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Krishnan A, Thomas S. Toward platelet transcriptomics in cancer diagnosis, prognosis and therapy. Br J Cancer 2022; 126:316-322. [PMID: 34811507 PMCID: PMC8810955 DOI: 10.1038/s41416-021-01627-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 10/26/2021] [Accepted: 11/02/2021] [Indexed: 12/29/2022] Open
Abstract
Widespread adoption of next-generation techniques such as RNA-sequencing (RNA-seq) has enabled research examining the transcriptome of anucleate blood platelets in health and disease, thus revealing a rich platelet transcriptomic signature that is reprogrammed in response to disease. Platelet signatures not only capture information from parent megakaryocytes and progenitor hematopoietic stem cells but also the bone marrow microenvironment, and underlying disease states. In cancer, the substantive body of research in patients with solid tumours has identified distinct signatures in 'tumour-educated platelets', reflecting influences of the tumour, stroma and vasculature on splicing, sequestration of tumour-derived RNAs, and potentially cytokine and microvesicle influences on megakaryocytes. More recently, platelet RNA expression has emerged as a highly sensitive approach to profiling chronic progressive haematologic malignancies, where the combination of large data cohorts and machine-learning algorithms enables precise feature selection and potential prognostication. Despite these advances, however, our ability to translate platelet transcriptomics toward clinical diagnostic and prognostic efforts remains limited. In this Perspective, we present a few actionable steps for our basic, translational and clinical research communities in advancing the utility of the platelet transcriptome as a highly sensitive biomarker in cancer and collectively enable efforts toward clinical translation and patient benefit.
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Affiliation(s)
- Anandi Krishnan
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
- Stanford Cancer Institute, Stanford University, Stanford, CA, USA.
| | - Sally Thomas
- Department of Oncology and Metabolism, University of Sheffield Medical School, Sheffield, UK
- Department of Haematology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
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Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome. J Stroke Cerebrovasc Dis 2021; 30:105800. [PMID: 33964545 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/20/2021] [Accepted: 03/28/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Many studies showed that platelet reactivity testing can predict ischemic events after carotid stenting or ischemic stroke. The aim of our study was to assess the role of early platelet function monitoring in predicting 90-days functional outcome, stent thrombosis and hemorrhagic transformation in patients with ischemic stroke treated with endovascular procedures requiring emergent extracranial stenting. MATERIALS AND METHODS We performed a retrospective study on consecutive patients with acute anterior circulation stroke admitted to our hospital between January 2015 and March 2020, in whom platelet reactivity testing was performed within 10 days from stenting. Patients were divided according to validated cutoffs in acetylsalicylic acid and Clopidogrel responders and not responders. Group comparison and regression analyses were performed to identify differences between groups and outcome predictors. RESULTS We included in the final analysis 54 patients. Acetylsalicylic acid resistance was an independent predictor of poor 90 days outcome (OR for modified Rankin scale (mRS) ≤ 2: 0.10 95% CI: 0.02 - 0.69) whereas Clopidogrel resistance was an independent predictor of good outcome (OR for mRS ≤ 2: 7.09 95%CI: 1.33 - 37.72). Acetylsalicylic acid resistance was also associated with increased 90-days mortality (OR: 18.42; 95% CI: 1.67 - 203.14). CONCLUSION We found a significant association between resistance to acetylsalicylic acid and poor 90-days functional outcome and between resistance to Clopidogrel and good 90-days functional outcome. If confirmed, our results might improve pharmacological management after acute carotid stenting.
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Bélanger JC, Bandeira Ferreira FL, Welman M, Boulahya R, Tanguay JF, Y.F. So D, Lordkipanidzé M. Head-to-Head Comparison of Consensus-Recommended Platelet Function Tests to Assess P2Y 12 Inhibition-Insights for Multi-Center Trials. J Clin Med 2020; 9:E332. [PMID: 31991630 PMCID: PMC7073745 DOI: 10.3390/jcm9020332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/08/2020] [Accepted: 01/12/2020] [Indexed: 11/29/2022] Open
Abstract
The vasodilator-associated stimulated phosphoprotein (VASP) phosphorylation level is a highly specific method to assess P2Y12 receptor inhibition. Traditionally, VASP phosphorylation is analyzed by flow cytometry, which is laborious and restricted to specialized laboratories. Recently, a simple ELISA kit has been commercialized. The primary objective of this study was to compare the performance of VASP assessment by ELISA and flow cytometry in relation to functional platelet aggregation testing by Multiplate® whole-blood aggregometry. Blood from 24 healthy volunteers was incubated with increasing concentration of a P2Y12 receptor inhibitor (AR-C 66096). Platelet function testing was carried out simultaneously by Multiplate® aggregometry and by VASP assessment through ELISA and flow cytometry. As expected, increasing concentrations of the P2Y12 receptor inhibitor induced a proportional inhibition of platelet aggregation and P2Y12 receptor activation across the modalities. Platelet reactivity index values of both ELISA- and flow cytometry-based VASP assessment methods correlated strongly (r = 0.87, p < 0.0001) and showed minimal bias (1.05%). Correlation with Multiplate® was slightly higher for the flow cytometry-based VASP assay (r = 0.79, p < 0.0001) than for the ELISA-based assay (r = 0.69, p < 0.0001). Intraclass correlation (ICC) was moderate for all the assays tested (ICC between 0.62 and 0.84). However, categorization into low, optimal, or high platelet reactivity based on these assays was strongly concordant (κ between 0.86 and 0.92). In conclusion, the consensus-recommended assays with their standardized cut-offs should not be used interchangeably in multi-center clinical studies but, rather, they should be standardized throughout sites.
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Affiliation(s)
- Jean-Christophe Bélanger
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Faculty of Pharmacy, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Fabio Luiz Bandeira Ferreira
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Institut Armand-Frappier Santé et Biotechnologie-INRS, Laval, QC H7V 1B7, Canada
| | - Mélanie Welman
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
| | - Rahma Boulahya
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Faculty of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Jean-François Tanguay
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Faculty of Medicine, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Derek Y.F. So
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada;
| | - Marie Lordkipanidzé
- Montreal Heart Institute Research Center, Montréal, QC H1T 1C8, Canada; (J.-C.B.); (F.L.B.F.); (M.W.); (R.B.); (J.-F.T.)
- Faculty of Pharmacy, Université de Montréal, Montréal, QC H3C 3J7, Canada
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Zheng L, Yang C, Xiang L, Hao Z. Genotype-guided antiplatelet therapy compared with conventional therapy for patients with acute coronary syndromes: a systematic review and meta-analysis. Biomarkers 2019; 24:517-523. [PMID: 31215825 DOI: 10.1080/1354750x.2019.1634764] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Lukai Zheng
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Chunsong Yang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China Second Hospital, Sichuan University, Chengdu, China
| | - Lingbao Xiang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Zilong Hao
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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Lordkipanidzé M, Hvas AM, Harrison P. Clinical Tests of Platelet Function. Platelets 2019. [DOI: 10.1016/b978-0-12-813456-6.00033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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