, there are proteins considered as complement factors that activate hemostasis, and on the other side, there are coagulation proteins that modulate complement. In addition, complement and coagulation and their regulatory proteins strongly interact each other to modulate endothelial, platelet and leukocyte function and phenotype, creating a potentially devastating amplifying system that must be closely regulated to avoid unwanted damage and\or disseminated thrombosis. In view of its ability to amplify all complement activity through the C3b-dependent amplification loop, the alternative pathway of complement may play a crucial role in this context. In this review, we will focus on available and emerging evidence on the role of the alternative pathway of complement in regulating hemostasis and vice-versa, and on how dysregulation of either system can lead to severe thromboinflammatory events.
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Affiliation(s)
- Marina Noris
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
| | - Miriam Galbusera
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy
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Chaudhary PK, Kim S, Kim S. An Insight into Recent Advances on Platelet Function in Health and Disease. Int J Mol Sci 2022; 23:ijms23116022. [PMID: 35682700 PMCID: PMC9181192 DOI: 10.3390/ijms23116022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
Platelets play a variety of roles in vascular biology and are best recognized as primary hemostasis and thrombosis mediators. Platelets have a large number of receptors and secretory molecules that are required for platelet functionality. Upon activation, platelets release multiple substances that have the ability to influence both physiological and pathophysiological processes including inflammation, tissue regeneration and repair, cancer progression, and spreading. The involvement of platelets in the progression and seriousness of a variety of disorders other than thrombosis is still being discovered, especially in the areas of inflammation and the immunological response. This review represents an integrated summary of recent advances on the function of platelets in pathophysiology that connects hemostasis, inflammation, and immunological response in health and disease and suggests that antiplatelet treatment might be used for more than only thrombosis.
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Getawa S, Adane T. Hematological abnormalities among adults with type 1 diabetes mellitus at the University of Gondar Comprehensive Specialized Hospital. SAGE Open Med 2022; 10:20503121221094212. [PMID: 35492887 PMCID: PMC9047808 DOI: 10.1177/20503121221094212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/23/2022] [Indexed: 11/24/2022] Open
Abstract
Objective: Changes in the blood cell function, metabolism, and the coagulation system
were associated with diabetes mellitus. This study aimed to determine the
magnitude and associated factors of hematological abnormalities in adults
with type 1 diabetes mellitus. Methods: A total of 204 medical charts of adults with type 1 diabetes mellitus who
registered for follow-up at the University of Gondar Comprehensive
Specialized Hospital were reviewed from June to August 2021. Data were
collected using a structured data extraction checklist. To identify factors
associated with hematological abnormalities, both bivariate and multivariate
logistic regression analyses were done. Statistical significance was defined
as a p-value of <0.05. Results: The overall magnitude of leukocytosis and anemia in adults with type 1
diabetes mellitus was 76.0% (95% confidence interval: 70.07–81.89) and
30.90% (95% confidence interval: 24.49–37.28), respectively. Neutrophilia
and lymphocytosis were the common white blood cell abnormalities detected in
53.43% (95% confidence interval: 46.53–60.33) and 43.63% (95% confidence
interval: 36.76–50.49) of the patients, respectively. Besides,
thrombocytosis and thrombocytopenia were observed in 5.4% (95% confidence
interval: 2.27–8.52) and 10.3% (95% confidence interval: 6.09–14.5) of the
patients, respectively. Only being male (adjusted odds ratio = 2.28 (95%
confidence interval: 1.46–5.29)) and duration of diabetes mellitus
(⩾3 years) (adjusted odds ratio = 8.41 (95% confidence interval:
2.49–28.29)) were significantly associated with anemia and leukocytosis,
respectively. Conclusion: Hematological abnormalities, particularly anemia and leukocytosis, are common
in patients with type 1 diabetes mellitus. Therefore, preventive and control
strategies for hematological abnormalities are essential in patients with
type 1 diabetes mellitus particularly for male and patients with a long
duration on diabetes mellitus to reduce the burden and related
complications.
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Affiliation(s)
- Solomon Getawa
- Solomon Getawa, Department of Hematology
and Immunohematology, School of Biomedical and Laboratory Sciences, College of
Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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Gao Q, Qi P, Wang J, Hu S, Yang X, Fan J, Li L, Lu Y, Lu J, Chen J, Wang D. Effects of diabetes mellitus complicated by admission hyperglycemia on clot histological composition and ultrastructure in patients with acute ischemic stroke. BMC Neurol 2022; 22:130. [PMID: 35382802 PMCID: PMC8981928 DOI: 10.1186/s12883-022-02660-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) affects the occurrence and prognosis of acute ischemic stroke (AIS). However, the impact of diabetes on thrombus characteristics is unclear. The relationship between the composition and ultrastructure of clots and DM with admission hyperglycemia was investigated. Methods Consecutive patients with AIS who underwent endovascular thrombus retrieval between June 2017 and May 2021 were recruited. The thrombus composition and ultrastructure were evaluated using Martius scarlet blue stain and scanning electron microscopy. Clot perviousness was evaluated via thrombus attenuation increase on computed tomography angiography (CTA) versus non-contrast CT. Patients with admission hyperglycemia DM (ahDM) and those without DM (nonDM) were compared in terms of thrombus composition, ultrastructure, and perviousness. Results On admission, higher NIHSS scores (17 vs. 12, respectively, p = 0.015) was evident in ahDM patients. After the 90-day follow-up, the rates of excellent outcomes (mRS 0–1) were lower in patients with ahDM (16.6%, p = 0.038), but functional independence (mRS 0–2) and handicapped (mRS 3–5) were comparable between patients with ahDM and nonDM. The outcome of mortality was higher in patients with ahDM (33.3%, p = 0.046) than in nonDM patients. Clots in patients with ahDM had more fibrin (39.4% vs. 25.0%, respectively, p = 0.007), fewer erythrocyte components (21.2% vs. 41.5%, respectively, p = 0.043), equivalent platelet fraction (27.7% vs. 24.6%, respectively, p = 0.587), and higher WBC counts (4.6% vs. 3.3%, respectively, p = 0.004) than in nonDM patients. The percentage of polyhedral erythrocytes in thrombi was significantly higher in ahDM patients than in nonDM patients (68.9% vs. 45.6%, respectively, p = 0.007). The proportion of pervious clots was higher in patients nonDM than in patients with ahDM (82.61% vs. 40%, respectively, p = 0.026). Conclusion Patients with ahDM presented with greater stroke severity on admission and poorer functional outcomes after 3 months. Clots in patients with ahDM had more fibrin, leucocytes, and fewer erythrocyte components than in patients nonDM. The content of polyhedral erythrocytes and impervious clots proportion were significantly higher in thrombi of patients with AIS and ahDM. Further research is required to validate these findings.
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Affiliation(s)
- Qun Gao
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China.,Graduate School of Peking Union Medical College, Beijing, China
| | - Peng Qi
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Junjie Wang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Shen Hu
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Ximeng Yang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China
| | - Jingwen Fan
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China.,Peking University Fifth School of Clinical Medicine, Beijing Hospital, Beijing, China
| | - Ling Li
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China.,Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Yao Lu
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China.,Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Jun Lu
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China. .,Graduate School of Peking Union Medical College, Beijing, China.
| | - Juan Chen
- Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, China. .,Beijing Institute of Geriatrics, Beijing Hospital, National Center of Gerontology, Beijing, China.
| | - Daming Wang
- Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, No.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China. .,Graduate School of Peking Union Medical College, Beijing, China.
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Pluta K, Porębska K, Urbanowicz T, Gąsecka A, Olasińska-Wiśniewska A, Targoński R, Krasińska A, Filipiak KJ, Jemielity M, Krasiński Z. Platelet-Leucocyte Aggregates as Novel Biomarkers in Cardiovascular Diseases. BIOLOGY 2022; 11:biology11020224. [PMID: 35205091 PMCID: PMC8869671 DOI: 10.3390/biology11020224] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 12/18/2022]
Abstract
Simple Summary Cardiovascular diseases are the most common cause of death worldwide. Hence, novel biomarkers are urgently needed to improve diagnosis and treatment. Platelet–leucocyte aggregates are conglomerates of platelets and leucocytes and are widely investigated as biomarkers in cardiovascular diseases. Platelet–leucocytes aggregates are present in health, but increase in patients with cardiovascular risk factors and acute or stable coronary syndromes, making them a potential diagnostic marker. Moreover, platelet–leucocyte aggregates predict outcomes after surgery or percutaneous treatment and could be used to monitor antiplatelet therapy. Emerging data about the participation of platelet–leucocyte aggregates in cardiovascular diseases pathogenesis make them an attractive target for novel therapies. Furthermore, simple detection with conventional flow cytometry provides accurate and reproducible results, although requires specific sample handling. The main task for the future is to determine the standardized protocol to measure blood concentrations of platelet–leucocyte aggregates and subsequently establish their normal range in health and disease. Abstract Platelet–leucocyte aggregates (PLA) are a formation of leucocytes and platelets bound by specific receptors. They arise in the condition of sheer stress, thrombosis, immune reaction, vessel injury, and the activation of leukocytes or platelets. PLA participate in cardiovascular diseases (CVD). Increased levels of PLA were revealed in acute and chronic coronary syndromes, carotid stenosis cardiovascular risk factors. Due to accessible, available, replicable, quick, and low-cost quantifying using flow cytometry, PLA constitute an ideal biomarker for clinical practice. PLA are promising in early diagnosing and estimating prognosis in patients with acute or chronic coronary syndromes treated by percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). PLA were also a reliable marker of platelet activity for monitoring antiplatelet therapy. PLA consist also targets potential therapies in CVD. All of the above potential clinical applications require further studies to validate methods of assay and proof clinical benefits.
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Affiliation(s)
- Kinga Pluta
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (K.P.); (K.P.)
| | - Kinga Porębska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (K.P.); (K.P.)
| | - Tomasz Urbanowicz
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (T.U.); (A.O.-W.); (M.J.)
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (K.P.); (K.P.)
- Correspondence: ; Tel.: +48-22-599-1951
| | - Anna Olasińska-Wiśniewska
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (T.U.); (A.O.-W.); (M.J.)
| | - Radosław Targoński
- 1st Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Aleksandra Krasińska
- Department of Ophtalmology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Krzysztof J. Filipiak
- Department of Clinical Sciences, Maria Sklodowska-Curie Medical Academy in Warsaw, 00-136 Warsaw, Poland;
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (T.U.); (A.O.-W.); (M.J.)
| | - Zbigniew Krasiński
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
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Qian Y, Zeng Y, Lin Q, Huang H, Zhang W, Yu H, Deng B. Association of platelet count and plateletcrit with nerve conduction function and peripheral neuropathy in patients with type 2 diabetes mellitus. J Diabetes Investig 2021; 12:1835-1844. [PMID: 33650778 PMCID: PMC8504918 DOI: 10.1111/jdi.13535] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/12/2021] [Accepted: 02/25/2021] [Indexed: 12/20/2022] Open
Abstract
AIMS/INTRODUCTION Diabetes has been considered as a 'pro-thrombotic state' with enhanced platelet reactivity. Abnormality in platelet aggregation has been found in patients with its most common chronic complication - diabetic peripheral neuropathy (DPN). The purpose of this study was to investigate the potential association of platelet indices with nerve conduction function and the presence of DPN in Chinese patients with type 2 diabetes mellitus. MATERIALS AND METHODS This study involved a total of 211 inpatients with type 2 diabetes mellitus and 55 healthy individuals for whom nerve conduction studies were carried out. DPN was diagnosed according to the American Diabetes Association recommendation. Clinical data were retrospectively collected. RESULTS Patients with diabetes in whom neuropathy developed had lower levels of platelet count (PLT) and plateletcrit (PCT) than healthy controls (P < 0.05). Statistically significant associations of low PLT and PCT levels with the reduction of summed amplitude/velocity Z-score, and the prolongation of F-wave minimum latency in nerve conduction studies were found. Furthermore, after multivariate adjustment, logistic regression analysis showed that low levels of PLT (odds ratio 2.268, 95% confidence interval 1.072-4.797; P < 0.05; PLT <226 vs PLT ≥226) and PCT (odds ratio 2.050, 95% confidence interval 1.001-4.201; P < 0.05; PCT <0.222 vs PCT ≥0.222) in type 2 diabetes mellitus patients were risk factors for the presence of DPN. CONCLUSIONS Lower PLT and PCT levels are closely associated with poorer peripheral nerve conduction functions and the presence of neuropathy in patients with type 2 diabetes mellitus, which suggests that PLT and PCT might be potential biomarkers for showing DPN.
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Affiliation(s)
- Yuqin Qian
- Department of NeurologyInstitute of NeurologyRuijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yaying Zeng
- First School of Clinical MedicineWenzhou Medical UniversityWenzhouChina
| | - Qingxia Lin
- Department of PsychiatryThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Huanjie Huang
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Wanli Zhang
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Huan Yu
- Department of PediatricsTianjin Children's HospitalTianjinChina
| | - Binbin Deng
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
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Zamora C, Riudavets M, Anguera G, Alserawan L, Sullivan I, Barba A, Serra J, Ortiz MA, Gallardo P, Perea L, Gavira J, Barnadas A, Majem M, Vidal S. Circulating leukocyte-platelet complexes as a predictive biomarker for the development of immune-related adverse events in advanced non-small cell lung cancer patients receiving anti-PD-(L)1 blocking agents. Cancer Immunol Immunother 2021; 70:1691-1704. [PMID: 33388994 DOI: 10.1007/s00262-020-02793-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/07/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Anti-PD-(L)1 blocking agents can induce immune-related adverse events (irAEs), which can compromise treatment continuation. Since circulating leukocyte-platelet (PLT) complexes contribute to inflammatory and autoimmune diseases, we aimed to analyze the role of these complexes as predictors of irAEs in non-small cell lung cancer (NSCLC) patients receiving anti-PD-(L)1. MATERIALS AND METHODS Twenty-six healthy donors (HD) and 87 consecutive advanced NSCLC patients treated with anti-PD-(L)1 were prospectively included. Percentages of circulating leukocyte-PLT complexes were analyzed by flow cytometry and compared between HD and NSCLC patients. The association of leukocyte-PLT complexes with the presence and severity of irAEs was analyzed. RESULTS NSCLC patients had higher percentages of circulating leukocyte-PLT complexes. Higher percentages of monocytes with bound PLT (CD14 + PLT +) were observed in patients who received prior therapies while CD4 + T lymphocytes with bound PLT (CD4 + PLT +) correlated with platelets counts. The CD4 + PLT + high percentage group presented a higher rate of dermatological irAEs while the CD4 + PLT + low percentage group showed a higher rate of non-dermatological irAEs (p < 0.001). A lower frequency of grade ≥ 2 irAEs was observed in the CD4 + PLT + high percentage group (p < 0.05). Patients with CD4 + PLT + low and CD14 + PLT + high percentages presented a higher rate of grade ≥ 3 irAEs and predominantly developed non-dermatological irAEs (p < 0.01). CONCLUSIONS Our results suggest that circulating leukocyte-PLT complexes and the combination of CD4 + PLT + and CD14 + PLT + percentages can be used as a predictive biomarker of the development and severity of irAEs in advanced NSCLC patients receiving anti-PD-(L)1 agents.
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Affiliation(s)
- Carlos Zamora
- Group of Immunology-Inflammatory Diseases, Biomedical Research Institut Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Mariona Riudavets
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Georgia Anguera
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain
| | - Letícia Alserawan
- Department of Immunology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ivana Sullivan
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain
| | - Andrés Barba
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain
| | - Jorgina Serra
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain
| | - M Angels Ortiz
- Group of Immunology-Inflammatory Diseases, Biomedical Research Institut Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Pablo Gallardo
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain
| | - Lidia Perea
- Group of Immunology-Inflammatory Diseases, Biomedical Research Institut Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Javier Gavira
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain
| | - Agustí Barnadas
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain
| | - Margarita Majem
- Department of Medical Oncology, Hospital de la Santa Creu i Sant Pau, Sant Quintí, 89, 08041, Barcelona, Spain.
| | - Silvia Vidal
- Group of Immunology-Inflammatory Diseases, Biomedical Research Institut Sant Pau (IIB Sant Pau), Barcelona, Spain
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Fu G, Deng M, Neal MD, Billiar TR, Scott MJ. Platelet-Monocyte Aggregates: Understanding Mechanisms and Functions in Sepsis. Shock 2021; 55:156-166. [PMID: 32694394 PMCID: PMC8008955 DOI: 10.1097/shk.0000000000001619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ABSTRACT Platelets have been shown to play an important immunomodulatory role in the pathogenesis of various diseases through their interactions with other immune and nonimmune cells. Sepsis is a major cause of death in the United States, and many of the mechanisms driving sepsis pathology are still unresolved. Monocytes have recently received increasing attention in sepsis pathogenesis, and multiple studies have associated increased levels of platelet-monocyte aggregates observed early in sepsis with clinical outcomes in sepsis patients. These findings suggest platelet-monocyte aggregates may be an important prognostic indicator. However, the mechanisms leading to platelet interaction and aggregation with monocytes, and the effects of aggregation during sepsis are still poorly defined. There are few studies that have really investigated functions of platelets and monocytes together, despite a large body of research showing separate functions of platelets and monocytes in inflammation and immune responses during sepsis. The goal of this review is to provide insights into what we do know about mechanisms and biological meanings of platelet-monocyte interactions, as well as some of the technical challenges and limitations involved in studying this important potential mechanism in sepsis pathogenesis. Improving our understanding of platelet and monocyte biology in sepsis may result in identification of novel targets that can be used to positively affect outcomes in sepsis.
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Affiliation(s)
- Guang Fu
- Department of General Surgery, The 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China (visiting scholar in Pittsburgh 2018-09/2020-09)
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Meihong Deng
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Matthew D. Neal
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Pittsburgh Trauma Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Timothy R. Billiar
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Pittsburgh Trauma Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Melanie J. Scott
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Pittsburgh Trauma Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
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11
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Lee MKS, Kraakman MJ, Dragoljevic D, Hanssen NMJ, Flynn MC, Al-Sharea A, Sreejit G, Bertuzzo-Veiga C, Cooney OD, Baig F, Morriss E, Cooper ME, Josefsson EC, Kile BT, Nagareddy PR, Murphy AJ. Apoptotic Ablation of Platelets Reduces Atherosclerosis in Mice With Diabetes. Arterioscler Thromb Vasc Biol 2021; 41:1167-1178. [PMID: 33441028 DOI: 10.1161/atvbaha.120.315369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE People with diabetes are at a significantly higher risk of cardiovascular disease, in part, due to accelerated atherosclerosis. Diabetic subjects have increased number of platelets that are activated, more reactive, and respond suboptimally to antiplatelet therapies. We hypothesized that reducing platelet numbers by inducing their premature apoptotic death would decrease atherosclerosis. Approach and Results: This was achieved by targeting the antiapoptotic protein Bcl-xL (B-cell lymphoma-extra large; which is essential for platelet viability) via distinct genetic and pharmacological approaches. In the former, we transplanted bone marrow from mice carrying the Tyr15 to Cys loss of function allele of Bcl-x (known as Bcl-xPlt20) or wild-type littermate controls into atherosclerotic-prone Ldlr+/- mice made diabetic with streptozotocin and fed a Western diet. Reduced Bcl-xL function in hematopoietic cells significantly decreased platelet numbers, exclusive of other hematologic changes. This led to a significant reduction in atherosclerotic lesion formation in Bcl-xPlt20 bone marrow transplanted Ldlr+/- mice. To assess the potential therapeutic relevance of reducing platelets in atherosclerosis, we next targeted Bcl-xL with a pharmacological strategy. This was achieved by low-dose administration of the BH3 (B-cell lymphoma-2 homology domain 3) mimetic, ABT-737 triweekly, in diabetic Apoe-/- mice for the final 6 weeks of a 12-week study. ABT-737 normalized platelet numbers along with platelet and leukocyte activation to that of nondiabetic controls, significantly reducing atherosclerosis while promoting a more stable plaque phenotype. CONCLUSIONS These studies suggest that selectively reducing circulating platelets, by targeting Bcl-xL to promote platelet apoptosis, can reduce atherosclerosis and lower cardiovascular disease risk in diabetes. Graphic Abstract: A graphic abstract is available for this article.
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Affiliation(s)
- Man K S Lee
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.).,Department of Diabetes (M.K.S.L., N.M.J.H., O.D.C., M.E.C.), Monash University, Melbourne, Australia.,Department of Cardiometabolic Health (M.K.S.L., D.D., A.J.M.), University of Melbourne, Australia
| | - Michael J Kraakman
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.)
| | - Dragana Dragoljevic
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.).,Department of Cardiometabolic Health (M.K.S.L., D.D., A.J.M.), University of Melbourne, Australia
| | - Nordin M J Hanssen
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.).,Department of Diabetes (M.K.S.L., N.M.J.H., O.D.C., M.E.C.), Monash University, Melbourne, Australia.,Department of Internal Medicine, CARIM, School of Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands (N.M.J.H.).,Amsterdam Diabetes Centrum, Internal and vascular medicine, Amsterdam UMC, AMC, the Netherlands (N.M.J.H.)
| | - Michelle C Flynn
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.).,Department of Immunology (M.C.F., A.J.M.), Monash University, Melbourne, Australia
| | - Annas Al-Sharea
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.)
| | - Gopalkrishna Sreejit
- Division of Cardiac Surgery, Department of Surgery, Ohio State University, Columbus (G.S., P.R.N.)
| | - Camilla Bertuzzo-Veiga
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.).,Department of Physiology (C.B.-V., A.J.M.), University of Melbourne, Australia
| | - Olivia D Cooney
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.).,Department of Diabetes (M.K.S.L., N.M.J.H., O.D.C., M.E.C.), Monash University, Melbourne, Australia
| | - Fatima Baig
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.)
| | - Elizabeth Morriss
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.)
| | - Mark E Cooper
- Department of Diabetes (M.K.S.L., N.M.J.H., O.D.C., M.E.C.), Monash University, Melbourne, Australia
| | - Emma C Josefsson
- Department of Medical Biology (E.C.J.), University of Melbourne, Australia.,The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia (E.C.J.)
| | - Benjamin T Kile
- Monash Biomedicine Discovery Institute (B.T.K.), Monash University, Melbourne, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Australia (B.T.K.)
| | - Prabhakara R Nagareddy
- Division of Cardiac Surgery, Department of Surgery, Ohio State University, Columbus (G.S., P.R.N.)
| | - Andrew J Murphy
- Haematopoiesis and Leukocyte Biology, Baker Heart and Diabetes Institute, Melbourne, Australia (M.K.S.L., M.J.K., D.D., N.M.J.H., M.C.F., A.A.-S., C.B.-V., O.D.C., F.B., E.M., A.J.M.).,Department of Immunology (M.C.F., A.J.M.), Monash University, Melbourne, Australia.,Department of Cardiometabolic Health (M.K.S.L., D.D., A.J.M.), University of Melbourne, Australia.,Department of Physiology (C.B.-V., A.J.M.), University of Melbourne, Australia
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12
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Chimen M, Evryviadou A, Box CL, Harrison MJ, Hazeldine J, Dib LH, Kuravi SJ, Payne H, Price JMJ, Kavanagh D, Iqbal AJ, Lax S, Kalia N, Brill A, Thomas SG, Belli A, Crombie N, Adams RA, Evans SA, Deckmyn H, Lord JM, Harrison P, Watson SP, Nash GB, Rainger GE. Appropriation of GPIbα from platelet-derived extracellular vesicles supports monocyte recruitment in systemic inflammation. Haematologica 2020; 105:1248-1261. [PMID: 31467123 PMCID: PMC7193470 DOI: 10.3324/haematol.2018.215145] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 08/23/2019] [Indexed: 01/13/2023] Open
Abstract
Interactions between platelets, leukocytes and the vessel wall provide alternative pathological routes of thrombo-inflammatory leukocyte recruitment. We found that when platelets were activated by a range of agonists in whole blood, they shed platelet-derived extracellular vesicles which rapidly and preferentially bound to blood monocytes compared to other leukocytes. Platelet-derived extracellular vesicle binding to monocytes was initiated by P-selectin-dependent adhesion and was stabilised by binding of phosphatidylserine. These interactions resulted in the progressive transfer of the platelet adhesion receptor GPIbα to monocytes. GPIbα+-monocytes tethered and rolled on immobilised von Willebrand Factor or were recruited and activated on endothelial cells treated with TGF-β1 to induce the expression of von Willebrand Factor. In both models monocyte adhesion was ablated by a function-blocking antibody against GPIbα. Monocytes could also bind platelet-derived extracellular vesicle in mouse blood in vitro and in vivo Intratracheal instillations of diesel nanoparticles, to model chronic pulmonary inflammation, induced accumulation of GPIbα on circulating monocytes. In intravital experiments, GPIbα+-monocytes adhered to the microcirculation of the TGF-β1-stimulated cremaster muscle, while in the ApoE-/- model of atherosclerosis, GPIbα+-monocytes adhered to the carotid arteries. In trauma patients, monocytes bore platelet markers within 1 hour of injury, the levels of which correlated with severity of trauma and resulted in monocyte clearance from the circulation. Thus, we have defined a novel thrombo-inflammatory pathway in which platelet-derived extracellular vesicles transfer a platelet adhesion receptor to monocytes, allowing their recruitment in large and small blood vessels, and which is likely to be pathogenic.
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Affiliation(s)
- Myriam Chimen
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
- NIHR Surgical Reconstruction and Microbiology Research Centre, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, UK
| | - Aigli Evryviadou
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Clare L Box
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Matthew J Harrison
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Jon Hazeldine
- NIHR Surgical Reconstruction and Microbiology Research Centre, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, UK
| | - Lea H Dib
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Sahithi J Kuravi
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Holly Payne
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Joshua M J Price
- NIHR Surgical Reconstruction and Microbiology Research Centre, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, UK
| | - Dean Kavanagh
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Asif J Iqbal
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Sian Lax
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Neena Kalia
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - Alex Brill
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
- Centre of Membrane Proteins and Receptors, University of Birmingham and Nottingham, The Midlands, UK
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Steve G Thomas
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
- Centre of Membrane Proteins and Receptors, University of Birmingham and Nottingham, The Midlands, UK
| | - Antonio Belli
- NIHR Surgical Reconstruction and Microbiology Research Centre, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, UK
| | - Nicholas Crombie
- NIHR Surgical Reconstruction and Microbiology Research Centre, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, UK
| | - Rachel A Adams
- Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Shelley-Ann Evans
- Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Hans Deckmyn
- Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium
| | - Janet M Lord
- NIHR Surgical Reconstruction and Microbiology Research Centre, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, UK
| | - Paul Harrison
- NIHR Surgical Reconstruction and Microbiology Research Centre, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, UK
| | - Steve P Watson
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
- Centre of Membrane Proteins and Receptors, University of Birmingham and Nottingham, The Midlands, UK
| | - Gerard B Nash
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
| | - G Ed Rainger
- Institute of Cardiovascular Sciences, College of Medicine and Dentistry, University of Birmingham, Birmingham, UK
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13
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Alharbi A, Thompson JP, Brindle NP, Stover CM. Ex vivo modelling of the formation of inflammatory platelet-leucocyte aggregates and their adhesion on endothelial cells, an early event in sepsis. Clin Exp Med 2019; 19:321-337. [PMID: 30191349 PMCID: PMC6647484 DOI: 10.1007/s10238-018-0526-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/27/2018] [Indexed: 12/18/2022]
Abstract
Septicaemia is an acute inflammatory reaction in the bloodstream to the presence of pathogen-associated molecular patterns. Whole blood stimulation assays capture endotoxin-induced formation of aggregates between platelets and leucocytes using flow cytometry. We wanted to assess extent of spontaneous aggregate formation in whole blood stimulation assays and compare the effects of endotoxin and heat-killed, clinically relevant, bacterial pathogens on aggregate formation and then on adhesion of aggregates to TNFα-stimulated endothelial cells. We found that endotoxin (from Escherichia coli or Salmonella enteritidis) was not a suitable stimulus to provoke platelet-leucocyte aggregates in vitro, as it did not further increase the extent of aggregates formed spontaneously in stasis of hirudin-anticoagulated blood. Specifically, whole blood samples stimulated with or without LPS produced aggregates with a mean surface area of 140.97 and 117.68 μm2, respectively. By contrast, incubation of whole blood with heat-killed Klebsiella pneumoniae or Staphylococcus aureus produced significantly enhanced and complex cellular aggregates (with a mean surface area of 470.61 and 518.39 μm2, respectively) which adhered more frequently to TNFα (and free fatty acid)-stimulated endothelial cells. These were reliably captured by scanning electron microscopy. Adhesion of cellular aggregates could be blocked by incubation of endothelial cells with a commercial P-selectin antibody and an angiopoietin-2 ligand trap. In conclusion, we have developed an in vitro method that models the acute inflammatory reaction in whole blood in the presence of sepsis-relevant bacterial pathogen surfaces.
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Affiliation(s)
- Azzah Alharbi
- Department of Infection, Immunity and Inflammation, College of Life Sciences, University of Leicester, Leicester, LE1 9HN, UK
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jonathan P Thompson
- Department of Cardiovascular Sciences, Division of Anaesthesia, Critical Care and Pain Management, University of Leicester, Robert Kilpatrick Clinical Sciences Building, Leicester Royal Infirmary, Leicester, LE2 7LX, UK
| | - Nicholas P Brindle
- Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Leicester, LE1 9HN, UK
- Department of Molecular & Cell Biology, College of Life Sciences, University of Leicester, Leicester, LE1 9HN, UK
| | - Cordula M Stover
- Department of Infection, Immunity and Inflammation, College of Life Sciences, University of Leicester, Leicester, LE1 9HN, UK.
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14
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Abdel-Moneim A, Semmler M, Abdel-Reheim ES, Zanaty MI, Addaleel W. Association of glycemic status and interferon-γ production with leukocytes and platelet indices alterations in type2 diabetes. Diabetes Metab Syndr 2019; 13:1963-1969. [PMID: 31235122 DOI: 10.1016/j.dsx.2019.04.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/24/2019] [Indexed: 12/15/2022]
Abstract
AIMS The present study aimed to evaluate the correlation between glycemic status and the inflammation biomarkers; leukocytes, platelets indices and interferon gamma (IFN-γ) production in type 2 diabetes mellitus (T2DM) patients regarding diabetic complications. METHODS Study was conducted on 158 patients allocated as normal healthy subjects (50) and 108 patients diagnosed as T2DM. The diabetic patients were subdivided into six groups according to metformin administration as mono-or dual therapies. RESULTS The current results exhibited a significant elevation in systolic blood pressure, total and LDL-cholesterol levels and IFN-γ as well as a noticeable decrease in HDL-cholesterol and anti-atherogenic factor values compared to the healthy patients. Leukocytes and neutrophils count, main platelets volume (MPV) and platelet distribution width (PDW) values revealed noticeable elevations in most treated T2DM groups, while a marked depletion was recorded in platelets count compared to healthy subjects. Glycemic control, most treated diabetic patients with metformin mono- and dual therapies showed an ameliorative effect in HbA1c, IFN-γ, MPV, and PDW values compared to recent diabetic ones. CONCLUSION Diabetes was correlated significantly with dyslipidemia and atherogenic risk in parallel with an increase in IFN-γ production and hematological inflammatory biomarkers; leukocytes, neutrophil/lymphocyte and platelet/lymphocyte ratios, MPV and PDW values. The amelioration in inflammatory biomarkers was associated with improvement in glycemic control.
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Affiliation(s)
- Adel Abdel-Moneim
- Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Egypt.
| | - Margit Semmler
- Institute, Diabetes Research Düsseldorf University, Düsseldorf, Germany
| | - Eman S Abdel-Reheim
- Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Egypt
| | - Mohamed I Zanaty
- Biotechnology Department, Postgraduate Studies for Advanced Science, Beni-Suef University, Egypt
| | - Wessam Addaleel
- Physiology Division, Zoology Department, Faculty of Science, Beni-Suef University, Egypt
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15
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16
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Antwi-Baffour S, Kyeremeh R, Boateng SO, Annison L, Seidu MA. Haematological parameters and lipid profile abnormalities among patients with Type-2 diabetes mellitus in Ghana. Lipids Health Dis 2018; 17:283. [PMID: 30545361 PMCID: PMC6293632 DOI: 10.1186/s12944-018-0926-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 11/26/2018] [Indexed: 12/02/2022] Open
Abstract
Background Diabetes mellitus is a non-infectious disease that has a high prevalence worldwide. Altered level of many haematological parameters have been observed in patients with diabetes. The levels of lipids are also affected in diabetes by many factors since carbohydrate metabolism affect lipid metabolism. So far, very little work has been done linking haematological parameters and lipid profile in diabetics. The purpose of this study was therefore to evaluate the haematological parameters and lipid profiles of patients with type-2 diabetes and to correlate the results. Method Three hundred and four (304) patients with type-2 diabetes with an age range of 28 to 70 years (171 males and 133 females) were recruited. About 5 ml of venous blood samples were collected from each participant after an overnight fast. A part of the blood samples was used to determine the lipid profile parameters and the other parts for the haematological parameters. The Statistical Package for Social Science (SPSS) version 21.0 and Microsoft office excel (2010) for windows were used for the statistical analysis of the data. Pearson’s correlation were performed between haematological and lipid parameters. Significance was set at p < 0.05. Results The means and standard deviation of all the lipid parameters except TC showed significant difference in both males and females. There was also proportional increment in LDL-C (in males), LDL-C and Triglycerides (in females) as the age of participants increased and the ratio of TC/HDL was higher in males. There was also significant difference in all of the haematological parameters between the male and female populations. Further, a strong, significant positive correlation between RBC and lymphocytes and lipid parameters was observed. However, the correlation between platelets, haematocrit and haemoglobin and the lipid parameters was negatively significant. Conclusion From the results obtained, it can be concluded that there is significant difference in lipid parameters between male and female diabetic patients. Levels of LDL-C and Triglycerides increased as the age of participants increased and the male population showed increased risk for coronary disease. Almost all of the haematological parameters examined differed significantly between the sexes. There was also, both strong positive and negative correlations between the haematological parameters and the lipid profiles.
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Affiliation(s)
- Samuel Antwi-Baffour
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P. O. Box KB 143, Korle-Bu, Accra, Ghana. .,Department of Medical Laboratory Sciences, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana.
| | - Ransford Kyeremeh
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P. O. Box KB 143, Korle-Bu, Accra, Ghana
| | - Samuel Owusu Boateng
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
| | - Lawrence Annison
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Narh-Bita College, Tema, Ghana
| | - Mahmood Abdulai Seidu
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, P. O. Box KB 143, Korle-Bu, Accra, Ghana
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17
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Chang HY, Yazdani A, Li X, Douglas KAA, Mantzoros CS, Karniadakis GE. Quantifying Platelet Margination in Diabetic Blood Flow. Biophys J 2018; 115:1371-1382. [PMID: 30224049 PMCID: PMC6170725 DOI: 10.1016/j.bpj.2018.08.031] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/23/2018] [Accepted: 08/24/2018] [Indexed: 12/23/2022] Open
Abstract
Patients with type 2 diabetes mellitus (T2DM) develop thrombotic abnormalities strongly associated with cardiovascular diseases. In addition to the changes of numerous coagulation factors such as elevated levels of thrombin and fibrinogen, the abnormal rheological effects of red blood cells (RBCs) and platelets flowing in blood are crucial in platelet adhesion and thrombus formation in T2DM. An important process contributing to the latter is the platelet margination. We employ the dissipative particle dynamics method to seamlessly model cells, plasma, and vessel walls. We perform a systematic study on RBC and platelet transport in cylindrical vessels by considering different cell shapes, sizes, and RBC deformabilities in healthy and T2DM blood, as well as variable flowrates and hematocrit. In particular, we use cellular-level RBC and platelet models with parameters derived from patient-specific data and present a sensitivity study. We find T2DM RBCs, which are less deformable compared to normal RBCs, lower the transport of platelets toward the vessel walls, whereas platelets with higher mean volume (often observed in T2DM) lead to enhanced margination. Furthermore, increasing the flowrate or hematocrit enhances platelet margination. We also investigated the effect of platelet shape and observed a nonmonotonic variation with the highest near-wall concentration corresponding to platelets with a moderate aspect ratio of 0.38. We examine the role of white blood cells (WBCs), whose count is increased notably in T2DM patients. We find that WBC rolling or WBC adhesion tends to decrease platelet margination due to hydrodynamic effects. To the best of our knowledge, such simulations of blood including all blood cells have not been performed before, and our quantitative findings can help separate the effects of hydrodynamic interactions from adhesive interactions and potentially shed light on the associated pathological processes in T2DM such as increased inflammatory response, platelet activation and adhesion, and ultimately thrombus formation.
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Affiliation(s)
- Hung-Yu Chang
- Division of Applied Mathematics, Brown University, Providence, Rhode Island
| | - Alireza Yazdani
- Division of Applied Mathematics, Brown University, Providence, Rhode Island
| | - Xuejin Li
- Division of Applied Mathematics, Brown University, Providence, Rhode Island
| | - Konstantinos A A Douglas
- S. Lepida Biomedical Laboratory, Athens, Greece; Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Christos S Mantzoros
- Division of Endocrinology, Diabetes and Metabolism, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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Agu KC. Diabetes mellitus: A review of some of the prognostic markers of response to treatment and management. JOURNAL OF INSULIN RESISTANCE 2018. [DOI: 10.4102/jir.v3i1.36] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: The WHO defined ‘diabetes mellitus’ (DM) as a metabolic disorder characterised by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism resulting from the defect in insulin secretion, or inaction, or both. When not identified early and controlled, acute and chronic life-threatening consequences may result. Identifying DM early for treatment and management, as well as clinically monitoring recovery and improvement during treatment, involves the assessments of biomarkers. The types, choice, sensitivity and descriptive information trends of these biomarkers are very important. Aim: Some prognostic biomarkers and parameters that this review identified include glycated haemoglobin, white blood cells, mean neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, total leukocytes and neutrophils, plasma low-density lipoprotein, high-density lipoprotein and very low-density lipoprotein, platelet, fibrinogen, D-dimer and C-reactive proteins. Results: These parameters display increases in DM, while red blood cell, haemoglobin concentration, activated partial thromboplastin time, prothrombin time and partial thromboplastin time are decreased. Conclusion: With sound knowledge of the variations of these markers and parameters, observed reversal during treatment and management of DM and its complications can be better monitored, and guided decisions can be made.
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Zamora C, Canto E, Nieto JC, Garcia-Planella E, Gordillo J, Ortiz MA, Suarez-Calvet X, Perea L, Julia G, Juarez C, Vidal S. Inverse Association Between Circulating Monocyte-Platelet Complexes and Inflammation in Ulcerative Colitis Patients. Inflamm Bowel Dis 2018. [PMID: 29529212 DOI: 10.1093/ibd/izx106] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Circulating monocytes from active ulcerative colitis (UC) patients produced high levels of tumor necrosis factor-alpha(TNFα) and interleukin(IL)-6 after Toll-like receptors (TLR) stimulation. Since platelets (PLT) can bind to leukocytes, thereby decreasing inflammatory cytokine production, UC patients may exhibit different levels of monocyte-platelet complexes depending on disease activity. METHODS We compared among healthy donors, active (onset flare and relapse), and inactive UC patients the presence of circulating monocyte-platelet complexes (CD14+PLT+) and membrane CD162 expression by flow cytometry. Lipopolysaccharide- binding protein, TNFα, and IL-10 were compared by ELISA. Binding of CD14+PLT+ to human umbilical vein endothelial cells (HUVECs) were analyzed by immunofluorescence. RESULTS Onset flare UC patients had the lowest levels of CD14+PLT+. Membrane CD162, crucial for the PLT binding, was downregulated only on monocytes from onset flare UC patients. Membrane CD162 expression on CD14+ cells inversely correlated with lipopolysaccharide binding protein levels. As an expected consequence, more CD14+PLT+ than CD14+PLT- from onset flare UC patients bound to activated HUVECs. TNFα tended to negatively correlate with CD14+PLT+ in relapse and inactive UC patients, whereas IL-10 positively correlated with CD14+PLT+ in all UC patients (r = -0.43, P = 0.1 and r = 0.61, P = 0.01, respectively). The anti-inflammatory role of PLT binding to monocytes was confirmed in cocultures of PLT and monocytes. These cocultures increased the percentage of CD14+PLT+ and IL-10 production, and decreased TNFα production. These anti-inflammatory effects were abolished when we blocked the binding of PLT with neutralizing anti-CD62P antibody. CONCLUSIONS Decreased CD162 expression associated with endotoxemia reduced the binding of PLT to monocytes through membrane CD162-CD62P, favoring the inflammatory response of onset flare UC patients.
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Affiliation(s)
- Carlos Zamora
- Dep. of Immunology, Institut de Recerca Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elisabet Canto
- Dep. of Immunology, Institut de Recerca Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan C Nieto
- Dep. of Immunology, Institut de Recerca Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ester Garcia-Planella
- Gastroenterology and Hepatology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jordi Gordillo
- Gastroenterology and Hepatology Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mª Angels Ortiz
- Dep. of Immunology, Institut de Recerca Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Suarez-Calvet
- Neuromuscular Diseases Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau and Institut de Recerca Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lidia Perea
- Dep. of Immunology, Institut de Recerca Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Germà Julia
- Dep. of Immunology, Institut de Recerca Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Candido Juarez
- Dep. of Immunology Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Silvia Vidal
- Dep. of Immunology, Institut de Recerca Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Krga I, Vidovic N, Milenkovic D, Konic-Ristic A, Stojanovic F, Morand C, Glibetic M. Effects of anthocyanins and their gut metabolites on adenosine diphosphate-induced platelet activation and their aggregation with monocytes and neutrophils. Arch Biochem Biophys 2018; 645:34-41. [PMID: 29555206 DOI: 10.1016/j.abb.2018.03.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 03/08/2018] [Accepted: 03/13/2018] [Indexed: 12/21/2022]
Abstract
Accumulating evidence suggests that anthocyanins play an important role in the cardioprotective effects associated with consumption of anthocyanin-rich foods. These benefits may partly be attributed to their effects on platelets, significant contributors to cardiovascular disease development. This study aimed to investigate the impact of physiologically relevant concentrations of anthocyanins and their metabolites on platelet activation and platelet-leukocyte aggregation. Whole blood from seven healthy volunteers was treated with anthocyanins: cyanidin-3-arabinoside, cyanidin-3-glucoside, cyanidin-3-galactoside, delphinidin-3-glucoside and peonidin-3-glucoside at 0.1 μM concentration or gut metabolites: 4-hydroxybenzaldehyde, protocatechuic, vanillic, ferulic and hippuric acids at 0.5 μM, 0.2 μM, 2 μM, 1 μM, 2 μM concentration, respectively. Markers of adenosine diphosphate-induced platelet activation (P-selectin and GPIIb-IIIa expression) and platelet-monocyte and platelet-neutrophil aggregation were analyzed using flow cytometry. Cyanidin-3-arabinoside, delphinidin-3-glucoside, and peonidin-3-glucoside decreased agonist-induced P-selectin expression, while cyanidin-3-galactoside and cyanidin-3-arabinoside reduced platelet-neutrophil aggregation. Hippuric and protocatechuic acids inhibited P-selectin expression, ferulic acid reduced platelet-monocyte aggregation, while 4-hydroxybenzaldehyde affected P-selectin expression, platelet-neutrophil and monocyte aggregation. Only cyanidin-3-glucoside and protocatechuic acid decreased GPIIb-IIIa expression. These results demonstrate the bioactivity of anthocyanins and their gut metabolites at physiologically relevant concentrations on platelet function and interaction with leukocytes, presenting mechanisms by which they contribute to the beneficial effects of habitual consumption of anthocyanin-rich foods on cardiovascular health.
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Affiliation(s)
- Irena Krga
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia; Université Clermont Auvergne, INRA, UNH, CRNH Auvergne, F-63000, Clermont-Ferrand, France
| | - Nevena Vidovic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Dragan Milenkovic
- Université Clermont Auvergne, INRA, UNH, CRNH Auvergne, F-63000, Clermont-Ferrand, France; Department of Internal Medicine, Division of Cardiovascular Medicine, School of Medicine, University of California Davis, Davis, CA, 95616, USA.
| | - Aleksandra Konic-Ristic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia; School of Food Science and Nutrition, University of Leeds, United Kingdom
| | - Filip Stojanovic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Christine Morand
- Université Clermont Auvergne, INRA, UNH, CRNH Auvergne, F-63000, Clermont-Ferrand, France
| | - Marija Glibetic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
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Navarro-Núñez L, Teruel R, Antón AI, Nurden P, Martínez-Martínez I, Lozano ML, Rivera J, Corral J, Mezzano D, Vicente V, Martínez C. Rare homozygous status of P43 β1-tubulin polymorphism causes alterations in platelet ultrastructure. Thromb Haemost 2017; 105:855-63. [DOI: 10.1160/th10-08-0536] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Accepted: 02/03/2011] [Indexed: 11/05/2022]
Abstract
Summaryβ1-tubulin is the main constituent of the platelet marginal band and studies with deficient mice showed that it maintains discoid shape and it is required for normal platelet formation. TUBB1 Q43P polymorphism is associated with decreased β1-tubulin expression, diminished platelet reactivity, and partial loss of discoid shape in heterozygous carriers. However, to date no studies have been carried out on homozygous PP individuals. Our study included 19 subjects genotyped for TUBB1 Q43P polymorphism (4 QQ, 4 QP, and 2 PP). The two PP individuals were recruited after genotyping of 2073 individuals. Biochemical, microscopy, and molecular studies were performed. Real-time PCR showed ∼40% decrease in TUBB1 mRNA in the two PP individuals compared to four QQ subjects. Western blot analysis confirmed this reduction. Electron microscopy revealed a majority of normal discoid platelets in PP individuals, although platelets with loose, re-orientated or invaginated protofilaments, and an over-developed open canalicular system were observed. Such abnormalities were not observed in QQ subjects. Morphometric analyses showed no differences between PP and QQ individuals. Immunofluorescence confirmed the presence of a normal marginal band in a majority of platelets from PP subjects. Interestingly, both PP subjects had a 40% lower platelet count than QP and QQ. TUBB1 Q43P polymorphism in homozygosity mildly affects platelet ultrastructure and our data further suggest that high levels of β1-tubulin might not be critical to sustain platelet discoid shape.
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22
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Ahmadian F, Mozaffari-Khosravi H, Azaraein MH, Faraji R, Zavar-Reza J. The effect of consumption of garlic tablet on proteins oxidation biomarkers in postmenopausal osteoporotic women: A randomized clinical trial. Electron Physician 2017; 9:5670-5675. [PMID: 29403603 PMCID: PMC5783112 DOI: 10.19082/5670] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 08/30/2017] [Indexed: 11/22/2022] Open
Abstract
Background Osteoporosis (OP) is one of the most prevalent metabolic bone diseases at higher ages, especially in postmenopausal women. Objective To determine the effect of consumption of garlic tablet on proteins oxidation biomarkers in postmenopausal osteoporotic women. Methods The present study was a double-blind randomized controlled clinical trial that included 42 postmenopausal women in Yazd during 2014–2015. Osteoporotic women were randomly assigned into two groups: the garlic group (GG) and the placebo group (PG). Participants in GG took two garlic tablets daily for 1 month and the participants in PG took placebo tablets in the same manner. After 30 days, the plasma level of carbonyl groups (PCO), total antioxidant capacity (TAC), and advanced oxidation protein products (AOPPs) were assessed by spectrophotometric assays. Also, Malondialdehyde (MDA) content was measured according to the procedure of Thiobarbituric Acid (TBA). Data were analyzed by SPSS version 18, using paired-samples t-test, independent-samples t-test, Wilcoxon, and Mann-Whitney U test. Results This study showed that garlic tablets had decreased PCO plasma levels (47.37±5.98 vs. 19.62±3.40 nM, p≤0.001, before and after the study, respectively), AOPPs (738.95±151.86 vs. 585.12±209.99 μM, p≤0.008, before and after the study, respectively), and increased TAC (11.34±10.80 vs. 47.93±17.80, p≤0.001, before and after the study, respectively). The parameters in placebo groups showed no significant differences before and after the study, respectively. The levels of MDA before taking the drug in comparison to before Garlic group was also reduced (1.30±1.04 vs. 0.92±0.81 μM, p=0.01, before and after the study, respectively). Conclusion The role of oxidative stress in the pathophysiology of many diseases such as osteoporosis has been demonstrated. The present study showed that garlic consumption can reduce the oxidative stress. Trial registration The protocol of trial was registered at the Iranian clinical trial register (www.irct.ir) with ID: IRCT138811183273N1. Funding This study funded by Shahid Sadoughi University of Medical Sciences (Yazd, Iran).
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Affiliation(s)
- Fereshte Ahmadian
- M.Sc., Department of Biochemistry, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hassan Mozaffari-Khosravi
- Ph.D., Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Reza Faraji
- Ph.D., Kermanshah Cardiovascular Research Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Javad Zavar-Reza
- Ph.D., Department of Biochemistry, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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23
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Ziaee A, Ghorbani A, Kalbasi S, Hejrati A, Moradi S. Association of hematological indices with prediabetes: A cross-sectional study. Electron Physician 2017; 9:5206-5211. [PMID: 29038698 PMCID: PMC5633214 DOI: 10.19082/5206] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 08/05/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Prediabetes is a condition that occurs when blood glucose levels are higher than normal, but not high enough to be classified as diabetes. Prediabetic people have an increased risk of developing type 2 diabetes and cardiovascular disease. Moreover Hyperglycemia has multiple effects on the hematological parameters. OBJECTIVE To examine the association between hematological indices and anthropometric measurement, with prediabetes. METHODS This cross-sectional study was conducted on 125 diabetics and 259 prediabetics in the 20-70 age range. They were selected by a convenience sampling method at the Taban Diabetes Center in 2015. An oral glucose tolerance test was performed for each participant who had never been diagnosed with diabetes. Participants were characterized as having prediabetes or diabetes according to American Diabetes Association criteria. The hematologic parameters were measured by using Sysmex-KX 21N analyzers. Data were analyzed by IBM-SPSS version 22 using independent-samples t-test, Mann-Whitney U test, and Pearson's correlation coefficient at p<0.05. RESULTS There was significant difference in mean corpuscular hemoglobin concentration (MCVH) (33.81±0.92 g/dL vs. 34.06±1.05 g/dL) between prediabetes patients and diabetes. There was not a statistically significant difference in the prediabetics' hematological parameters, compared with the diabetics. In the prediabetic group, only the mean corpuscular hemoglobin concentration was found to be negatively correlated with diastolic blood pressure (p=0.013) and FBS (p=0.026). CONCLUSION Hematological indices are important markers for the assessment of variations in size, number, and maturity of different blood cells. Hematological indices could be utile indicators of vascular complication and glycemic control in type 2 DM patients. Thus, they are important for the evaluation and early management of patients with per diabetes.
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Affiliation(s)
- Amir Ziaee
- M.D., Endocrinologist, Professor, Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Azam Ghorbani
- M.Sc., MSN, of Nursing Education, Faculty Member, Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Saied Kalbasi
- M.D., Endocrinologist, Associate Professor, Department of Endocrinology, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Hejrati
- M.D., Endocrinologist, Assistant Professor, Department of Endocrinology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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24
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Wang B, Yee Aw T, Stokes KY. N-acetylcysteine attenuates systemic platelet activation and cerebral vessel thrombosis in diabetes. Redox Biol 2017; 14:218-228. [PMID: 28961512 PMCID: PMC5619994 DOI: 10.1016/j.redox.2017.09.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 09/07/2017] [Accepted: 09/12/2017] [Indexed: 01/03/2023] Open
Abstract
Objective We previously demonstrated that diabetes exacerbates
stroke-induced brain injury, and that this correlates with brain methylglyoxal
(MG)-to-glutathione (GSH) status. Cerebral injury was reversed by N-acetylcysteine
(NAC). Here we tested if the pro-thrombotic phenotype seen in the systemic
circulation and brain during diabetes was associated with increased MG-glycation of
proteins, and if NAC could reverse this. Methods The streptozotocin (STZ)-induced mouse model of type 1
diabetes was used. Thrombus formation in venules and arterioles (pial circulation)
was determined by intravital videomicroscopy using the light-dye method. Circulating
blood platelet-leukocyte aggregates (PLAs) were analyzed by flow cytometry 1 wk
before other measurements. GSH and MG levels in platelets were measured by HPLC.
MG-modified proteins, glutathione peroxidase-1 (GPx-1), and superoxide dismutase-1
(SOD1) levels were detected in platelets by western blot at 20 weeks. Proteins
involved in coagulation were quantified by ELISA. NAC (2 mM) was
given in drinking water for 3 weeks before the terminal experiment. Results Thrombus development was accelerated by diabetes in a
time-dependent manner. % PLAs were significantly elevated by diabetes. Plasma
activated plasminogen activator inhibitor type 1 levels were progressively increased
with diabetes duration, with tail bleeding time reduced by 20 wks diabetes. Diabetes
lowered platelet GSH levels, GPx-1 and SOD-1 expression. This was associated with
higher MG levels, and increased MG-adduct formation in platelets. NAC treatment
partly or completely reversed the effects of diabetes. Conclusion Collectively, these results show that the diabetic blood and
brain become progressively more susceptible to platelet activation and thrombosis.
NAC, given after the establishment of diabetes, may offer protection against the risk
for stroke by altering both systemic and vascular prothrombotic responses via
enhancing platelet GSH, and GSH-dependent MG elimination, as well as correcting
levels of antioxidants such as SOD1 and GPx-1. Diabetes elevates dicarbonyl stress leading to enhanced
thrombosis in the brain. Glutathione levels decrease leading to impaired elimination
of methylglyoxal in platelets during diabetes. Platelet proteins are glycated and platelets form
aggregates with leukocytes in diabetes. Diabetes increases circulating levels of plasminogen
activator inhibitor-1. NAC, via GSH synthesis, reverses the platelet activation,
protein glycation and pro-coagulation responses & protects against
thrombosis in the diabetic brain.
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Affiliation(s)
- Bin Wang
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center-Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA; Center for Cardiovascular Diseases and Sciences, LSU Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71130, USA; Department of Geriatrics, Union hospital, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Tak Yee Aw
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center-Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA; Center for Cardiovascular Diseases and Sciences, LSU Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71130, USA
| | - Karen Y Stokes
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center-Shreveport, 1501 Kings Highway, Shreveport, LA 71103, USA; Center for Cardiovascular Diseases and Sciences, LSU Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71130, USA; Center for Molecular and Tumor Virology, LSU Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71130, USA.
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25
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Blatt AZ, Pathan S, Ferreira VP. Properdin: a tightly regulated critical inflammatory modulator. Immunol Rev 2017; 274:172-190. [PMID: 27782331 PMCID: PMC5096056 DOI: 10.1111/imr.12466] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The complement alternative pathway is a powerful arm of the innate immune system that enhances diverse inflammatory responses in the human host. Key to the effects of the alternative pathway is properdin, a serum glycoprotein that can both initiate and positively regulate alternative pathway activity. Properdin is produced by many different leukocyte subsets and circulates as cyclic oligomers of monomeric subunits. While the formation of non‐physiological aggregates in purified properdin preparations and the presence of potential properdin inhibitors in serum have complicated studies of its function, properdin has, regardless, emerged as a key player in various inflammatory disease models. Here, we review basic properdin biology, emphasizing the major hurdles that have complicated the interpretation of results from properdin‐centered studies. In addition, we elaborate on an emerging role for properdin in thromboinflammation and discuss the potential utility of properdin inhibitors as long‐term therapeutic options to treat diseases marked by increased formation of platelet/granulocyte aggregates. Finally, we describe the interplay between properdin and the alternative pathway negative regulator, Factor H, and how aiming to understand these interactions can provide scientists with the most effective ways to manipulate alternative pathway activation in complex systems.
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Affiliation(s)
- Adam Z Blatt
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Sabina Pathan
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Viviana P Ferreira
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA.
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26
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Davison GM, Nkambule BB, Mkandla Z, Hon GM, Kengne AP, Erasmus RT, Matsha TE. Platelet, monocyte and neutrophil activation and glucose tolerance in South African Mixed Ancestry individuals. Sci Rep 2017; 7:40329. [PMID: 28091589 PMCID: PMC5238515 DOI: 10.1038/srep40329] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 12/05/2016] [Indexed: 12/14/2022] Open
Abstract
Platelet activation has been described in patients with chronic inflammation, however in type 2 diabetes mellitus it remains controversial. We compared levels of platelet leucocyte aggregates, monocyte and granulocyte activation across glucose tolerance statuses in mixed ancestry South Africans. Individuals (206) were recruited from Bellville-South, Cape Town, and included 66% with normal glucose tolerance, 18.7% pre-diabetes, 8.7% screen-detected diabetes and 6.3% known diabetes. Monocyte and neutrophil activation were measured by calculating the percentage of cells expressing CD142 and CD69 while platelet monocyte aggregates were defined as CD14++ CD42b+ events and platelet neutrophil aggregates as CD16++ CD42b+ events. The percentage of monocytes and neutrophils expressing CD69 and CD142 was significantly higher in known diabetes and prediabetes, but, lowest in screen-detected diabetes (both p ≤ 0.016). The pattern was similar for platelet monocyte and neutrophil aggregates (both p ≤ 0.003). In robust linear regressions adjusted for age and gender, known diabetes was significantly and positively associated with the percentage of monocytes expressing CD69 [beta 11.06 (p = 0.016)] and CD42b (PMAs) [19.51 (0.003)] as well as the percentage of neutrophils expressing CD69 [14.19 (<0.0001)] and CD42b [17.7 (0.001)]. We conclude that monitoring platelet activation in diagnosed diabetic patients may have a role in the management and risk stratification.
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Affiliation(s)
- Glenda M Davison
- Department of Biomedical sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| | - Bongani B Nkambule
- Department of Biomedical sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| | - Zibusiso Mkandla
- Department of Biomedical sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| | - Gloudina M Hon
- Department of Biomedical sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
| | - Andre P Kengne
- NonCommunicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.,Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Rajiv T Erasmus
- Department of Pathology, Faculty of Medicine and Health Sciences, National Health Laboratory Service (NHLS) and Stellenbosch University, Cape Town, South Africa
| | - Tandi E Matsha
- Department of Biomedical sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, South Africa
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Gerrits AJ, Frelinger AL, Michelson AD. Whole Blood Analysis of Leukocyte-Platelet Aggregates. CURRENT PROTOCOLS IN CYTOMETRY 2016; 78:6.15.1-6.15.10. [PMID: 27723089 DOI: 10.1002/cpcy.8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In inflammatory and thrombotic syndromes, platelets aggregate with circulating leukocytes, especially monocytes and neutrophils. This leukocyte-platelet aggregate formation is initiated primarily through platelet surface expression of P-selectin (CD62P), following activation-dependent degranulation of α-granules, binding to its constitutively expressed counter-receptor, P-selectin glycoprotein ligand 1 (PSGL-1), on leukocytes. Monocyte-platelet aggregates are a more sensitive marker of platelet activation than platelet surface P-selectin. Detection of leukocyte-platelet aggregates is relatively simple by whole-blood flow cytometry. Light scatter and at least one leukocyte-specific antibody are used to gate the desired population, and the presence of associated platelets is detected by immunostaining for abundant platelet-specific markers. © 2016 by John Wiley & Sons, Inc.
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Affiliation(s)
- Anja J Gerrits
- Center for Platelet Research Studies, Division of Hematology/Oncology, Boston Children's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Andrew L Frelinger
- Center for Platelet Research Studies, Division of Hematology/Oncology, Boston Children's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Alan D Michelson
- Center for Platelet Research Studies, Division of Hematology/Oncology, Boston Children's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial. Can J Anaesth 2016; 63:1223-32. [PMID: 27470233 DOI: 10.1007/s12630-016-0704-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/13/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE Postoperative cognitive dysfunction (POCD) occurs frequently after cardiac surgery. The pathophysiology of POCD remains elusive, but previous work showed that intravenous lidocaine may be protective against POCD, possibly by modulating cerebral inflammation. We hypothesized that intravenous lidocaine would attenuate the cerebral inflammatory response to cardiopulmonary bypass (CPB) by reducing the transcerebral activation gradients of platelets, leukocytes, and/or platelet-leukocyte conjugates. METHODS We studied 202 patients undergoing cardiac surgery with CPB in this prospective randomized double-blinded placebo-controlled trial. Subjects were randomized to receive either intravenous lidocaine (bolus + 48-hr infusion) or placebo (identical infusion volume and duration). Paired jugular venous and radial arterial blood samples were drawn at several time points and analyzed by fluorescence-activated cell sorting to identify activated platelets and platelet-leukocyte conjugates. Transcerebral activation gradients were calculated by subtracting arterial values from venous values and were compared between groups using repeated measures regression models with covariate adjustment for age, sex, surgery type, and CPB duration. RESULTS Beginning after aortic cross-clamp release and peaking ten minutes after the termination of CPB, the mean (SD) transcerebral activation gradient of platelet-monocyte conjugates decreased in lidocaine-treated vs placebo-treated patients [-1.84 (11.47) mean linear fluorescence intensity (MLFI) vs 1.46 (13.88) MLFI, respectively; mean difference, -4.08 MLFI; 95% confidence interval, -7.86 to -0.29; P = 0.03). No difference was seen at any time point for activated platelets or for platelet-neutrophil conjugates. CONCLUSION While lidocaine did not affect the systemic or transcerebral activation of platelets or leukocytes, we did observe a reduction in the transcerebral activation of platelet-monocyte conjugates after aortic cross-clamp release. This may be a manifestation of reduced cerebral inflammation during cardiopulmonary bypass in response to treatment with lidocaine. This trial was registered at ClinicalTrials.gov (NCT00938964).
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29
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Blatt AZ, Saggu G, Kulkarni KV, Cortes C, Thurman JM, Ricklin D, Lambris JD, Valenzuela JG, Ferreira VP. Properdin-Mediated C5a Production Enhances Stable Binding of Platelets to Granulocytes in Human Whole Blood. THE JOURNAL OF IMMUNOLOGY 2016; 196:4671-4680. [PMID: 27183616 DOI: 10.4049/jimmunol.1600040] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/28/2016] [Indexed: 12/11/2022]
Abstract
Enhanced levels of platelet/granulocyte aggregates (PGAs) are found in patients suffering from many different inflammatory vascular diseases, and their formation in animal models of vascular disease is associated with increased thromboinflammation and worsened outcomes. The complement system, a part of the innate immune system, influences PGA formation, but the mechanisms for its effects are unknown. In this study, we have defined complement-mediated mechanisms that enhance PGA formation in human whole blood stimulated with thrombin receptor-activating peptide (TRAP) using ex vivo flow cytometry assays. We demonstrate that physiological properdin, a positive regulator of complement alternative pathway activity, increases PGA formation when added to TRAP-stimulated blood. All physiological properdin forms increase PGA formation, but properdin tetramers are the most efficient at increasing complement activity and PGA formation. Inhibition of endogenous properdin, either circulating in the blood or produced locally by leukocytes, impairs TRAP-mediated PGA formation to the same level as specific inhibition of either the alternative or classical pathway. Additionally, blocking the interaction of C5a with its cellular receptor prevents properdin-mediated increases in PGA formation. Adding either properdin tetramers or C5a to whole blood increases CD11b expression on granulocytes, and this increase is prevented by blockade of the C5a-C5a receptor axis. Finally, we demonstrate that the effects of properdin on PGA formation are tightly regulated by Factor H. Cumulatively, our data indicate that properdin enhances PGA formation via increased production of C5a, and that inhibition of properdin function has therapeutic potential to limit thromboinflammation in diseases characterized by increased PGA formation.
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Affiliation(s)
- Adam Z Blatt
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Gurpanna Saggu
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Koustubh V Kulkarni
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Claudio Cortes
- Department of Biomedical Sciences, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Joshua M Thurman
- Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Daniel Ricklin
- Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John D Lambris
- Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jesus G Valenzuela
- Vector Molecular Biology Section, LMVR, National Institute of Allergy and Infectious Diseases, NIH, Rockville, Maryland
| | - Viviana P Ferreira
- Department of Medical Microbiology and Immunology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
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Takeda Y, Marumo M, Nara H, Feng ZG, Asao H, Wakabayashi I. Selective induction of anti-inflammatory monocyte-platelet aggregates in a model of pulsatile blood flow at low shear rates. Platelets 2016; 27:583-92. [PMID: 27078265 DOI: 10.3109/09537104.2016.1153616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In patients with cardiovascular abnormalities or immunological disorders, an increased number of circulating leukocyte-platelet aggregates is observed. Leukocyte-platelet aggregates play an essential role in linking the hemostatic and immune systems. High shear stress and pro-coagulant and pro-inflammatory stimulants are known to activate platelets and promote the formation of aggregates. Pulsatile blood flow under low shear stress can also induce platelet activation in comparatively mild conditions. However, the effect of such events on leukocyte-platelet aggregates has not yet been investigated. To determine whether low shear stress affects the formation of aggregates, we established a simple "inverting rotation" method of inducing periodic changes in the direction of blood flow in combination with low shear stress. We demonstrated that after the inverting rotation treatment for 10-20 min more than 70% of monocytes selectively aggregated with platelets. The formation of monocyte-platelet complexes was inhibited by an anti-CD162 (PSGL-1) monoclonal antibody or a Ca(2+) chelator. The phagocytic activity of monocytes was augmented by inverting rotation, whereas phagocytosis mediated by granulocytes remained unaffected. Interestingly, the formation of monocyte-platelet complexes suppressed the production of pro-inflammatory cytokines such as interleukin (IL)-1β. At the same time, monocyte-platelet complexes augmented the expression of the anti-inflammatory cytokine IL-10. Our results suggest that platelet-bound monocytes show an anti-inflammatory phenotype under low shear stress conditions. Thus, our method provided new insights into the mechanisms of monocyte-platelet aggregate formation and regulation.
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Affiliation(s)
- Yuji Takeda
- a Department of Environmental and Preventive Medicine , Hyogo College of Medicine , Nishinomiya , Japan.,b Department of Immunology, Faculty of Medicine , Yamagata University , Yamagata , Japan
| | - Mikio Marumo
- a Department of Environmental and Preventive Medicine , Hyogo College of Medicine , Nishinomiya , Japan
| | - Hidetoshi Nara
- b Department of Immunology, Faculty of Medicine , Yamagata University , Yamagata , Japan
| | - Zhong-Gang Feng
- c Department of Bio-Systems Engineering , Graduate School of Science and Engineering, Yamagata University , Yamagata , Japan
| | - Hironobu Asao
- b Department of Immunology, Faculty of Medicine , Yamagata University , Yamagata , Japan
| | - Ichiro Wakabayashi
- a Department of Environmental and Preventive Medicine , Hyogo College of Medicine , Nishinomiya , Japan
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Biadgo B, Melku M, Abebe SM, Abebe M. Hematological indices and their correlation with fasting blood glucose level and anthropometric measurements in type 2 diabetes mellitus patients in Gondar, Northwest Ethiopia. Diabetes Metab Syndr Obes 2016; 9:91-9. [PMID: 27042134 PMCID: PMC4801204 DOI: 10.2147/dmso.s97563] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Diabetes mellitus is (DM) a global public health problem and a complex disease characterized by chronic hyperglycemia that leads to long-term macrovascular and microvascular complications. Recent studies have reported the role of hematological indices in contributing to the vascular injury in diabetic patients. Thus, the aim of this study was to determine hematological indices and their correlation with fasting blood glucose level and anthropometric measurement in type 2 DM patients in comparison with healthy controls. METHODS A comparative cross-sectional study was conducted at the chronic illness clinic of Gondar University Hospital from February to April 2015. A total of 296 participants (148 cases and 148 healthy controls) were selected using systematic random sampling technique. Data were collected using a pretested structured questionnaire. Fasting blood glucose levels and hematological indices were determined by using Bio Systems A25 and Sysmex-KX 21N analyzers, respectively. Independent sample t-test, Mann-Whitney U-test, and correlation statistics were used. A P-value <0.05 was considered as statistically significant. RESULT There was significant difference in red blood cell distribution width (47.3±2.6 fL vs 45.2±3 fL) between diabetic patients and controls. Total white blood cells in 10(3)/µL (6.59±1.42 vs 5.56±1.38), absolute lymphocyte count in 10(3)/µL (2.60±0.70 vs 2.04±0.63), and absolute neutrophil count in 10(3)/µL (3.57±1.46 vs 3.11±1.04) increased significantly in diabetic patients compared with controls, respectively. Among platelet indices, mean platelet volume (10.4±1.1 fL vs 9.9±1.1 fL) and platelet distribution width (14.5±2.1 fL vs 13.4 ±2.1 fL) were found to be significantly increased in the diabetic patients (P<0.05). Anthropometric measurements significantly correlated with white blood cell and platelet indices. CONCLUSION The study showed statistically significant difference in some hematological parameters of diabetic patients compared to controls. Thus, hematological indices could be useful indicators of vascular complication and glycemic control in type 2 DM patients.
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Affiliation(s)
- Belete Biadgo
- School of Biomedical and Laboratory Sciences, Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Melku
- School of Biomedical and Laboratory Sciences, Department of Hematology and Immunohematology, University of Gondar, Gondar, Ethiopia
| | - Solomon Mekonnen Abebe
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Abebe
- School of Biomedical and Laboratory Sciences, Department of Clinical Chemistry, University of Gondar, Gondar, Ethiopia
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Ed Rainger G, Chimen M, Harrison MJ, Yates CM, Harrison P, Watson SP, Lordkipanidzé M, Nash GB. The role of platelets in the recruitment of leukocytes during vascular disease. Platelets 2015. [PMID: 26196409 PMCID: PMC4673595 DOI: 10.3109/09537104.2015.1064881] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Besides their role in the formation of thrombus during haemostasis, it is becoming clear that platelets contribute to a number of other processes within the vasculature. Indeed, the integrated function of the thrombotic and inflammatory systems, which results in platelet-mediated recruitment of leukocytes, is now considered to be of great importance in the propagation, progression and pathogenesis of atherosclerotic disease of the arteries. There are three scenarios by which platelets can interact with leukocytes: (1) during haemostasis, when platelets adhere to and are activated on sub-endothelial matrix proteins exposed by vascular damage and then recruit leukocytes to a growing thrombus. (2) Platelets adhere to and are activated on stimulated endothelial cells and then bridge blood borne leukocytes to the vessel wall and. (3) Adhesion between platelets and leukocytes occurs in the blood leading to formation of heterotypic aggregates prior to contact with endothelial cells. In the following review we will not discuss leukocyte recruitment during haemostasis, as this represents a physiological response to tissue trauma that can progress, at least in its early stages, in the absence of inflammation. Rather we will deal with scenarios 2 and 3, as these pathways of platelet–leukocyte interactions are important during inflammation and in chronic inflammatory diseases such as atherosclerosis. Indeed, these interactions mean that leukocytes possess means of adhesion to the vessel wall under conditions that may not normally be permissive of leukocyte–endothelial cell adhesion, meaning that the disease process may be able to bypass the regulatory pathways which would ordinarily moderate the inflammatory response.
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Affiliation(s)
- G Ed Rainger
- Centre for Cardiovascular Sciences, Institute for Biomedical Research, The Medical School, The University of Birmingham , Birmingham , UK and
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Flierl U, Bauersachs J, Schäfer A. Modulation of platelet and monocyte function by the chemokine fractalkine (CX3 CL1) in cardiovascular disease. Eur J Clin Invest 2015; 45:624-33. [PMID: 25832902 DOI: 10.1111/eci.12443] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 03/27/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND The chemokine fractalkine, CX3CL1, bears unique features within the chemokine family: it exists in a membrane bound form acting as an adhesion molecule and surface receptor; however, when cleaved by ADAM 10, it functions as a soluble chemokine. Fractalkine and its chemokine receptor CX3CR1 are known to have multiple roles in diverse human diseases, for example inflammatory diseases, rheumatoid arthritis, renal diseases and atherosclerosis. MATERIALS AND METHODS This review is based on the material obtained via PubMed up to November 2014. The key search terms used were 'fractalkine', 'CX3CL1', 'CX3CR1', 'cardiovascular disease', 'platelets', 'monocytes' and 'platelet-monocyte complexes'. RESULTS Atherosclerosis is recognized as a highly inflammatory disease, and it has become increasingly evident that the immune system plays an important role in atherogenesis and atheroprogression. Two blood cell populations are crucially involved in the early development of atherosclerotic lesions: monocytes and platelets. They are detected at vascular sites of endothelial dysfunction and are involved in inflammatory immune responses. These cells directly interact with each other, forming platelet-monocyte complexes that are increased in cardiovascular diseases. During the development of atherosclerosis, fractalkine mediates leukocyte recruitment to the inflamed endothelium, which promotes early formation of lesions. This process only effectively works in the presence of activated platelets. It has been suggested that fractalkine and its receptor contribute to platelet-monocyte aggregate formation underlining the two important impacts of this chemokine for platelets as well as monocytes. CONCLUSION Interesting data hint at a role of fractalkine for platelet activation, adhesion and subsequent monocyte recruitment to activated endothelial cells in cardiovascular diseases. However, the exact mechanisms remain to become unravelled.
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Affiliation(s)
- Ulrike Flierl
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Andreas Schäfer
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
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Schmitt C, Abt M, Ciorciaro C, Kling D, Jamois C, Schick E, Solier C, Benghozi R, Gaudreault J. First-in-Man Study With Inclacumab, a Human Monoclonal Antibody Against P-selectin. J Cardiovasc Pharmacol 2015; 65:611-9. [PMID: 25714598 PMCID: PMC4461388 DOI: 10.1097/fjc.0000000000000233] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 01/20/2015] [Indexed: 11/25/2022]
Abstract
Inclacumab, a novel monoclonal antibody against P-selectin in development for the treatment and prevention of atherosclerotic cardiovascular diseases, was administered in an ascending single-dose study as intravenous infusion to evaluate safety, pharmacokinetics, and pharmacodynamics. Fifty-six healthy subjects were enrolled in this randomized, double-blind placebo-controlled study. Each dose level (0.03-20 mg/kg) was investigated in separate groups of 8 subjects (6 on inclacumab, 2 on placebo). Platelet-leukocyte aggregates, free/total soluble P-selectin concentration ratio, drug concentrations, bleeding time, platelet aggregation, antibody formation, and routine laboratory parameters were measured frequently until 32 weeks. Pharmacokinetic profiles were indicative of target-mediated drug disposition. Platelet-leukocyte aggregate inhibition and soluble P-selectin occupancy showed dose dependency and were strongly correlated to inclacumab plasma concentrations, with IC50 of 740 and 4600 ng/mL, respectively. Inclacumab was well tolerated by the majority of subjects and did neither affect bleeding time nor platelet aggregation. These findings allowed the investigation of the potential beneficial therapeutic use of inclacumab in patient study.
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Affiliation(s)
| | - Markus Abt
- F. Hoffmann-La Roche AG, Basel, Switzerland; and
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Shiu HT, Goss B, Lutton C, Crawford R, Xiao Y. Formation of blood clot on biomaterial implants influences bone healing. TISSUE ENGINEERING PART B-REVIEWS 2014; 20:697-712. [PMID: 24906469 DOI: 10.1089/ten.teb.2013.0709] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The first step in bone healing is forming a blood clot at injured bones. During bone implantation, biomaterials unavoidably come into direct contact with blood, leading to a blood clot formation on its surface prior to bone regeneration. Despite both situations being similar in forming a blood clot at the defect site, most research in bone tissue engineering virtually ignores the important role of a blood clot in supporting healing. Dental implantology has long demonstrated that the fibrin structure and cellular content of a peri-implant clot can greatly affect osteoconduction and de novo bone formation on implant surfaces. This article reviews the formation of a blood clot during bone healing in relation to the use of platelet-rich plasma (PRP) gels. It is implicated that PRP gels are dramatically altered from a normal clot in healing, resulting in conflicting effect on bone regeneration. These results indicate that the effect of clots on bone regeneration depends on how the clots are formed. Factors that influence blood clot structure and properties in relation to bone healing are also highlighted. Such knowledge is essential for developing strategies to optimally control blood clot formation, which ultimately alter the healing microenvironment of bone. Of particular interest are modification of surface chemistry of biomaterials, which displays functional groups at varied composition for the purpose of tailoring blood coagulation activation, resultant clot fibrin architecture, rigidity, susceptibility to lysis, and growth factor release. This opens new scope of in situ blood clot modification as a promising approach in accelerating and controlling bone regeneration.
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Affiliation(s)
- Hoi Ting Shiu
- 1 Science and Engineering Faculty, Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane, Australia
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Singh MV, Davidson DC, Jackson JW, Singh VB, Silva J, Ramirez SH, Maggirwar SB. Characterization of platelet-monocyte complexes in HIV-1-infected individuals: possible role in HIV-associated neuroinflammation. THE JOURNAL OF IMMUNOLOGY 2014; 192:4674-84. [PMID: 24729609 DOI: 10.4049/jimmunol.1302318] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
HIV-1-associated neuroinflammation persists even with effective combined antiretroviral therapy, and it is associated with the presence of activated monocytes/macrophages within the CNS. To infiltrate the CNS, monocytes transmigrate across the selectively permeable blood-brain barrier, which is compromised during HIV-1 infection. Interestingly, platelet-derived excess soluble CD40 ligand found in the plasma and cerebrospinal fluid of HIV-1-infected individuals with cognitive impairment has previously been implicated in increased blood-brain barrier permeability. In this study we show that soluble CD40 ligand also promotes the formation of complexes between inflammatory monocytes and activated platelets (PMCs), which are detected by flow cytometry as monocytes that express excess of CD61, a platelet marker, and that these complexes are increased in individuals with HIV-1 infection. PMCs exhibit an enhanced ability to adhere to human brain microvascular endothelial cells as compared with monocytes alone, and they migrate across the transendothelial barrier. These complexes can be found marginalized in the lumen of postcapillary venules in postmortem brain tissue derived from cases of HIV-1-associated encephalitis. The extravasation of monocytes across the brain endothelium may exacerbate neuroinflammation, indicating that enhancing this event via platelet interaction may be a contributing factor in the development of cognitive impairment. Thus, dampening platelet activation, and in turn PMC formation, with antiplatelet agents may prove beneficial in developing adjunctive therapies for use in combination with combined antiretroviral therapy in an effort to reduce HIV-1-associated neurologic deficit.
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Affiliation(s)
- Meera V Singh
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY 14642
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Pharmacological control of platelet-leukocyte interactions by the human anti-P-selectin antibody inclacumab--preclinical and clinical studies. Thromb Res 2013; 131:401-10. [PMID: 23522853 DOI: 10.1016/j.thromres.2013.02.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 02/01/2013] [Accepted: 02/28/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Elevated levels of platelet-leukocyte aggregates (PLAs) have been reported in several cardiovascular diseases and suggested to contribute to disease pathology. Our aim was to characterize the effects of inclacumab, a novel human anti-P-selectin antibody, on the interactions between leukocytes and platelets in preclinical and clinical studies. EXPERIMENTAL APPROACHES Dual-label flow cytometry was used to detect the effect of inclacumab on agonist-induced platelet-leukocyte/platelet-monocyte aggregates in cynomolgus monkeys and humans, following ex vivo and in vivo administration. Platelet-dependent leukocyte activation and leukocyte adhesion to a platelet monolayer were also investigated after ex vivo administration of inclacumab to human blood. RESULTS Treatment of cynomolgus monkeys with inclacumab profoundly inhibited thrombin receptor-activating peptide (TRAP) or adenosine diphosphate (ADP)-induced PLAs with an IC50 (<2 μg/mL) similar to the in vitro spiking experiments. Maximal inhibition of PLAs persisted for ≥28 days following single dose of inclacumab. In human blood, inclacumab was about 2-fold more potent in inhibiting TRAP-induced PLAs (IC50: 0.7 μg/mL) compared to monkeys. PLA formation was suppressed independently of the inducing platelet agonist. Inclacumab also inhibited the activation of the leukocyte integrin Mac-1 and leukocyte adhesion to a platelet monolayer under flow conditions. In clinical studies, inclacumab inhibited TRAP-induced PLA formation in a dose-dependent manner following single and multiple dose administration to healthy volunteers. It also reduced elevated circulating PLA levels in patients with peripheral arterial disease. CONCLUSION By inhibiting platelet-leukocyte interactions, demonstrated in multiple preclinical and clinical studies, inclacumab may provide an effective treatment for cardiovascular diseases.
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Schwarzmaier SM, Zimmermann R, McGarry NB, Trabold R, Kim SW, Plesnila N. In vivo temporal and spatial profile of leukocyte adhesion and migration after experimental traumatic brain injury in mice. J Neuroinflammation 2013; 10:32. [PMID: 23448240 PMCID: PMC3610295 DOI: 10.1186/1742-2094-10-32] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 02/05/2013] [Indexed: 01/18/2023] Open
Abstract
Background Leukocytes are believed to be involved in delayed cell death following traumatic brain injury (TBI). However, data demonstrating that blood-borne inflammatory cells are present in the injured brain prior to the onset of secondary brain damage have been inconclusive. We therefore investigated both the interaction between leukocytes and the cerebrovascular endothelium using in vivo imaging and the accumulation of leukocytes in the penumbra following experimentally induced TBI. Methods Experimental TBI was induced in C57/Bl6 mice (n = 42) using the controlled cortical impact (CCI) injury model, and leukocyte-endothelium interactions (LEI) were quantified using both intravital fluorescence microscopy (IVM) of superficial vessels and 2-photon microscopy of cortical vessels for up to 14 h post-CCI. In a separate experimental group, leukocyte accumulation and secondary lesion expansion were analyzed in mice that were sacrificed 15 min, 2, 6, 12, 24, or 48 h after CCI (n = 48). Finally, leukocyte adhesion was blocked with anti-CD18 antibodies, and the effects on LEI and secondary lesion expansion were determined 16 (n = 12) and 24 h (n = 21), respectively, following TBI. Results One hour after TBI leukocytes and leukocyte-platelet aggregates started to roll on the endothelium of pial venules, whereas no significant LEI were observed in pial arterioles or in sham-operated mice. With a delay of >4 h, leukocytes and aggregates did also firmly adhere to the venular endothelium. In deep cortical vessels (250 μm) LEIs were much less pronounced. Transmigration of leukocytes into the brain parenchyma only became significant after the tissue became necrotic. Treatment with anti-CD18 antibodies reduced adhesion by 65%; however, this treatment had no effect on secondary lesion expansion. Conclusions LEI occurred primarily in pial venules, whereas little or no LEI occurred in arterioles or deep cortical vessels. Inhibiting LEI did not affect secondary lesion expansion. Importantly, the majority of migrating leukocytes entered the injured brain parenchyma only after the tissue became necrotic. Our results therefore suggest that neither intravascular leukocyte adhesion nor the migration of leukocytes into cerebral tissue play a significant role in the development of secondary lesion expansion following TBI.
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Affiliation(s)
- Susanne M Schwarzmaier
- Institute for Surgical Research in the Walter-Brendel-Centre of Experimental Medicine, University of Munich Medical Center, Marchioninistr, 15, 81377 Munich, Germany
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Nagasawa A, Matsuno K, Tamura S, Hayasaka K, Shimizu C, Moriyama T. The basis examination of leukocyte-platelet aggregates with CD45 gating as a novel platelet activation marker. Int J Lab Hematol 2013; 35:534-41. [DOI: 10.1111/ijlh.12051] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 11/28/2012] [Indexed: 11/30/2022]
Affiliation(s)
- A. Nagasawa
- Graduate School of Health Sciences; Hokkaido University; Sapporo Hokkaido Japan
| | - K. Matsuno
- Division of Laboratory and Transfusion Medicine; Hokkaido University Hospital; Sapporo Japan
| | - S. Tamura
- Graduate School of Health Sciences; Hokkaido University; Sapporo Hokkaido Japan
- Research Fellow of the Japan Society for the Promotion of Science; Tokyo Japan
| | - K. Hayasaka
- Division of Laboratory and Transfusion Medicine; Hokkaido University Hospital; Sapporo Japan
| | - C. Shimizu
- Division of Laboratory and Transfusion Medicine; Hokkaido University Hospital; Sapporo Japan
| | - T. Moriyama
- Medical Laboratory Science; Faculty of Health Sciences; Hokkaido University; Sapporo Japan
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Gerotziafas GT, Zarifis J, Bandi A, Mossialos L, Galea V, Tsinopoulos G, Chaari M, Baccouche H, Sassi M, Elalamy I. Description of response to aspirin and clopidogrel in outpatients with coronary artery disease using multiple electrode impedance aggregometry. Clin Appl Thromb Hemost 2012; 18:356-63. [PMID: 22311629 DOI: 10.1177/1076029611429122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Identification of outpatients with high platelet reactivity (HPR) on antiplatelet treatment is an unmet need. The present study was conducted in healthy individuals (n = 50) and in outpatients with coronary artery disease (CAD) at a distance from the acute ischemic episode (aspirin group, n = 71; aspirin/clopidogrel group, n = 106). We studied the feasibility and the precision of whole blood multiple electrode aggregometry (MEA) after triggering platelet aggregation by arachidonic acid or adenosine diphospate (ADP). The MEA can be performed on whole blood within 2 hours after sample venipuncture. The threshold for the diagnosis of HPR is situated at 55 and 50 U for the arachidonic acid and ADP test, respectively. Frequency of HPR was 7% and 20% in aspirin and aspirin/clopidogrel groups, respectively. In 3.8% of patients in aspirin/clopidogrel group, combined HPR on aspirin and clopidogrel was found. In outpatients with CAD, use of MEA is feasible for the diagnosis of HPR.
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Affiliation(s)
- Grigoris T Gerotziafas
- Service d'Hématologie Biologique, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France.
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Increased atherothrombotic burden in patients with diabetes mellitus and acute coronary syndrome: a review of antiplatelet therapy. Cardiol Res Pract 2012; 2012:909154. [PMID: 22347666 PMCID: PMC3278919 DOI: 10.1155/2012/909154] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 10/23/2011] [Indexed: 02/07/2023] Open
Abstract
Patients with diabetes mellitus presenting with acute coronary syndrome have a higher risk of cardiovascular complications and recurrent ischemic events when compared to nondiabetic counterparts. Different mechanisms including endothelial dysfunction, platelet hyperactivity, and abnormalities in coagulation and fibrinolysis have been implicated for this increased atherothrombotic risk. Platelets play an important role in atherogenesis and its thrombotic complications in diabetic patients with acute coronary syndrome. Hence, potent platelet inhibition is of paramount importance in order to optimise outcomes of diabetic patients with acute coronary syndrome. The aim of this paper is to provide an overview of the increased thrombotic burden in diabetes and acute coronary syndrome, the underlying pathophysiology focussing on endothelial and platelet abnormalities, currently available antiplatelet therapies, their benefits and limitations in diabetic patients, and to describe potential future therapeutic strategies to overcome these limitations.
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Using ASEPSIS and National Nosocomial Infections Surveillance Risk Index in the Assessment of Surgical Site Infections After Cardiac Surgery Among Jordanian Patients. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2011. [DOI: 10.1097/ipc.0b013e3181f744cf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Maeda NY, Carvalho JH, Otake AH, Mesquita SM, Bydlowski SP, Lopes AA. Platelet protease-activated receptor 1 and membrane expression of P-selectin in pulmonary arterial hypertension. Thromb Res 2010; 125:38-43. [DOI: 10.1016/j.thromres.2009.04.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Revised: 04/16/2009] [Accepted: 04/22/2009] [Indexed: 10/20/2022]
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Saadoun D, Elalamy I, Ghillani-Dalbin P, Sene D, Delluc A, Cacoub P. Cryofibrinogenemia: new insights into clinical and pathogenic features. Am J Med 2009; 122:1128-35. [PMID: 19958891 DOI: 10.1016/j.amjmed.2009.03.040] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2008] [Revised: 02/21/2009] [Accepted: 03/30/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Cryofibrinogenemia is an under-recognized cryoprotein that can be life-threatening when untreated. Our aim was to describe the prevalence and clinical findings of patients with cryofibrinogenemia and to clarify the mechanisms involved. METHODS Between 1996 and 2006, 2312 patients were tested for cryofibrinogenemia in a single university hospital. A total of 515 patients had positive test results, of whom 455 (88.3%) had an associated cryoglobulin. RESULTS Sixty patients (11.7%) with persistent cryofibrinogenemia and without cryoglobulin were included in the study. Main clinical manifestations related to cryofibrinogenemia included purpura (46.6%), skin necrosis (36.6%), and arthralgia (31.6%) with cold sensitivity in 40%. Overall thrombotic events occurred in up to 40% of cases. Cryofibrinogen plasma concentration was 2 times greater in patients with thrombotic events (P=.012). Complications included gangrene (5%), septicemia (5%), and leg amputation (3.3%). Complete remission of cryofibrinogenemia was achieved in 78% of patients receiving antithrombotic agents, steroids, or immunosuppressants, whereas 41.6% of patients experienced a relapse after a median time of 9 months (range 7-42 months). After a mean follow-up of 85 months, 3 patients died of sepsis (n=2) and cardiovascular disease (n=1). Fibrinolysis status analyzed in a patient with cryofibrinogenemia showed an increase in fibrinolysis inhibitor levels, plasminogen activator inhibitor-1, alpha-2 macroglobulin, and euglobulin lysis time, which normalized after fibrinolytic therapy. CONCLUSION Essential cryofibrinogenemia represents 12% of all the cryoproteins at Pitie-Salpêtriere Hospital. Thrombotic events are frequent and could be associated with the amount of plasma cryofibrinogen. Defects in the fibrinolysis process might lead to cryofibrinogen accumulation and clotting in small and medium arteries.
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Affiliation(s)
- David Saadoun
- Pierre et Marie Curie-Paris 6 University, Department of Internal Medicine, Hôpital Pitié-Salpétrière, Paris, France
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Ståhl AL, Sartz L, Nelsson A, Békássy ZD, Karpman D. Shiga toxin and lipopolysaccharide induce platelet-leukocyte aggregates and tissue factor release, a thrombotic mechanism in hemolytic uremic syndrome. PLoS One 2009; 4:e6990. [PMID: 19750223 PMCID: PMC2735777 DOI: 10.1371/journal.pone.0006990] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Accepted: 08/03/2009] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Aggregates formed between leukocytes and platelets in the circulation lead to release of tissue factor (TF)-bearing microparticles contributing to a prothrombotic state. As enterohemorrhagic Escherichia coli (EHEC) may cause hemolytic uremic syndrome (HUS), in which microthrombi cause tissue damage, this study investigated whether the interaction between blood cells and EHEC virulence factors Shiga toxin (Stx) and lipopolysaccharide (LPS) led to release of TF. METHODOLOGY/PRINCIPAL FINDINGS The interaction between Stx or LPS and blood cells induced platelet-leukocyte aggregate formation and tissue factor (TF) release, as detected by flow cytometry in whole blood. O157LPS was more potent than other LPS serotypes. Aggregates formed mainly between monocytes and platelets and less so between neutrophils and platelets. Stimulated blood cells in complex expressed activation markers, and microparticles were released. Microparticles originated mainly from platelets and monocytes and expressed TF. TF-expressing microparticles, and functional TF in plasma, increased when blood cells were simultaneously exposed to the EHEC virulence factors and high shear stress. Stx and LPS in combination had a more pronounced effect on platelet-monocyte aggregate formation, and TF expression on these aggregates, than each virulence factor alone. Whole blood and plasma from HUS patients (n = 4) were analyzed. All patients had an increase in leukocyte-platelet aggregates, mainly between monocytes and platelets, on which TF was expressed during the acute phase of disease. Patients also exhibited an increase in microparticles, mainly originating from platelets and monocytes, bearing surface-bound TF, and functional TF was detected in their plasma. Blood cell aggregates, microparticles, and TF decreased upon recovery. CONCLUSIONS/SIGNIFICANCE By triggering TF release in the circulation, Stx and LPS can induce a prothrombotic state contributing to the pathogenesis of HUS.
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Affiliation(s)
- Anne-lie Ståhl
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Lisa Sartz
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Anders Nelsson
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Zivile D. Békássy
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Diana Karpman
- Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden
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Ruef J, Kuehnl P, Meinertz T, Merten M. The complement factor properdin induces formation of platelet-leukocyte aggregates via leukocyte activation. Platelets 2008; 19:359-64. [PMID: 18791942 DOI: 10.1080/09537100802105040] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Both the complement system and platelet-leukocyte aggregates are involved in chronic and acute stages of atherosclerosis. Properdin, a positive regulator of the complement system, is secreted by leukocytes and endothelial cells. In the present study, the role of properdin in the formation of platelet-leukocyte aggregates was investigated. Incubation of human whole blood with properdin (25-200 microg/ml) resulted in a dose-dependent formation of platelet-leukocyte aggregates, with an increase of up to 2.2-fold compared to controls (p < 0.05), as analysed by flow cytometry. In addition, properdin significantly amplified ADP-induced aggregation of platelets with leukocytes by 53% (p < 0.05), while it had no effect on ADP-induced aggregation of platelets alone. Consistent with these results, properdin did not activate platelets as shown by the expression of activated GPIIb/IIIa (PAC-1 epitope) and P-selectin (CD62P) on the platelet surface. However, properdin significantly induced expression of CD11b (MAC-1) on leukocytes by 12-fold (p < 0.05) as a measure of leukocyte activation. In conclusion, the complement system component properdin induces the formation of platelet-leukocyte aggregates via leukocyte activation. The data establish a link between the complement system and platelet-leukocyte aggregates with potential significance in atherosclerotic vascular disease.
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Affiliation(s)
- Johannes Ruef
- Red Cross Hospital Cardiology Center, Frankfurt, Germany
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Chakroun T, Abdelkefi S, Bouslama M, Houissa B, Zaier M, Miled A, Kortas M, Yacoub S. [Platelet-leukocyte aggregates as a marker for platelet activation in platelet concentrates]. Transfus Clin Biol 2008; 15:148-53. [PMID: 18760949 DOI: 10.1016/j.tracli.2008.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Accepted: 07/02/2008] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Several in vitro laboratory tests to assess the quality control of platelet concentrates (PC) are available. Some of them have a good correlation with the platelet recovery index. To assess the quality control of standard PC prepared in our blood bank, we measured the blood gas and the degree of platelet activation. MATERIALS AND METHODS SPC were prepared by the PRP method. Fifty-five SPC (45 SPC at day one of storage and 20 SPC at day five of storage) were analysed. Blood gas (pH, PO(2), PCO(2) and bicarbonate concentration) in the SPC were measured by blood gas automate. Platelet activation profile were determined by measuring the percentage of platelet expressing the CD62p (% CD62) and the percentage of platelet-leukocyte aggregate (% PLA). RESULTS The pH values of all studied SPC were comprised between 7.0 and 7.6. SPC at day 1 of storage have a significantly higher pH than those at day 5 of storage (7.5+/-0.05 versus 7.3+/-0.14; p<0.001). The % CD62p were higher in SPC at day five compared to the SCP at day one without reaching a statistical significance (28.4+/-15% versus 24.3+/-9.7%, p=0.052). The percentage of PLA were higher in SPC at day one compared to SCP at day five although this difference is not statistically significant (22.2+/-7.5% versus 17.9+/-8.0%; p=0.23). CONCLUSION Preparation and storage procedure adopted in our centre did not significantly affect the quality SPC. Our study is the first to assess the PLA in PC. Studies assessing the PLA are warranted to appreciate the clinical impact of this parameter.
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Affiliation(s)
- T Chakroun
- Centre régional de transfusion sanguine, unité de recherche étude des fonctions plaquettaires (UR : 06SP05), hôpital Faraht-Hached, Sousse, Tunisie.
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Double vs single internal thoracic artery harvesting in diabetic patients: role in perioperative infection rate. J Cardiothorac Surg 2008; 3:35. [PMID: 18573201 PMCID: PMC2467417 DOI: 10.1186/1749-8090-3-35] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 06/23/2008] [Indexed: 01/18/2023] Open
Abstract
Background The aim of this prospective study is to evaluate the role in the onset of surgical site infections of bilateral internal thoracic arteries harvesting in patients with decompensated preoperative glycemia. Methods 81 consecutive patients with uncontrolled diabetes mellitus underwent elective CABG harvesting single or double internal thoracic arteries. Single left ITA was harvested in 41 patients (Group 1, 50.6%), BITAs were harvested in 40 (Group 2, 49.4%). The major clinical end points analyzed in this study were infection rate, type of infection, duration of infection, infection relapse rate and total hospital length of stay. Results Five patients developed sternal SSI in the perioperative period, 2 in group 1 and 3 in group 2 without significant difference. All sternal SSIs were superficial with no sternal dehiscence. The development of infection from the time of surgery took 18.5 ± 2.1 and 7.3 ± 3.0 days for Groups 1 and 2 respectively. The infections were treated with wound irrigation and debridement, and with VAC therapy as well as with antibiotics. The VAC system was removed after a mean of 12.8 ± 5.1 days, when sterilization was achieved. The overall survival estimate at 1 year was 98.7%. Only BMI was a significant predictor of SSI using multivariate stepwise logistic regression analysis (Odds Ratio: 1.34; 95%Conficdence Interval: 1.02–1.83; p value: 0.04). In the model, the use of BITA was not an independent predictor of SSI. Conclusion CABG with bilateral pedicled ITAs grafting could be performed safely even in diabetics with poor preoperative glycaemic control.
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