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Song YD, Bai XM, Ma J. The association of systemic immune-inflammation index with lung function, risk of COPD and COPD severity: A population-based study. PLoS One 2024; 19:e0303286. [PMID: 38875233 PMCID: PMC11178193 DOI: 10.1371/journal.pone.0303286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 04/22/2024] [Indexed: 06/16/2024] Open
Abstract
PURPOSE The relationship between the levels of Systemic Immune-inflammation Index (SII) and chronic obstructive pulmonary disease (COPD), lung function, and COPD severity were not fully understood. We conducted this cross-sectional, population-based study to investigate the complex association between SII and COPD, lung function, and COPD severity among the US adults. METHODS Overall, 18,349 participants were included in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. The exposure variable was SII, calculated from platelet counts, neutrophil counts, and lymphocyte counts. Weighted univariable and multivariable logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were performed to assess the relationship between COPD, lung function, COPD severity and SII. Last, we used a propensity score matching (PSM) analysis to reduce selective bias and validate these relationships. RESULTS Approximately 1,094 (5.96%) of the participants were diagnosed as COPD. The multivariable-adjusted odds ratio (OR) (95% confidence interval, CI) for the Q2 group (Log-SII > 2.740) was 1.39 (1.16 to 1.68). Before and after matching, multivariable logistic regression models revealed that increased Log-SII levels (SII Logarithmic transformation) associated positively with the risk of COPD. The subgroup analysis showed no interaction between Log-SII and a variety of variables (P for interaction > 0.05). RCS showed a reversed L-shaped relationship between Log-SII with COPD (P for nonlinear = 0.001) in individuals. In addition, we observed negative significant correlations between forced expiratory volume in one second (FEV1) / forced vital capacity (FVC) %, FEV1/FVC% predicted and SII, and reversed U-shaped curve relationships between FEV1, FEV1% predicted and SII. High SII level is associated with severity of COPD, especially at Global Initiative on Obstructive Lung Disease (GOLD) 1 and GOLD 3. CONCLUSIONS In summary, the Log-SII level is associated with COPD risk, lung function, and COPD severity.
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Affiliation(s)
- Ying-da Song
- Department of Thoracic Surgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi Province, China
- Fifth Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi Province, People's Republic of China
| | - Xiao-Ming Bai
- Department of Thoracic Surgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi Province, China
| | - Jun Ma
- Department of Thoracic Surgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi Province, China
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Cui Y, Yi C, Zhang C, Yang C, Wang X, Chen W, Peng Y, Dai J. Risk factors for bloodstream infection among patients admitted to an intensive care unit of a tertiary hospital of Shanghai, China. Sci Rep 2024; 14:12765. [PMID: 38834645 DOI: 10.1038/s41598-024-63594-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/30/2024] [Indexed: 06/06/2024] Open
Abstract
Blood flow infections (BSIs) is common occurrences in intensive care units (ICUs) and are associated with poor prognosis. The study aims to identify risk factors and assess mortality among BSI patients admitted to the ICU at Shanghai Ruijin hospital north from January 2022 to June 2023. Additionally, it seeks to present the latest microbiological isolates and their antimicrobial susceptibility. Independent risk factors for BSI and mortality were determined using the multivariable logistic regression model. The study found that the latest incidence rate of BSI was 10.11%, the mortality rate was 35.21% and the mean age of patients with BSI was 74 years old. Klebsiella pneumoniae was the predominant bacterial isolate. Logistic multiple regression revealed that tracheotomy, tigecycline, gastrointestinal bleeding, shock, length of hospital stay, age and laboratory indicators (such as procalcitonine and hemoglobin) were independent risk factors for BSI. Given the elevated risk associated with use of tracheotomy and tigecycline, it underscores the importance of the importance of cautious application of tracheostomy and empirical antibiotic management strategies. Meanwhile, the independent risk factors of mortality included cardiovascular disease, length of hospital stay, mean platelet volume (MPV), uric acid levels and ventilator. BSI patients exhibited a significant decrease in platelet count, and MPV emerged as an independent factor of mortality among them. Therefore, continuous monitoring of platelet-related parameters may aid in promptly identifying high-risk patients and assessing prognosis. Moreover, monitoring changes in uric acid levels may serve as an additional tool for prognostic evaluation in BSI patients.
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Affiliation(s)
- Yingchao Cui
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin ER Road, Shanghai, 200025, China
| | - Changlin Yi
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin ER Road, Shanghai, 200025, China
| | - Chaomin Zhang
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin ER Road, Shanghai, 200025, China
| | - Chihui Yang
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin ER Road, Shanghai, 200025, China
| | - Xinyi Wang
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin ER Road, Shanghai, 200025, China
| | - Wenkai Chen
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin ER Road, Shanghai, 200025, China
| | - Yibing Peng
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin ER Road, Shanghai, 200025, China.
| | - Jing Dai
- Department of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197 Second Ruijin ER Road, Shanghai, 200025, China.
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Yang Y, Zhu J, Zhang M, Wang Y, Cheng F, Ma W, Li M. Systemic inflammation response index predicts the postoperative recurrence of chronic rhinosinusitis with nasal polyps: a retrospective study in the Chinese population. Eur Arch Otorhinolaryngol 2024; 281:207-217. [PMID: 37589753 DOI: 10.1007/s00405-023-08182-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE Endoscopic sinus surgery (ESS) is now frequently used to treat chronic sinusitis with nasal polyps (CRSwNP), but postoperative recurrence plagues many patients. We aimed to assess the value of the systemic inflammation response index (SIRI) and the systemic immune-inflammatory index (SII) for the prediction of postoperative recurrence in patients with CRSwNP. METHODS A total of 143 patients with CRSwNP and 76 age- and sex-matched healthy subjects were enrolled. Patients were divided into the recurrence group and the non-recurrence group according to the recurrence of CRSwNP. Univariate and multivariate analyses showed independent risk factors for the recurrence. A receiver operating characteristic curve analysis was conducted to assess the predictive accuracy of the variables and determine the optimal cut-off values. Finally, a survival analysis was conducted. RESULTS Univariate analysis revealed that age, sex, CRP, EOS, SIRI, SII, NLR, ELR, and Lund-Mackay CT scores were significant predictors of the recurrence of CRSwNP. Multivariate analysis confirmed that SIRI (OR = 1.310, p < 0.001) and Lund-Mackay CT scores (OR = 1.396, p < 0.001) were independent predictors. SIRI (AUC = 0.761, 95% CI: 0.685-0.836) had a certain value in predicting the recurrence of CRSwNP. CONCLUSION SIRI is a potential predictive marker of the postoperative recurrence of CRSwNP.
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Affiliation(s)
- Yuqing Yang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215000, Jiangsu, China
| | - Jing Zhu
- Center for Health Management, The First Affiliated Hospital, Soochow University, Suzhou, China
| | - Mengyu Zhang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215000, Jiangsu, China
| | - Yihong Wang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215000, Jiangsu, China
| | - Fuwei Cheng
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215000, Jiangsu, China
| | - Wenxia Ma
- Department of Quality Management, The First Affiliated Hospital, Soochow University, Suzhou, China
| | - Manyi Li
- Department of Otorhinolaryngology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215000, Jiangsu, China.
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De Vrij EL, Bouma HR, Henning RH, Cooper ST. Hibernation and hemostasis. Front Physiol 2023; 14:1207003. [PMID: 37435313 PMCID: PMC10331295 DOI: 10.3389/fphys.2023.1207003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Hibernating mammals have developed many physiological adaptations to accommodate their decreased metabolism, body temperature, heart rate and prolonged immobility without suffering organ injury. During hibernation, the animals must suppress blood clotting to survive prolonged periods of immobility and decreased blood flow that could otherwise lead to the formation of potentially lethal clots. Conversely, upon arousal hibernators must be able to quickly restore normal clotting activity to avoid bleeding. Studies in multiple species of hibernating mammals have shown reversible decreases in circulating platelets, cells involved in hemostasis, as well as in protein coagulation factors during torpor. Hibernator platelets themselves also have adaptations that allow them to survive in the cold, while those from non-hibernating mammals undergo lesions during cold exposure that lead to their rapid clearance from circulation when re-transfused. While platelets lack a nucleus with DNA, they contain RNA and other organelles including mitochondria, in which metabolic adaptations may play a role in hibernator's platelet resistance to cold induced lesions. Finally, the breakdown of clots, fibrinolysis, is accelerated during torpor. Collectively, these reversible physiological and metabolic adaptations allow hibernating mammals to survive low blood flow, low body temperature, and immobility without the formation of clots during torpor, yet have normal hemostasis when not hibernating. In this review we summarize blood clotting changes and the underlying mechanisms in multiple species of hibernating mammals. We also discuss possible medical applications to improve cold preservation of platelets and antithrombotic therapy.
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Affiliation(s)
- Edwin L. De Vrij
- Department of Plastic Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, Netherlands
| | - Hjalmar R. Bouma
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, Netherlands
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Robert H. Henning
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, Netherlands
| | - Scott T. Cooper
- Biology Department, University of Wisconsin-La Crosse, La Crosse, WI, United States
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Zheng Y, Wu J, Zhu Y, Wu C. Inorganic-based biomaterials for rapid hemostasis and wound healing. Chem Sci 2022; 14:29-53. [PMID: 36605747 PMCID: PMC9769395 DOI: 10.1039/d2sc04962g] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2022] Open
Abstract
The challenge for the treatment of severe traumas poses an urgent clinical need for the development of biomaterials to achieve rapid hemostasis and wound healing. In the past few decades, active inorganic components and their derived composites have become potential clinical products owing to their excellent performances in the process of hemorrhage control and tissue repair. In this review, we provide a current overview of the development of inorganic-based biomaterials used for hemostasis and wound healing. We highlight the methods and strategies for the design of inorganic-based biomaterials, including 3D printing, freeze-drying, electrospinning and vacuum filtration. Importantly, inorganic-based biomaterials for rapid hemostasis and wound healing are presented, and we divide them into several categories according to different chemistry and forms and further discuss their properties, therapeutic mechanisms and applications. Finally, the conclusions and future prospects are suggested for the development of novel inorganic-based biomaterials in the field of rapid hemostasis and wound healing.
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Affiliation(s)
- Yi Zheng
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences No. 1295 Dingxi Road Shanghai 200050 People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences No. 19(A) Yuquan Road Beijing 100049 People's Republic of China
| | - Jinfu Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences No. 1295 Dingxi Road Shanghai 200050 People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences No. 19(A) Yuquan Road Beijing 100049 People's Republic of China
| | - Yufang Zhu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences No. 1295 Dingxi Road Shanghai 200050 People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences No. 19(A) Yuquan Road Beijing 100049 People's Republic of China
| | - Chengtie Wu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences No. 1295 Dingxi Road Shanghai 200050 People's Republic of China
- Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences No. 19(A) Yuquan Road Beijing 100049 People's Republic of China
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6
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Memory-like response in platelet attenuates platelet hyperactivation in arterial thrombosis. Biochem Biophys Res Commun 2022; 612:154-161. [DOI: 10.1016/j.bbrc.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/03/2022] [Accepted: 04/06/2022] [Indexed: 11/18/2022]
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Panigrahi S, Ghosh SK, Ferrari B, Wyrick JM, Podrez EA, Weinberg A, Sieg SF. Human β-Defensin-3 is Associated With Platelet-Derived Extracellular Vesicles and is a Potential Contributor to Endothelial Dysfunction. Front Mol Biosci 2022; 9:824954. [PMID: 35355507 PMCID: PMC8959671 DOI: 10.3389/fmolb.2022.824954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
While platelets are the essential mediators of hemostasis, they are being increasingly recognized for their potential of contributing to host defenses. Here, using immunofluorescent microscopy, western blot, and ELISA, we found that human β-defensin 3 (hBD-3), an important antimicrobial peptide produced by epithelial cells, can be detected in human platelets and megakaryocytes. Flow cytometry and immuno-electron microscopy revealed hBD-3 on the surface of thrombin activated platelets. Moreover, hBD-3 was also found in platelet derived extracellular vesicles (p-EVs), isolated from platelet poor plasma and from platelet supernatants following thrombin stimulation. Incubation of platelets with hBD-3 peptide resulted in modest platelet activation and pre-incubation of platelets with synthetic hBD-3 prior to exposure to thrombin appeared to increase hBD-3 content in platelet lysates as well as in p-EVs, suggesting that hBD-3 can be initially taken up by platelets, perhaps via their open canalicular system. Interestingly, in vitro exposure of primary human endothelial cells to either hBD-3 peptide or purified p-EVs, caused significant endothelial dysfunction as documented by diminished levels of phosphorylated endothelial nitric oxide synthase (eNOS), Krüppel like factor-2 (KLF-2), and elevated relative expression of von Willebrand Factor (vWF). Pre-incubation of platelets with hBD-3 appeared to augment endothelial dysfunction caused by p-EVs. Overall, the current study provides evidence that hBD-3 enriched EVs can be released by activated platelets and may play a role in positive feedback of platelet activation as well as in endothelial dysfunction. Theoretically, these effects could contribute to both cellular recruitment to the endothelium creating a pro-thrombotic vascular microenvironment which serve as a bridge between innate immunity and hemostasis.
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Affiliation(s)
- Soumya Panigrahi
- Case Western Reserve School of Medicine, Division of Infectious Diseases and HIV Medicine, Cleveland, OH, United States
- *Correspondence: Soumya Panigrahi, ; Scott F. Sieg,
| | - Santosh K. Ghosh
- Department of Biological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Brian Ferrari
- Case Western Reserve School of Medicine, Division of Infectious Diseases and HIV Medicine, Cleveland, OH, United States
| | - Jonathan M. Wyrick
- Case Western Reserve School of Medicine, Division of Infectious Diseases and HIV Medicine, Cleveland, OH, United States
- Case Western Reserve University School of Medicine, Cleveland, OH, United States
| | - Eugene A Podrez
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, OH, United States
| | - Aaron Weinberg
- Department of Biological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Scott F. Sieg
- Case Western Reserve School of Medicine, Division of Infectious Diseases and HIV Medicine, Cleveland, OH, United States
- *Correspondence: Soumya Panigrahi, ; Scott F. Sieg,
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Sekhon UDS, Swingle K, Girish A, Luc N, de la Fuente M, Alvikas J, Haldeman S, Hassoune A, Shah K, Kim Y, Eppell S, Capadona J, Shoffstall A, Neal MD, Li W, Nieman M, Gupta AS. Platelet-mimicking procoagulant nanoparticles augment hemostasis in animal models of bleeding. Sci Transl Med 2022; 14:eabb8975. [PMID: 35080915 PMCID: PMC9179936 DOI: 10.1126/scitranslmed.abb8975] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Treatment of bleeding disorders using transfusion of donor-derived platelets faces logistical challenges due to their limited availability, high risk of contamination, and short (5 to 7 days) shelf life. These challenges could be potentially addressed by designing platelet mimetics that emulate the adhesion, aggregation, and procoagulant functions of platelets. To this end, we created liposome-based platelet-mimicking procoagulant nanoparticles (PPNs) that can expose the phospholipid phosphatidylserine on their surface in response to plasmin. First, we tested PPNs in vitro using human plasma and demonstrated plasmin-triggered exposure of phosphatidylserine and the resultant assembly of coagulation factors on the PPN surface. We also showed that this phosphatidylserine exposed on the PPN surface could restore and enhance thrombin generation and fibrin formation in human plasma depleted of platelets. In human plasma and whole blood in vitro, PPNs improved fibrin stability and clot robustness in a fibrinolytic environment. We then tested PPNs in vivo in a mouse model of thrombocytopenia where treatment with PPNs reduced blood loss in a manner comparable to treatment with syngeneic platelets. Furthermore, in rat and mouse models of traumatic hemorrhage, treatment with PPNs substantially reduced bleeding and improved survival. No sign of systemic or off-target thrombotic risks was observed in the animal studies. These findings demonstrate the potential of PPNs as a platelet surrogate that should be further investigated for the management of bleeding.
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Affiliation(s)
- Ujjal Didar Singh Sekhon
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA,Corresponding author. (U.D.S.S); (A.S.G.)
| | - Kelsey Swingle
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Aditya Girish
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Norman Luc
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Maria de la Fuente
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Jurgis Alvikas
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15123, USA
| | - Shannon Haldeman
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15123, USA
| | - Adnan Hassoune
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15123, USA
| | - Kaisal Shah
- Hathaway Brown School, Shaker Heights, OH 44122, USA
| | - Youjoung Kim
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA,Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA
| | - Steven Eppell
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Jeffrey Capadona
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA,Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA
| | - Andrew Shoffstall
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA,Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH 44106, USA
| | - Matthew D. Neal
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15123, USA
| | - Wei Li
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine of Marshall University, Huntington, WV 25755, USA
| | - Marvin Nieman
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Anirban Sen Gupta
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH 44106, USA,Department of Pharmacology, Case Western Reserve University, Cleveland, OH 44106, USA,Corresponding author. (U.D.S.S); (A.S.G.)
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9
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Luc NF, Rohner N, Girish A, Sekhon UDS, Neal MD, Gupta AS. Bioinspired artificial platelets: past, present and future. Platelets 2022; 33:35-47. [PMID: 34455908 PMCID: PMC8795470 DOI: 10.1080/09537104.2021.1967916] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Platelets are anucleate blood cells produced from megakaryocytes predominantly in the bone marrow and released into blood circulation at a healthy count of 150,000-400,00 per μL and circulation lifespan of 7-9 days. Platelets are the first responders at the site of vascular injury and bleeding, and participate in clot formation via injury site-specific primary mechanisms of adhesion, activation and aggregation to form a platelet plug, as well as secondary mechanisms of augmenting coagulation via thrombin amplification and fibrin generation. Platelets also secrete various granule contents that enhance these mechanisms for clot growth and stability. The resultant clot seals the injury site to stanch bleeding, a process termed as hemostasis. Due to this critical role, a reduction in platelet count or dysregulation in platelet function is associated with bleeding risks and hemorrhagic complications. These scenarios are often treated by prophylactic or emergency transfusion of platelets. However, platelet transfusions face significant challenges due to limited donor availability, difficult portability and storage, high bacterial contamination risks, and very short shelf life (~5-7 days). These are currently being addressed by a robust volume of research involving reduced temperature storage and pathogen reduction processes on donor platelets to improve shelf-life and reduce contamination, as well as bioreactor-based approaches to generate donor-independent platelets from stem cells in vitro. In parallel, a complementary research field has emerged that involves the design of artificial platelets utilizing biosynthetic particle constructs that functionally emulate various hemostatic mechanisms of platelets. Here, we provide a comprehensive review of the history and the current state-of-the-art artificial platelet approaches, along with discussing the translational opportunities and challenges.
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Affiliation(s)
- Norman F. Luc
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH 44106, USA
| | - Nathan Rohner
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH 44106, USA
| | - Aditya Girish
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH 44106, USA
| | | | - Matthew D. Neal
- University of Pittsburgh, Pittsburgh Trauma Research Center, Department of Surgery, Pittsburgh, PA 15123, USA
| | - Anirban Sen Gupta
- Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH 44106, USA
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10
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Cheney A, Woolcock AD, Mukhopadhyay A, Knapp D, Moore GE. Interleukin-6 and thrombopoietin concentrations in dogs with carcinoma with and without thrombocytosis. J Vet Intern Med 2022; 36:227-233. [PMID: 34881459 PMCID: PMC8783347 DOI: 10.1111/jvim.16317] [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: 06/16/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Carcinoma-associated thrombocytosis involves tumor production of mediators such as interleukin-6 (IL-6) and thrombopoietin (TPO) that increase thrombopoiesis and may play a role in tumor evasion and metastasis. Carcinoma-associated thrombocytosis is described in people, but has not been described in dogs. HYPOTHESIS/OBJECTIVES Evaluate the concentrations of IL-6 and TPO in dogs diagnosed with carcinoma with or without thrombocytosis. We hypothesized that IL-6 and TPO concentrations would be higher in dogs with carcinoma compared to healthy dogs, and that IL-6 and TPO concentrations would be higher in dogs with carcinoma and thrombocytosis when compared to dogs with carcinoma and normal platelet counts. ANIMALS One-hundred sixteen dogs: 63 with carcinoma and 53 healthy control dogs. METHODS Complete blood count was performed in all dogs, and they were stratified for sub-group analysis based on the presence or absence of thrombocytosis (platelet count > 500 103/µL). Serum TPO and IL-6 concentrations were measured by ELISA. Results of selected numeric variables were compared using Wilcoxon rank sum tests for pairwise comparisons. A value of P < .05 was considered significant. RESULTS Twelve of the dogs with carcinoma (12/63, 19.0%) and none of the healthy control dogs (0%) had thrombocytosis. Thrombopoietin concentrations (median [range]) were significantly higher in dogs with carcinoma when compared to controls (87.42 pg/mL [0 to >600] vs 15.99 pg/mL [0 to >600], P < .001). Interleukin-6 concentrations (median [range]) were not different between dogs with carcinoma and healthy control dogs (9.70 pg/mL [0-181.53] vs 3.03 pg/mL [0-280.77], P = .15). In dogs with carcinoma, the TPO and IL-6 concentrations were not different between dogs with thrombocytosis and dogs with normal platelet count. CONCLUSIONS AND CLINICAL IMPORTANCE Thrombopoietin concentrations were significantly higher in dogs with carcinoma, regardless of platelet count. Thrombopoietin is likely to be 1 of multiple factors that can impact platelet number, production, and consumption in dogs with carcinoma.
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Affiliation(s)
- Adrienne Cheney
- Department of Veterinary Clinical Sciences, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
| | - Andrew D. Woolcock
- Department of Veterinary Clinical Sciences, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
| | - Abhijit Mukhopadhyay
- Department of Veterinary Clinical Sciences, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
| | - Deborah Knapp
- Department of Veterinary Clinical Sciences, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
| | - George E. Moore
- Department of Veterinary Administration, College of Veterinary MedicinePurdue UniversityWest LafayetteIndianaUSA
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11
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Gao Q, Li Z, Mo X, Wu Y, Zhou H, Peng J. Combined procalcitonin and hemogram parameters contribute to early differential diagnosis of Gram-negative/Gram-positive bloodstream infections. J Clin Lab Anal 2021; 35:e23927. [PMID: 34363413 PMCID: PMC8418508 DOI: 10.1002/jcla.23927] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/16/2021] [Accepted: 07/20/2021] [Indexed: 12/29/2022] Open
Abstract
Background Hemogram parameters and procalcitonin (PCT) play auxiliary roles in the diagnosis and outcome of sepsis. However, it is not clear whether these indicators can quickly distinguish bacterial classification or guide the choice of empirical antibiotics. Methods We retrospectively enrolled 381 patients with bloodstream infections (BSI), divided into Gram‐positive bloodstream infections (GP‐BSI) and Gram‐negative bloodstream infections (GN‐BSI). Demographic parameters, hemogram parameters, and PCT were recorded and compared between the two groups. Results The mean platelet volume (MPV), platelet distribution width (PDW), and PCT in the GN‐BSI group were significantly higher than those in the GP‐BSI group, while the platelet count (PLT), plateletcrit, platelet count‐to‐white blood cell count ratio (PWR), platelet count‐to‐neutrophil count ratio (PNR), platelet count‐to‐PCT ratio (PLT/PCT), and mean platelet volume‐to‐PCT ratio (MPV/PCT) were significantly lower in the GN‐BSI group. Multivariate stepwise logistic regression analysis revealed that the independent predictors of GN‐BSI were MPV, PWR, and PCT. The areas under the curve (AUC) for this prediction model was 0.79, with sensitivity =0.75 and specificity =0.71. Conclusions There were significant differences in terms of PCT, platelet parameters, and platelet‐related index‐PCT ratio between GN‐BSI and GP‐BSI. Combined PCT and hemogram parameters are more conducive to the early differential diagnosis of bacterial classification of BSI.
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Affiliation(s)
- Qiqing Gao
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhuohong Li
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xichao Mo
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yihua Wu
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Hao Zhou
- Department of Hospital Infection Management of Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jie Peng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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12
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Chaudhary PK, Kim S. The GRKs Reactome: Role in Cell Biology and Pathology. Int J Mol Sci 2021; 22:ijms22073375. [PMID: 33806057 PMCID: PMC8036551 DOI: 10.3390/ijms22073375] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/21/2021] [Accepted: 03/22/2021] [Indexed: 02/06/2023] Open
Abstract
G protein-coupled receptor kinases (GRKs) are protein kinases that function in concert with arrestins in the regulation of a diverse class of G protein-coupled receptors (GPCRs) signaling. Although GRKs and arrestins are key participants in the regulation of GPCR cascades, the complex regulatory mechanisms of GRK expression, its alternation, and their function are not thoroughly understood. Several studies together with the work from our lab in recent years have revealed the critical role of these kinases in various physiological and pathophysiological processes, including cardiovascular biology, inflammation and immunity, neurodegeneration, thrombosis, and hemostasis. A comprehensive understanding of the mechanisms underlying functional interactions with multiple receptor proteins and how these interactions take part in the development of various pathobiological processes may give rise to novel diagnostic and therapeutic strategies. In this review, we summarize the current research linking the role of GRKs to various aspects of cell biology, pathology, and therapeutics, with a particular focus on thrombosis and hemostasis.
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13
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Ntzouvani A, Antonopoulou S, Fragopoulou E, Kontogianni MD, Nomikos T, Mikellidi A, Xanthopoulou Μ, Kalogeropoulos N, Panagiotakos D. Effect of Differently Fed Farmed Gilthead Sea Bream Consumption on Platelet Aggregation and Circulating Haemostatic Markers among Apparently Healthy Adults: A Double-Blind Randomized Crossover Trial. Nutrients 2021; 13:nu13020286. [PMID: 33498445 PMCID: PMC7909403 DOI: 10.3390/nu13020286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 01/21/2023] Open
Abstract
Fish consumption beneficially affects coagulation markers. Few dietary intervention studies have investigated differently fed farmed fish against these cardio-metabolic risk factors in humans. This double-blind randomized crossover trial evaluated differently fed farmed gilthead sea bream consumption against platelet aggregation and circulating haemostatic markers among apparently healthy adults. Subjects aged 30-65 years, with a body mass index 24.0-31.0 kg/m2, consuming less than 150 g cooked fish per week, were recruited in Attica, Greece. Participants were randomized (n = 38, 1:1) to one of two sequences; consumption of fish fed with fish oil diet (conventional fish, CF)/fish fed with olive pomace-enriched diet (enriched fish, EF) versus EF/CF. The primary outcomes were ex vivo human platelet aggregation and circulating plasminogen activator inhibitor-1 (PAI-1) and P-selectin (sP-selectin) concentrations. EF consumption had no significant effect on platelet sensitivity or haemostatic markers compared to CF. Platelet sensitivity to platelet-activating factor (PAF) decreased after CF consumption during the second period (p < 0.01). Plasma PAI-1 and sP-selectin concentrations increased after CF consumption during both periods (p < 0.01 for both). Based on current findings, consumption of enriched farmed gilthead sea bream had no greater effect on coagulation markers in adults compared to the conventionally fed fish.
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14
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Farghly S, Abd-Elkader R, El Zohne RA, Abd El-Kareem DM. Mean platelet volume change (∆MPV) and red blood cell distribution width (RDW) as promising markers of community-acquired pneumonia (CAP) outcome. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2020. [PMCID: PMC7439238 DOI: 10.1186/s43168-020-00024-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Prognostic markers play an essential role in the proper management of community-acquired pneumonia. This research work aimed to evaluate the association of RDW and /or MPV with mortality and morbidity in patients with CAP to improve the yield of already used prognostic scores.
Results
The current study enrolled 153 patients with community-acquired pneumonia (CAP). Out of them, 101 (64%) patients improved while 52 (36%) died. It was noticed that each of delta MPV and RDW (P < 0.001) had positive significant correlation with PSI and CURB-65. Delta MPV and RDW was significantly higher in patients who died (2.61 ± 1.01 vs. 1.78 ± 0.76; P = 0.01 for delta MPV and 16.50 ± 3.54 vs. 15.50 ± 2.81; P = 0.02 for RDW).
Conclusion
Initial RDW and rising MPV during hospitalization for CAP is associated with more severe clinical characteristics and high mortality. Moreover, the use of RDW and delta MPV in patients admitted with CAP can improve the performance of prognostic scales.
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15
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Lozano ML. Avatrombopag for the management of thrombocytopenia in patients with chronic liver disease. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 113:136-140. [PMID: 33233913 DOI: 10.17235/reed.2020.7309/2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Severe thrombocytopenia (platelet count < 50 x 109/l) is the most frequent hematological disorder in patients with chronic liver disease, affecting 64-84 % of individuals with cirrhosis. The pathophysiological mechanisms that underlie thrombocytopenia are complex, but the reduction of thrombopoietin levels is considered to play a key role. Until recently, there was a continuous debate about the optimal management of patients with chronic liver disease and whether low platelet counts require a scheduled invasive procedure. Transfusion of platelet concentrates is considered to be the standard treatment, but has major limitations such as its short lifespan, limited efficacy and relevant adverse effects. Avatrombopag is an oral thrombopoietin receptor agonist that induces megakaryocytic proliferation and differentiation and platelet production. It has been approved by the Spanish Agency of Medicines and Health Products for the treatment of severe thrombocytopenia in adult patients with chronic liver disease before scheduled procedures, to decrease the risk of bleeding. Randomized trials have demonstrated that this agent is effective in maintaining platelet counts above 50 × 109/l over a period of more than two weeks, with a similar safety profile to the placebo. In this article, we review avatrombopag in the treatment of thrombocytopenia in patients with chronic liver disease. Furthermore, the main differences of this intervention in comparison to the previous standard of care therapy are discussed.
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16
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Sun H, Xu H, Wang T, Yan Y, Ji W, Zhu C, Wang Y, Hao C, Chen Z. The implications of platelet count changes during hospitalization in the disease management of paediatric patients with bronchiolitis. Infect Dis (Lond) 2020; 52:786-792. [PMID: 32609033 DOI: 10.1080/23744235.2020.1787504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND The objective of this study was to investigate the significance of the platelet count on admission and platelet count changes during hospitalization in paediatric patients with bronchiolitis. METHODS Clinical data from 404 consecutive patients hospitalized for bronchiolitis were collected and compared after grouping according to the platelet count on admission and the delta platelet count during hospitalization (the platelet count 3-5 days after admission minus the platelet count on admission; Group A, delta platelet count < -50 × 109/L; Group B, -50 × 109/L ≤ delta platelet count ≤ 50 × 109/L; Group C, delta platelet count > 50 × 109/L). RESULTS Thrombocytosis was found in 79 (19.6%) patients, while 325 (80.4%) patients had a normal platelet count on admission. There was no difference in disease severity between these two groups. Groups A, B and C comprised 57 (14.1%), 133 (32.9%) and 214 (53.0%) patients, respectively. The patients from Group A had longer periods of oxygen therapy and stay in the paediatric intensive care unit, and a greater frequency of mechanical ventilation than the patients from Group B or Group C (all p < .05). Notably, among all the patients, the delta platelet count negatively correlated with the numbers of days of oxygen therapy (r = -0.385, p < .001) and stay in the paediatric intensive care unit (r = -0.603, p < .001). CONCLUSIONS A decrease in the platelet count during hospitalization in paediatric patients with bronchiolitis may provide useful information for disease management.
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Affiliation(s)
- Huiming Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Hua Xu
- Department of Respiratory Medicine, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Ting Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wei Ji
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Canhong Zhu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yuqing Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
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17
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ROS in Platelet Biology: Functional Aspects and Methodological Insights. Int J Mol Sci 2020; 21:ijms21144866. [PMID: 32660144 PMCID: PMC7402354 DOI: 10.3390/ijms21144866] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/26/2020] [Accepted: 07/07/2020] [Indexed: 12/22/2022] Open
Abstract
Reactive oxygen species (ROS) and mitochondria play a pivotal role in regulating platelet functions. Platelet activation determines a drastic change in redox balance and in platelet metabolism. Indeed, several signaling pathways have been demonstrated to induce ROS production by NAPDH oxidase (NOX) and mitochondria, upon platelet activation. Platelet-derived ROS, in turn, boost further ROS production and consequent platelet activation, adhesion and recruitment in an auto-amplifying loop. This vicious circle results in a platelet procoagulant phenotype and apoptosis, both accounting for the high thrombotic risk in oxidative stress-related diseases. This review sought to elucidate molecular mechanisms underlying ROS production upon platelet activation and the effects of an altered redox balance on platelet function, focusing on the main advances that have been made in platelet redox biology. Furthermore, given the increasing interest in this field, we also describe the up-to-date methods for detecting platelets, ROS and the platelet bioenergetic profile, which have been proposed as potential disease biomarkers.
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18
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Petrey AC, Obery DR, Kessler SP, Zawerton A, Flamion B, de la Motte CA. Platelet hyaluronidase-2 regulates the early stages of inflammatory disease in colitis. Blood 2019; 134:765-775. [PMID: 31262781 PMCID: PMC6716076 DOI: 10.1182/blood.2018893594] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/12/2019] [Indexed: 12/31/2022] Open
Abstract
Platelets are specialized cells essential for hemostasis that also function as crucial effectors capable of mediating inflammatory and immune responses. These sentinels continually survey their environment and discriminate between homeostatic and danger signals such as modified components of the extracellular matrix. The glycosaminoglycan hyaluronan (HA) is a major extracellular matrix component that coats the vascular lumen and, under normal conditions, restricts access of inflammatory cells. In response to tissue damage, the endothelial HA matrix enhances leukocyte recruitment and regulates the early stages of the inflammatory response. We have shown that platelets can degrade HA from the surface of activated endothelial cells via the enzyme hyaluronidase-2 (HYAL2) and that HYAL2 is deficient in platelets isolated from patients with inflammatory bowel disease (IBD). Platelets are known to be involved in the pathogenesis of several chronic disease states, including IBD, but they have been largely overlooked in the context of intestinal inflammation. We therefore wanted to define the mechanism by which platelet HYAL2 regulates the inflammatory response during colitis. In this study, we provide evidence that HA catabolism is disrupted in human intestinal microvascular endothelial cells isolated from patients with IBD. Furthermore, mice deficient in HYAL2 are more susceptible to an acute model of colitis, and this increased susceptibility is abrogated by transfusion of HYAL2-competent platelets. Finally, we show that platelets, via HYAL2-dependent degradation of endothelial HA, regulate the early stages of inflammation in colitis by limiting leukocyte extravasation.
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Affiliation(s)
- Aaron C Petrey
- Department of Inflammation and Immunity, Cleveland Clinic Lerner Research Institute, Cleveland, OH; and
| | - Dana R Obery
- Department of Inflammation and Immunity, Cleveland Clinic Lerner Research Institute, Cleveland, OH; and
| | - Sean P Kessler
- Department of Inflammation and Immunity, Cleveland Clinic Lerner Research Institute, Cleveland, OH; and
| | - Ash Zawerton
- Department of Inflammation and Immunity, Cleveland Clinic Lerner Research Institute, Cleveland, OH; and
| | - Bruno Flamion
- Molecular Physiology Research Unit, Namur Research Institute for Life Sciences, University of Namur, Namur, Belgium
| | - Carol A de la Motte
- Department of Inflammation and Immunity, Cleveland Clinic Lerner Research Institute, Cleveland, OH; and
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19
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Masuch A, Budde K, Kastenmüller G, Artati A, Adamski J, Völzke H, Nauck M, Pietzner M. Metabolic signature associated with parameters of the complete blood count in apparently healthy individuals. J Cell Mol Med 2019; 23:5144-5153. [PMID: 31215770 PMCID: PMC6652895 DOI: 10.1111/jcmm.14383] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/02/2019] [Accepted: 04/17/2019] [Indexed: 12/16/2022] Open
Abstract
Metabolomics studies now approach large sample sizes and the health characterization of the study population often include complete blood count (CBC) results. Upon careful interpretation the CBC aids diagnosis and provides insight into the health status of the patient within a clinical setting. Uncovering metabolic signatures associated with parameters of the CBC in apparently healthy individuals may facilitate interpretation of metabolomics studies in general and related to diseases. For this purpose 879 subjects from the population‐based Study of Health in Pomerania (SHIP)‐TREND were included. Using metabolomics data resulting from mass‐spectrometry based measurements in plasma samples associations of specific CBC parameters with metabolites were determined by linear regression models. In total, 118 metabolites significantly associated with at least one of the CBC parameters. Strongest associations were observed with metabolites of heme degradation and energy production/consumption. Inverse association seen with mean corpuscular volume and mean corpuscular haemoglobin comprised metabolites potentially related to kidney function. The presently identified metabolic signatures are likely derived from the general function and formation/elimination of blood cells. The wealth of associated metabolites strongly argues to consider CBC in the interpretation of metabolomics studies, in particular if mutual effects on those parameters by the disease of interest are known.
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Affiliation(s)
- Annette Masuch
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Kathrin Budde
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Disease (DZHK e.V.), partner site Greifswald, Greifswald, Germany
| | - Gabi Kastenmüller
- Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Anna Artati
- Institute of Experimental Genetics, Genome Analysis Centre, Helmholtz Zentrum München, Neuherberg, Germany
| | - Jerzy Adamski
- Institute of Experimental Genetics, Genome Analysis Centre, Helmholtz Zentrum München, Neuherberg, Germany.,Lehrstuhl für Experimentelle Genetik, Technische Universität München, Freising-Weihenstephan, Germany.,DZD (German Centre for Diabetes Research), München-Neuherberg, Germany
| | - Henry Völzke
- German Centre for Cardiovascular Disease (DZHK e.V.), partner site Greifswald, Greifswald, Germany.,Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.,DZD (German Centre for Diabetes Research), site Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Disease (DZHK e.V.), partner site Greifswald, Greifswald, Germany
| | - Maik Pietzner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.,German Centre for Cardiovascular Disease (DZHK e.V.), partner site Greifswald, Greifswald, Germany
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20
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Pluthero FG, Kahr WHA. The Birth and Death of Platelets in Health and Disease. Physiology (Bethesda) 2019; 33:225-234. [PMID: 29638183 DOI: 10.1152/physiol.00005.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Blood platelets are involved in a wide range of physiological responses and pathological processes. Recent studies have considerably advanced our understanding of the mechanisms of platelet production and clearance, revealing new connections between the birth and death of these tiny, abundant cells. Key insights have also been gained into how physiological challenges such as inflammation, infection, and chemotherapy can affect megakaryocytes, the cells that produce platelets.
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Affiliation(s)
- Fred G Pluthero
- Cell Biology Program, Research Institute, Hospital for Sick Children , Toronto, Ontario , Canada
| | - Walter H A Kahr
- Cell Biology Program, Research Institute, Hospital for Sick Children , Toronto, Ontario , Canada.,Department of Biochemistry, University of Toronto , Toronto, Ontario , Canada.,Department of Paediatrics, Division of Haematology/Oncology, University of Toronto and The Hospital for Sick Children , Toronto, Ontario , Canada
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21
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Miao D, Li DY, Chen M, Zhao MH. Platelets are activated in ANCA-associated vasculitis via thrombin-PARs pathway and can activate the alternative complement pathway. Arthritis Res Ther 2017; 19:252. [PMID: 29141676 PMCID: PMC5688714 DOI: 10.1186/s13075-017-1458-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/24/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In this study, we investigated the mechanism of platelet activation in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), as well as the activation of the alternative complement pathway by platelets in AAV. METHODS CD62P and platelet-leukocyte aggregates in AAV patients were tested by flow cytometry. Platelets were stimulated by plasma from active AAV patients. The effect of the thrombin-protease-activated receptors (PARs) pathway was evaluated by blocking thrombin or PAR1 antagonists. After platelets were activated by plasma from AAV patients, Ca/Mg-Tyrode's buffer and Mg-EGTA buffer were used to measure complement activation in liquid phase and on the surface of platelets. RESULTS The levels of CD62P-expressing platelets and platelet-leukocyte aggregates were significantly higher in active AAV patients than those in remission and normal controls. Platelets were activated by plasma from active AAV patients (percentage of CD62P-expressing platelets, 97.7 ± 3% vs. 1 ± 0.2%, p < 0.0001, compared with those incubated with healthy donor plasma), and this was inhibited by thrombin or PAR1 antagonists (percentage of CD62P-expressing platelets, 97.7 ± 3% vs. 2.7 ± 1%, p < 0.0001, 97.7 ± 3% vs. 5 ± 1.4%, p < 0.0001, respectively). Platelets activated by plasma from AAV patients could trigger complement activation via the alternative pathway, as demonstrated by significant elevation of C3a, C5a, and sC5b-9 and significantly more C3c and C5b-9 deposition on the surface of platelets. CONCLUSIONS Platelets were activated in AAV patients, and such activation was at least partially attributed to the thrombin-PARs pathway. Activated platelets triggered the alternative complement pathway in AAV.
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Affiliation(s)
- Di Miao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, 100034, China.,Institute of Nephrology, Peking University, Beijing, 100034, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, 100034, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Peking University, Beijing, 100034, China.,Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, 100871, China
| | - Dan-Yang Li
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, 100034, China.,Institute of Nephrology, Peking University, Beijing, 100034, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, 100034, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Peking University, Beijing, 100034, China
| | - Min Chen
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, 100034, China. .,Institute of Nephrology, Peking University, Beijing, 100034, China. .,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, 100034, China. .,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Peking University, Beijing, 100034, China.
| | - Ming-Hui Zhao
- Renal Division, Department of Medicine, Peking University First Hospital, Beijing, 100034, China.,Institute of Nephrology, Peking University, Beijing, 100034, China.,Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, 100034, China.,Key Laboratory of Chronic Kidney Disease Prevention and Treatment, Ministry of Education, Peking University, Beijing, 100034, China.,Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, 100871, China
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22
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Nava T, Rivard GE, Bonnefoy A. Challenges on the diagnostic approach of inherited platelet function disorders: Is a paradigm change necessary? Platelets 2017; 29:148-155. [PMID: 29090587 DOI: 10.1080/09537104.2017.1356918] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Inherited platelet function disorders (IPFD) have been assessed for more than 50 years by aggregation- and secretion-based tests. Several decision trees are available intending to standardize the investigation of IPFD. A large variability of approaches is still in use among the laboratories across the world. In spite of costly and lengthy laboratory evaluation, the results have been found inconclusive or negative in a significant part of patients having bleeding manifestations. Molecular investigation of newly identified IPFD has recently contributed to a better understanding of the complexity of platelet function. Once considered "classic" IPFDs, Glanzmann thrombasthenia and Bernard-Soulier syndrome have each had their pathophysiology reassessed and their diagnosis made more precise and informative. Megakaryopoiesis, platelet formation, and function have been found tightly interlinked, with several genes being involved in both inherited thrombocytopenias and impaired platelet function. Moreover, genetic approaches have moved from being used as confirmatory diagnostic tests to being tools for identification of genetic variants associated with bleeding disorders, even in the absence of a clear phenotype in functional testing. In this study, we aim to address some limits of the conventional tests used for the diagnosis of IPFD, and to highlight the potential contribution of recent molecular tools and opportunities to rethink the way we should approach the investigation of IPFD.
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Affiliation(s)
- Tiago Nava
- a Centre Hospitalier Universitaire Sainte-Justine , Hematology and Oncology Division , Montréal , QC , Canada.,b Child and Adolescent Health, School of Medicine , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil
| | - Georges-Etienne Rivard
- a Centre Hospitalier Universitaire Sainte-Justine , Hematology and Oncology Division , Montréal , QC , Canada
| | - Arnaud Bonnefoy
- a Centre Hospitalier Universitaire Sainte-Justine , Hematology and Oncology Division , Montréal , QC , Canada
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23
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Borst S, Sim X, Poncz M, French DL, Gadue P. Induced Pluripotent Stem Cell-Derived Megakaryocytes and Platelets for Disease Modeling and Future Clinical Applications. Arterioscler Thromb Vasc Biol 2017; 37:2007-2013. [PMID: 28982668 PMCID: PMC5675007 DOI: 10.1161/atvbaha.117.309197] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 09/21/2017] [Indexed: 12/13/2022]
Abstract
Platelets, derived from megakaryocytes, are anucleate cytoplasmic discs that circulate in the blood stream and play major roles in hemostasis, inflammation, and vascular biology. Platelet transfusions are used in a variety of medical settings to prevent life-threatening thrombocytopenia because of cancer therapy, other causes of acquired or inherited thrombocytopenia, and trauma. Currently, platelets used for transfusion purposes are donor derived. However, there is a drive to generate nondonor sources of platelets to help supplement donor-derived platelets. Efforts have been made by many laboratories to generate in vitro platelets and optimize their production and quality. In vitro-derived platelets have the potential to be a safer, more uniform product, and genetic manipulation could allow for better treatment of patients who become refractory to donor-derived units. This review focuses on potential clinical applications of in vitro-derived megakaryocytes and platelets, current methods to generate and expand megakaryocytes from pluripotent stem cell sources, and the use of these cells for disease modeling.
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Affiliation(s)
- Sara Borst
- From the Department of Cell and Molecular Biology, Perelman School of Medicine (S.B., X.S.), Department of Pharmacology, Perelman School of Medicine (M.P.), and Department of Pathology and Laboratory Medicine (D.L.F., P.G.), University of Pennsylvania, Philadelphia; and Center for Cellular and Molecular Therapeutics (S.B., X.S., D.L.F., P.G.) and Division of Hematology (M.P.), Children's Hospital of Philadelphia, PA
| | - Xiuli Sim
- From the Department of Cell and Molecular Biology, Perelman School of Medicine (S.B., X.S.), Department of Pharmacology, Perelman School of Medicine (M.P.), and Department of Pathology and Laboratory Medicine (D.L.F., P.G.), University of Pennsylvania, Philadelphia; and Center for Cellular and Molecular Therapeutics (S.B., X.S., D.L.F., P.G.) and Division of Hematology (M.P.), Children's Hospital of Philadelphia, PA
| | - Mortimer Poncz
- From the Department of Cell and Molecular Biology, Perelman School of Medicine (S.B., X.S.), Department of Pharmacology, Perelman School of Medicine (M.P.), and Department of Pathology and Laboratory Medicine (D.L.F., P.G.), University of Pennsylvania, Philadelphia; and Center for Cellular and Molecular Therapeutics (S.B., X.S., D.L.F., P.G.) and Division of Hematology (M.P.), Children's Hospital of Philadelphia, PA
| | - Deborah L French
- From the Department of Cell and Molecular Biology, Perelman School of Medicine (S.B., X.S.), Department of Pharmacology, Perelman School of Medicine (M.P.), and Department of Pathology and Laboratory Medicine (D.L.F., P.G.), University of Pennsylvania, Philadelphia; and Center for Cellular and Molecular Therapeutics (S.B., X.S., D.L.F., P.G.) and Division of Hematology (M.P.), Children's Hospital of Philadelphia, PA
| | - Paul Gadue
- From the Department of Cell and Molecular Biology, Perelman School of Medicine (S.B., X.S.), Department of Pharmacology, Perelman School of Medicine (M.P.), and Department of Pathology and Laboratory Medicine (D.L.F., P.G.), University of Pennsylvania, Philadelphia; and Center for Cellular and Molecular Therapeutics (S.B., X.S., D.L.F., P.G.) and Division of Hematology (M.P.), Children's Hospital of Philadelphia, PA.
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24
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Gorelik O, Tzur I, Barchel D, Almoznino-Sarafian D, Swarka M, Beberashvili I, Feldman L, Cohen N, Izhakian S. A rise in mean platelet volume during hospitalization for community-acquired pneumonia predicts poor prognosis: a retrospective observational cohort study. BMC Pulm Med 2017; 17:137. [PMID: 29084523 PMCID: PMC5663044 DOI: 10.1186/s12890-017-0483-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 10/26/2017] [Indexed: 12/27/2022] Open
Abstract
Background Clinical characteristics and the prognostic significance of changes in mean platelet volume (MPV) during hospitalization for community-acquired pneumonia (CAP) have not been investigated. Methods Among 976 adults hospitalized for CAP, clinical characteristics, in-hospital outcomes (transfer to the intensive care unit, treatment with mechanical ventilation, prolonged hospital stay and death), and all-cause mortality following discharge, were compared according to ΔMPV (MPV on discharge minus MPV on admission): groups A (no rising MPV, ΔMPV < 0.6 fL) and B (rising MPV, ΔMPV ≥ 0.6 fL). Results Groups A and B comprised 83.8% and 16.2% of patients, respectively. Patients with a rise in MPV were more likely to be older, and to present with renal dysfunction, cerebrovascular disorder and severe pneumonia than were patients with no rise in MPV. On discharge, lower values of platelets and higher levels of neutrophils were observed in group B. Rising MPV strongly predicted a need for mechanical ventilation and in-hospital death (the respective relative risks: 2.62 and 6.79; 95% confidence intervals: 1.54–4.45 and 3.48–13.20). The respective 90-day, 3-year and total (median follow-up of 54 months) mortality rates were significantly higher in group B (29.1%, 43.0% and 50.0%) than group A (7.3%, 24.2% and 32.6%), p < 0.001 for all comparisons. A rise in MPV was a powerful predictor of all-cause mortality (relative risk 1.26 and 95% confidence interval 1.11–1.43). Conclusions Rising MPV during hospitalization for CAP is associated with a more severe clinical profile than no rise in MPV. A rise in MPV strongly predicts in-hospital and long-term mortality.
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Affiliation(s)
- Oleg Gorelik
- Department of Internal Medicine "F", Assaf Harofeh Medical Center, 70300, Zerifin, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
| | - Irma Tzur
- Department of Internal Medicine "F", Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Dana Barchel
- Department of Internal Medicine "F", Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Dorit Almoznino-Sarafian
- Department of Internal Medicine "F", Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Muhareb Swarka
- Department of Internal Medicine "F", Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Ilia Beberashvili
- Nephrology Division, Assaf Harofeh Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Leonid Feldman
- Nephrology Division, Assaf Harofeh Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Natan Cohen
- Department of Internal Medicine "F", Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Shimon Izhakian
- Department of Internal Medicine "F", Assaf Harofeh Medical Center, 70300, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
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25
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Oświęcimska J, Malczyk Ż, Szymlak A, Mikołajczak A, Ziora K, Zamlynski J, Machura E, Zajac P, Koczy B, Kasperska-Zajac A. Changes in Platelet Count and Size Indices in Adolescent Patients With Anorexia Nervosa. Clin Appl Thromb Hemost 2017; 23:562-566. [PMID: 28449596 DOI: 10.1177/1076029617705727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The significance of platelet size indices has not been widely analyzed in anorexia nervosa (AN). It seems important to get more knowledge on the easily available indices of platelet function obtained by routine complete blood count analysis in patients with AN. We analyzed platelet count (PLT), platelet distribution width (PDW), and mean platelet volume using an automated blood cell counter in 25 females with AN and healthy age- and gender-matched nonatopic controls. Mean PLT was significantly lower in patients with AN than in the control group. Platelet distribution width values in patients with AN were significantly higher than those in the controls. Platelet distribution width values significantly correlated with the disease duration and rate of body weight loss in the anorectic patients. Anorexia nervosa in adolescents is associated with a decrease in PLT along with an increased PDW, which may be an indicator of dysregulated thrombopoiesis.
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Affiliation(s)
- Joanna Oświęcimska
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Żaneta Malczyk
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Agnieszka Szymlak
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Agata Mikołajczak
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Katarzyna Ziora
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Jacek Zamlynski
- 2 Department of Gynaecology, Obstetrics and Oncological Gynaecology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Bytom, Poland
| | - Edyta Machura
- 1 Department of Paediatrics, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Piotr Zajac
- 3 Department of Trauma and Orthopaedics, District Trauma and Orthopaedic Hospital, Piekary Sląskie, Poland
| | - Bogdan Koczy
- 3 Department of Trauma and Orthopaedics, District Trauma and Orthopaedic Hospital, Piekary Sląskie, Poland
| | - Alicja Kasperska-Zajac
- 4 Clinical Department of Internal Diseases, Dermatology and Allergology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland
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26
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Ferdous F, Saski C, Bridges W, Burns M, Dunn H, Elliott K, Scott TR. Transcriptome Profile of the Chicken Thrombocyte: New Implications as an Advanced Immune Effector Cell. PLoS One 2016; 11:e0163890. [PMID: 27711235 PMCID: PMC5053482 DOI: 10.1371/journal.pone.0163890] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/18/2016] [Indexed: 12/30/2022] Open
Abstract
Thrombocytes are nucleated platelets involved in immune functions such as pathogen recognition and release of pro-inflammatory bioactive compounds when exposed to bacterial and viral molecules. However, the complete role of these cells in innate and adaptive immune responses is not understood, and little is known about their biology at the molecular-genetic level. Highly sensitive RNA-sequencing technologies were used to analyze the complete transcriptome of thrombocytes for the first time with analytical resolution focused on cell-based components of the immune system/response. Amongst all the genes listed in the current chicken genome assembly, 10,041 gene transcripts were found in the chicken thrombocyte. After 1-hour in vitro stimulation with lipopolysaccharide (LPS, Salmonella minnesota), 490 genes were upregulated and 359 genes were downregulated, respectively, with at least a 1-fold change relative to unexposed thrombocytes. Additionally, by constructing a de novo assembly, we were able to identify a total of 3,030 novel genes in the thrombocyte transcriptome. The information generated here is useful in development of novel solutions to lower the economic burden and zoonotic threat that accompanies infectious diseases for birds and fish. In addition, the resources created here have translational utility as a model system to find orthologous genes and genes related to its enucleated counterpart, the platelet.
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Affiliation(s)
- Farzana Ferdous
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, South Carolina, United States of America
| | - Christopher Saski
- Clemson University Genomics Institute, Clemson University, Clemson, South Carolina, United States of America
| | - William Bridges
- Department of Mathematical Sciences, Clemson University, Clemson, South Carolina, United States of America
| | - Matthew Burns
- Clemson Cooperative Extension, Clemson University, Clemson, South Carolina, United States of America
| | - Heather Dunn
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, South Carolina, United States of America
| | - Kathryn Elliott
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, South Carolina, United States of America
| | - Thomas R. Scott
- Department of Animal and Veterinary Sciences, Clemson University, Clemson, South Carolina, United States of America
- * E-mail:
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27
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Chen XL, Xue L, Wang W, Chen HN, Zhang WH, Liu K, Chen XZ, Yang K, Zhang B, Chen ZX, Chen JP, Zhou ZG, Hu JK. Prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet in patients with gastric carcinoma: a retrospective cohort study. Oncotarget 2016; 6:41370-82. [PMID: 26497995 PMCID: PMC4747412 DOI: 10.18632/oncotarget.5629] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 09/09/2015] [Indexed: 02/05/2023] Open
Abstract
Nutritional and immune status is important to the prognosis of patients with gastric carcinoma (GC). Here, we evaluated the prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet (HALP) in patients with GC. From January 2005 to December 2011, 1332 patients with GC who underwent gastrectomy were randomly divided into the training (n = 888) and the validation sets (n = 444) by X-tile according to the sample size ratio 2:1. The cut-point of HALP was 56.8 and the patients were subsequently subdivided into HALP < 56.8 and HALP ≥ 56.8 groups in both two sets. Multivariate analysis revealed that gender (p < 0.001, p < 0.001), tumor size (p = 0.003, p = 0.035) and T stage (p < 0.001, p = 0.044) were independently related to HALP both in the training and the validation sets. Kaplan-Meier (p < 0.001, p = 0.003) and Cox regression (p = 0.043, p = 0.042) showed that the prognosis of HALP ≥ 56.8 group was significantly better than that of HALP < 56.8 group both in two sets (p < 0.001, p < 0.001). Nomograms of these two sets based on HALP was more accurate in prognostic prediction than TNM stage alone. Our findings suggested that HALP was closely associated with clinicopathological features and was an independent prognostic factor in GC patients. Nomogram based on HALP could accurately predict the prognosis of GC patients.
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Affiliation(s)
- Xiao-Long Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lian Xue
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hai-Ning Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei-Han Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kai Liu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xin-Zu Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kun Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Zhang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhi-Xin Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jia-Ping Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zong-Guang Zhou
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Digestive Surgery, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jian-Kun Hu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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28
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Ozturk N, Baygutalp NK, Bakan E, Altas GF, Polat H, Dorman E. Changes in platelet parameters in leukocytosis. Pan Afr Med J 2016; 24:185. [PMID: 27795782 PMCID: PMC5072879 DOI: 10.11604/pamj.2016.24.185.7510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 06/06/2016] [Indexed: 01/19/2023] Open
Abstract
Introduction In recent years, platelets are known to have a large variety of functions in many pathophysiological processes and their interaction with endothelial cells and leukocytes is known to play an important role in the pathophysiology of vascular inflammation. The aim of this study was to investigate the relationship between white blood cell count in conditions resulting in leukocytosis and platelet count and platelet parameters including mean platelet volume, platelet distribution width, and plateletcrit. Methods White blood cell counts count and all platelet parameters were evaluated in 341 results of normal complete blood count (of which the white blood cell counts were within reference range, group 1) and 327 results of elevated white blood cell counts count (group 2). Results There was a significant difference between these two groups in PLT counts and PCT values, being higher in Group 2. However, there was no statistically significant difference between two groups in MPV and PDW values. On the other hand, there were statistically significant, but weak, correlations between the WBC and platelet counts in both groups (p<0.01, r=0.235 for group 1, p<0.05, r=0.116 for group 2). Conclusion As a conclusion PLT count and PCT values increase in infectious conditions. This study and previous studies show that PLTs are employed in infectious conditions but the exact mechanism and the exact clinical importance of this response remains to be cleared by further studies.
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Affiliation(s)
- Nurinnisa Ozturk
- Ataturk University Faculty of Medicine, Department of Medical Biochemistry, Erzurum, Turkey
| | - Nurcan Kilic Baygutalp
- Ataturk University Faculty of Medicine, Department of Medical Biochemistry, Erzurum, Turkey
| | - Ebubekir Bakan
- Ataturk University Faculty of Medicine, Department of Medical Biochemistry, Erzurum, Turkey
| | - Gulsum Feyza Altas
- Dokuz Eylul University Faculty of Medicine, Department of Medical Biochemistry, Erzurum, Turkey
| | - Harun Polat
- Ataturk University Faculty of Medicine, Department of Medical Biochemistry, Erzurum, Turkey
| | - Emrullah Dorman
- Ataturk University Faculty of Medicine, Department of Medical Biochemistry, Erzurum, Turkey
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29
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mTORC1 promotes aging-related venous thrombosis in mice via elevation of platelet volume and activation. Blood 2016; 128:615-24. [PMID: 27288518 DOI: 10.1182/blood-2015-10-672964] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 05/17/2016] [Indexed: 12/14/2022] Open
Abstract
Aging is associated with an increased incidence of venous thromboembolism (VTE), resulting in significant morbidity and mortality in the elderly. Platelet hyperactivation is linked to aging-related VTE. However, the mechanisms through which aging enhances platelet activation and susceptibility to VTE are poorly understood. In this study, we demonstrated that mechanistic target of rapamycin complex 1 (mTORC1) signaling is essential for aging-related platelet hyperactivation and VTE. mTORC1 was hyperactivated in platelets and megakaryocytes (MKs) from aged mice, accompanied by elevated mean platelet volume (MPV) and platelet activation. Inhibition of mTORC1 with rapamycin led to a significant reduction in susceptibility to experimental deep vein thrombosis (DVT) in aged mice (P < .01). To ascertain the specific role of platelet mTORC1 activation in DVT, we generated mice with conditional ablation of the mTORC1-specific component gene Raptor in MKs and platelets (Raptor knockout). These mice developed markedly smaller and lighter thrombi, compared with wild-type littermates (P < .01) in experimental DVT. Mechanistically, increased reactive oxygen species (ROS) production with aging induced activation of mTORC1 in MKs and platelets, which, in turn, enhanced bone marrow MK size, MPV, and platelet activation to promote aging-related VTE. ROS scavenger administration induced a significant decrease (P < .05) in MK size, MPV, and platelet activation in aged mice. Our findings collectively demonstrate that mTORC1 contributes to enhanced venous thrombotic susceptibility in aged mice via elevation of platelet size and activation.
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30
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Comparison of atherogenic risk factors among poorly controlled and well-controlled adolescent phenylketonuria patients. Cardiol Young 2016; 26:901-8. [PMID: 26278115 DOI: 10.1017/s104795111500150x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous studies investigating the known risk factors of atherosclerosis in phenylketonuria patients have shown conflicting results. The primary aim of our study was to investigate the serum atherogenic markers in adolescent classical phenylketonuria patients and compare these parameters with healthy peers. The secondary aim was to compare these atherogenic markers in well-controlled and poorly controlled patients. METHODS A total of 59 patients (median age: 12.6 years, range: 11-17 years) and 44 healthy controls (median age: 12.0 years, range: 11-15 years) were enrolled in our study. Phenylketonuria patients were divided into two groups: well-controlled (serum phenylalanine levels below 360 µmol/L; 24 patients) and poorly controlled patients (serum phenylalanine levels higher than 360 µmol/L). RESULTS The mean high-density lipoprotein cholesterol levels of well-controlled patients (1.0±0.2 mmol/L) were significantly lower compared with poorly controlled patients and controls (1.1±0.2 mmol/L, p=0.011 and 1.4±0.2 mmol/L, p<0.001, respectively). Poorly controlled patients had lower high-density lipoprotein cholesterol levels than healthy controls (p=0.003). Homocysteine levels of both well-controlled (9.8±6.4 µmol/L) and poorly controlled (9.2±5.6 µmol/L) patients were higher compared with controls (5.8±1.8 µmol/L, p<0.01). The mean platelet volume of well-controlled patients (9.5±1.1 fL) was higher than that of poorly controlled patients and controls (8.9±0.8 fL, p=0.024 and 7.7±0.6 fL, p<0.001, respectively). CONCLUSION Lower high-density lipoprotein cholesterol and higher homocysteine and mean platelet volume levels were detected in phenylketonuria patients. In particular, these changes were more prominent in well-controlled patients. We conclude that phenylketonuria patients might be at risk for atherosclerosis, and therefore screening for atherosclerotic risk factors should be included in the phenylketonuria therapy and follow-up in addition to other parameters.
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31
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Carubbi C, Masselli E, Martini S, Galli D, Aversa F, Mirandola P, Italiano JE, Gobbi G, Vitale M. Human thrombopoiesis depends on Protein kinase Cδ/protein kinase Cε functional couple. Haematologica 2016; 101:812-20. [PMID: 27081176 DOI: 10.3324/haematol.2015.137984] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 04/12/2016] [Indexed: 01/12/2023] Open
Abstract
A deeper understanding of the molecular events driving megakaryocytopoiesis and thrombopoiesis is essential to regulate in vitro and in vivo platelet production for clinical applications. We previously documented the crucial role of PKCε in the regulation of human and mouse megakaryocyte maturation and platelet release. However, since several data show that different PKC isoforms fulfill complementary functions, we targeted PKCε and PKCδ, which show functional and phenotypical reciprocity, at the same time as boosting platelet production in vitro. Results show that PKCδ, contrary to PKCε, is persistently expressed during megakaryocytic differentiation, and a forced PKCδ down-modulation impairs megakaryocyte maturation and platelet production. PKCδ and PKCε work as a functional couple with opposite roles on thrombopoiesis, and the modulation of their balance strongly impacts platelet production. Indeed, we show an imbalance of PKCδ/PKCε ratio both in primary myelofibrosis and essential thrombocythemia, featured by impaired megakaryocyte differentiation and increased platelet production, respectively. Finally, we demonstrate that concurrent molecular targeting of both PKCδ and PKCε represents a strategy for in vitro platelet factories.
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Affiliation(s)
- Cecilia Carubbi
- Department of Biomedical, Biotechnological and Translational Sciences (SBiBiT), University of Parma, Italy
| | - Elena Masselli
- Department of Biomedical, Biotechnological and Translational Sciences (SBiBiT), University of Parma, Italy
| | - Silvia Martini
- Department of Biomedical, Biotechnological and Translational Sciences (SBiBiT), University of Parma, Italy
| | - Daniela Galli
- Department of Biomedical, Biotechnological and Translational Sciences (SBiBiT), University of Parma, Italy
| | - Franco Aversa
- Department of Clinical and Experimental Medicine, University of Parma, Italy
| | - Prisco Mirandola
- Department of Biomedical, Biotechnological and Translational Sciences (SBiBiT), University of Parma, Italy
| | - Joseph E Italiano
- Hematology Division, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - Giuliana Gobbi
- Department of Biomedical, Biotechnological and Translational Sciences (SBiBiT), University of Parma, Italy
| | - Marco Vitale
- Department of Biomedical, Biotechnological and Translational Sciences (SBiBiT), University of Parma, Italy
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32
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Tavares FL, Peichoto ME, Marcelino JR, Barbaro KC, Cirillo MC, Santoro ML, Sano-Martins IS. Platelet participation in the pathogenesis of dermonecrosis induced by Loxosceles gaucho venom. Hum Exp Toxicol 2015; 35:666-76. [PMID: 26253591 DOI: 10.1177/0960327115597983] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Loxosceles gaucho spider venom induces in vitro platelet activation and marked thrombocytopenia in rabbits. Herein, we investigated the involvement of platelets in the development of the dermonecrosis induced by L. gaucho venom, using thrombocytopenic rabbits as a model. L. gaucho venom evoked a drop in platelet and neutrophil counts 4 h after venom injection. Ecchymotic areas at the site of venom inoculation were noticed as soon as 4 h in thrombocytopenic animals but not in animals with initial normal platelet counts. After 5 days, areas of scars in thrombocytopenic animals were also larger, evidencing the marked development of lesions in the condition of thrombocytopenia. Histologically, local hemorrhage, collagen fiber disorganization, and edema were more severe in thrombocytopenic animals. Leukocyte infiltration, predominantly due to polymorphonuclears, was observed in the presence or not of thrombocytopenia. Thrombus formation was demonstrated by immunohistochemistry at the microvasculature, and it occurred even under marked thrombocytopenia. Taken together, platelets have an important role in minimizing not only the hemorrhagic phenomena but also the inflammatory and wound-healing processes, suggesting that cutaneous loxoscelism may be aggravated under thrombocytopenic conditions.
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Affiliation(s)
- F L Tavares
- Centro Universitário Dinâmica das Cataratas, Foz do Iguaçu, Paraná, Brazil Laboratório de Fisiopatologia, Instituto Butantan, São Paulo, Brazil
| | - M E Peichoto
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) e Instituto Nacional de Medicina Tropical (INMeT), Puerto Iguazú, Misiones, Argentina
| | - J R Marcelino
- Divisão de Desenvolvimento Tecnológico e Produção, Instituto Butantan, São Paulo, Brazil
| | - K C Barbaro
- Laboratório de Imunopatologia, Instituto Butantan, São Paulo, Brazil
| | - M C Cirillo
- Laboratório de Fisiopatologia, Instituto Butantan, São Paulo, Brazil
| | - M L Santoro
- Laboratório de Fisiopatologia, Instituto Butantan, São Paulo, Brazil
| | - I S Sano-Martins
- Laboratório de Fisiopatologia, Instituto Butantan, São Paulo, Brazil
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33
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Weth D, Benetti C, Rauch C, Gstraunthaler G, Schmidt H, Geisslinger G, Sabbadini R, Proia RL, Kress M. Activated platelets release sphingosine 1-phosphate and induce hypersensitivity to noxious heat stimuli in vivo. Front Neurosci 2015; 9:140. [PMID: 25954148 PMCID: PMC4406086 DOI: 10.3389/fnins.2015.00140] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 04/04/2015] [Indexed: 11/19/2022] Open
Abstract
At the site of injury activated platelets release various mediators, one of which is sphingosine 1-phosphate (S1P). It was the aim of this study to explore whether activated human platelets had a pronociceptive effect in an in vivo mouse model and whether this effect was based on the release of S1P and subsequent activation of neuronal S1P receptors 1 or 3. Human platelets were prepared in different concentrations (10(5)/μl, 10(6)/μl, 10(7)/μl) and assessed in mice with different genetic backgrounds (WT, S1P1 (fl/fl), SNS-S1P1 (-/-), S1P3 (-/-)). Intracutaneous injections of activated human platelets induced a significant, dose-dependent hypersensitivity to noxious thermal stimulation. The degree of heat hypersensitivity correlated with the platelet concentration as well as the platelet S1P content and the amount of S1P released upon platelet activation as measured with LC MS/MS. Despite the significant correlations between S1P and platelet count, no difference in paw withdrawal latency (PWL) was observed in mice with a global null mutation of the S1P3 receptor or a conditional deletion of the S1P1 receptor in nociceptive primary afferents. Furthermore, neutralization of S1P with a selective anti-S1P antibody did not abolish platelet induced heat hypersensitivity. Our results suggest that activated platelets release S1P and induce heat hypersensitivity in vivo. However, the platelet induced heat hypersensitivity was caused by mediators other than S1P.
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Affiliation(s)
- Daniela Weth
- Division of Physiology, Department of Physiology and Medical Physics, Medical University of InnsbruckInnsbruck, Austria
| | - Camilla Benetti
- Division of Physiology, Department of Physiology and Medical Physics, Medical University of InnsbruckInnsbruck, Austria
| | - Caroline Rauch
- Division of Physiology, Department of Physiology and Medical Physics, Medical University of InnsbruckInnsbruck, Austria
| | - Gerhard Gstraunthaler
- Division of Physiology, Department of Physiology and Medical Physics, Medical University of InnsbruckInnsbruck, Austria
| | - Helmut Schmidt
- Pharmazentrum Frankfurt/ZAFES, Institute of Clinical PharmacologyFrankfurt, Germany
| | - Gerd Geisslinger
- Pharmazentrum Frankfurt/ZAFES, Institute of Clinical PharmacologyFrankfurt, Germany
| | | | - Richard L. Proia
- Genetics of Development and Disease Branch, National Institute of Diabetes and Digestive and Kidney DiseasesBethesda, MD, USA
| | - Michaela Kress
- Division of Physiology, Department of Physiology and Medical Physics, Medical University of InnsbruckInnsbruck, Austria
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Comparative analysis of human ex vivo-generated platelets vs megakaryocyte-generated platelets in mice: a cautionary tale. Blood 2015; 125:3627-36. [PMID: 25852052 DOI: 10.1182/blood-2014-08-593053] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 03/30/2015] [Indexed: 02/06/2023] Open
Abstract
Thrombopoiesis is the process by which megakaryocytes release platelets that circulate as uniform small, disc-shaped anucleate cytoplasmic fragments with critical roles in hemostasis and related biology. The exact mechanism of thrombopoiesis and the maturation pathways of platelets released into the circulation remain incompletely understood. We showed that ex vivo-generated murine megakaryocytes infused into mice release platelets within the pulmonary vasculature. Here we now show that infused human megakaryocytes also release platelets within the lungs of recipient mice. In addition, we observed a population of platelet-like particles (PLPs) in the infusate, which include platelets released during ex vivo growth conditions. By comparing these 2 platelet populations to human donor platelets, we found marked differences: platelets derived from infused megakaryocytes closely resembled infused donor platelets in morphology, size, and function. On the other hand, the PLP was a mixture of nonplatelet cellular fragments and nonuniform-sized, preactivated platelets mostly lacking surface CD42b that were rapidly cleared by macrophages. These data raise a cautionary note for the clinical use of human platelets released under standard ex vivo conditions. In contrast, human platelets released by intrapulmonary-entrapped megakaryocytes appear more physiologic in nature and nearly comparable to donor platelets for clinical application.
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Zhang Q, Ding D, Liu X, Guo SW. Activated Platelets Induce Estrogen Receptor β Expression in Endometriotic Stromal Cells. Gynecol Obstet Invest 2015; 80:187-92. [PMID: 25766517 DOI: 10.1159/000377629] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/26/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Endometriosis is viewed first and foremost as an estrogen-dependent disease, featuring not only excessive estrogen production but also aberrant expression of estrogen receptors (ERs), particularly ERβ, that mediate the estrogen action. ERβ is the predominant ER in mediating estrogen action in endometriosis, and estrogen plays a vital role in the development of endometriosis; thus, ERβ is viewed as a strong candidate for therapeutic targeting. Given our recent finding that platelets aggregate in endometriotic lesions, we sought to investigate whether activated platelets can upregulate ERβ. METHODS Using primary endometriotic stromal cells derived from patients with ovarian endometriomas and platelets harvested from healthy donors, we performed real-time RT-PCR analysis of mRNA abundance (n = 8) and Western blot analysis of protein expression (n = 8) of ERα and ERβ when co-cultured with phosphate-buffered saline, platelets, thrombin alone, and platelets plus thrombin for 48 h. RESULTS Treatment of endometriotic stromal cells with activated platelets resulted in the upregulation of ERβ gene and protein expression. CONCLUSION In the presence of aggregated and thus activated platelets in endometriotic lesions, ERβ, but not ERα, is upregulated in endometriotic stromal cells. Our result suggests that the use of antiplatelet therapy may have potential in the treatment of endometriosis.
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Affiliation(s)
- Qi Zhang
- Shanghai OB/GYN Hospital, Fudan University, Shanghai, PR China
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Sadoul K. New explanations for old observations: marginal band coiling during platelet activation. J Thromb Haemost 2015; 13:333-46. [PMID: 25510620 DOI: 10.1111/jth.12819] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 12/07/2014] [Indexed: 11/26/2022]
Abstract
Blood platelets are tiny cell fragments derived from megakaryocytes. Their primary function is to control blood vessel integrity and ensure hemostasis if a vessel wall is damaged. Circulating quiescent platelets have a flat, discoid shape maintained by a circumferential microtubule bundle, called the marginal band (MB). In the case of injury platelets are activated and rapidly adopt a spherical shape due to microtubule motor-induced elongation and subsequent coiling of the MB. Platelet activation and shape change can be transient or become irreversible. This depends on the strength of the activation stimulus, which is translated into a cytoskeletal crosstalk between microtubules, their motors and the actomyosin cortex, ensuring stimulus-response coupling. Following microtubule motor-driven disc-to-sphere transition, a strong stimulus will lead to compression of the sphere through actomyosin cortex contraction. This will concentrate the granules in the center of the platelet and accelerate their exocytosis. Once granules are released, platelets have crossed the point of no return to irreversible activation. This review summarizes the current knowledge of the molecular mechanism leading to platelet shape change, with a special emphasis on microtubules, and refers to previously published observations, which have been essential for generating an integrated view of cytoskeletal rearrangements during platelet activation.
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Affiliation(s)
- K Sadoul
- University Grenoble Alpes, IAB, Grenoble, France; INSERM, IAB, Grenoble, France; CHU de Grenoble, IAB, Grenoble, France
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Stefanini L, Paul DS, Robledo RF, Chan ER, Getz TM, Campbell RA, Kechele DO, Casari C, Piatt R, Caron KM, Mackman N, Weyrich AS, Parrott MC, Boulaftali Y, Adams MD, Peters LL, Bergmeier W. RASA3 is a critical inhibitor of RAP1-dependent platelet activation. J Clin Invest 2015; 125:1419-32. [PMID: 25705885 DOI: 10.1172/jci77993] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/13/2015] [Indexed: 01/15/2023] Open
Abstract
The small GTPase RAP1 is critical for platelet activation and thrombus formation. RAP1 activity in platelets is controlled by the GEF CalDAG-GEFI and an unknown regulator that operates downstream of the adenosine diphosphate (ADP) receptor, P2Y12, a target of antithrombotic therapy. Here, we provide evidence that the GAP, RASA3, inhibits platelet activation and provides a link between P2Y12 and activation of the RAP1 signaling pathway. In mice, reduced expression of RASA3 led to premature platelet activation and markedly reduced the life span of circulating platelets. The increased platelet turnover and the resulting thrombocytopenia were reversed by concomitant deletion of the gene encoding CalDAG-GEFI. Rasa3 mutant platelets were hyperresponsive to agonist stimulation, both in vitro and in vivo. Moreover, activation of Rasa3 mutant platelets occurred independently of ADP feedback signaling and was insensitive to inhibitors of P2Y12 or PI3 kinase. Together, our results indicate that RASA3 ensures that circulating platelets remain quiescent by restraining CalDAG-GEFI/RAP1 signaling and suggest that P2Y12 signaling is required to inhibit RASA3 and enable sustained RAP1-dependent platelet activation and thrombus formation at sites of vascular injury. These findings provide insight into the antithrombotic effect of P2Y12 inhibitors and may lead to improved diagnosis and treatment of platelet-related disorders.
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Johnston LR, La Flamme AC, Larsen PD, Harding SA. Prasugrel inhibits platelet-enhanced pro-inflammatory CD4+ T cell responses in humans. Atherosclerosis 2015; 239:283-6. [PMID: 25635327 DOI: 10.1016/j.atherosclerosis.2015.01.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 12/14/2014] [Accepted: 01/07/2015] [Indexed: 12/17/2022]
Abstract
While platelets have well characterized effects on monocytes, the effect of platelet activation on CD4+ T-cell differentiation and cytokine production is not clear. To examine the effects of platelet T-cell interactions on T-cell phenotype, and whether these interactions were altered by prasugrel, we conducted a randomized, double-blind, placebo-controlled crossover study in healthy subjects. At baseline the addition of platelets to CD4+ T-cells resulted in an increase in the release of pro-inflammatory cytokine IFN-γ (192% increase in IFN-γ levels, p = 0.01) and pro-inflammatory CD4+ phenotypes, (38% and 58% increase in Th1 and Th17 phenotypic markers respectively, p = 0.01) but no change in Tregs. Prasugrel abolished the effects of platelets on CD4+ T-cells with similar levels of pro-inflammatory cytokines and cell numbers to T-cells stimulated. Antiplatelet therapy may provide therapeutic benefit both from direct platelet inhibition and also through indirect effects on immune response development.
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Affiliation(s)
- L R Johnston
- Victoria University of Wellington, Wellington, New Zealand; Wellington Cardiovascular Research Group, Wellington, New Zealand.
| | - A C La Flamme
- Victoria University of Wellington, Wellington, New Zealand; Wellington Cardiovascular Research Group, Wellington, New Zealand; Malaghan Institute of Medical Research, Wellington, New Zealand
| | - P D Larsen
- Victoria University of Wellington, Wellington, New Zealand; Wellington Cardiovascular Research Group, Wellington, New Zealand; University of Otago, Wellington, New Zealand
| | - S A Harding
- Victoria University of Wellington, Wellington, New Zealand; Wellington Cardiovascular Research Group, Wellington, New Zealand; Department of Cardiology, Wellington Hospital, Wellington, New Zealand
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Cattaneo M. The platelet P2 receptors in inflammation. Hamostaseologie 2015; 35:262-6. [PMID: 25579761 DOI: 10.5482/hamo-14-09-0044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 12/18/2014] [Indexed: 12/13/2022] Open
Abstract
UNLABELLED In addition to their well characterized and established role in haemostasis and thrombosis, platelets contribute to the pathogenesis of inflammation. Adenine nucleotides are signalling molecules that regulate the function of virtually every cell in the body, by interacting with P2 receptors. Their important role in inflammation is well established. In the last few years, the pro-inflammatory roles of adenine nucleotides interacting with their platelet P2 receptors has emerged. In particular, it was shown that the platelet P2Y12 receptor for ADP significantly contributed to the pro-inflammatory effects of cysteinyl leukotrienes (CysLT) in experimental models of asthma in mice. More importantly, it was recently shown that P2Y12 variants were associated with lung function in a large family-based asthma cohort and that the P2Y12 antagonist prasugrel tended to decrease bronchial hyper-reactivity to mannitol in patients with allergic bronchial asthma in a randomized, placebo controlled trial. CONCLUSION These data strongly suggest that P2Y12 may represent an important pharmacological target for the treatment of patients with allergic bronchial asthma.
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Affiliation(s)
- M Cattaneo
- Marco Cattaneo, MD, Divisione di Medicina Generale III, Azienda Ospedaliera San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Via di Rudinì, 8, 20142 Milano, Italy, Tel. +39/02 50 32 30-95, Fax -89
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Lussana F, Di Marco F, Terraneo S, Parati M, Razzari C, Scavone M, Femia EA, Moro A, Centanni S, Cattaneo M. Effect of prasugrel in patients with asthma: results of PRINA, a randomized, double-blind, placebo-controlled, cross-over study. J Thromb Haemost 2015; 13:136-41. [PMID: 25387888 DOI: 10.1111/jth.12779] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Indexed: 01/24/2023]
Abstract
BACKGROUND Although experimental studies have demonstrated that platelets are proinflammatory cells, no randomized studies have tested the anti-inflammatory effect of antiplatelet agents in humans. The platelet P2Y12 receptors mediated bronchial inflammation in a mouse model of asthma, suggesting that P2Y12 represents a pharmacologic target for asthma. OBJECTIVES In this proof-of concept, placebo-controlled, randomized, cross-over study, we tested the effects of the P2Y12 antagonist prasugrel on bronchial hyperreactivity of asthmatic patients. PATIENTS/METHODS Twenty-six asthmatic patients were randomly and blindly allocated to prasugrel (10 mg once daily) or placebo for 15 days. After a ≥ 15-day wash-out, patients were crossed over to the alternative treatment. Before and after each treatment, patients underwent a bronchial provocation test with mannitol and measurement of fractional exhaled nitric oxide (FeNO). Inhibition of P2Y12 -dependent platelet reactivity (platelet reactivity index [PRI]) was measured with the vasodilator-stimulated phosphoprotein phosphorylation assay. RESULTS The provocative dose of mannitol causing a 15% drop in forced expiratory volume in 1 s increased from 142 mg (95% confidence interval [CI] 82-202) to 187 mg (95% CI 113-262) after prasugrel treatment (P = 0.09), and did not change after placebo treatment (136 mg [95% CI 76-196] and 144 mg [95% CI 84-204], P = 0.65). FeNO did not change after either treatment. The PRI decreased from 80% (95% CI 77-83) to 23% (95% CI 7-29) after prasugrel treatment (P < 0.001) and remained unchanged after placebo. CONCLUSIONS Our proof-of-concept, randomized, controlled study is the first one to test in vivo the anti-inflammatory effects of platelet inhibition in human patients. The results suggest that pharmacologic inhibition of P2Y12 receptors may slightly reduce the bronchial inflammatory burden, and lay the groundwork for further studies, with clinical endpoints.
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Affiliation(s)
- F Lussana
- Divisione di Medicina Generale III, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy; Divisione di Ematologia, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
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Berndt MC, Metharom P, Andrews RK. Primary haemostasis: newer insights. Haemophilia 2014; 20 Suppl 4:15-22. [PMID: 24762270 DOI: 10.1111/hae.12427] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2014] [Indexed: 12/18/2022]
Abstract
At the same time as biophysical and omics approaches are drilling deeper into the molecular details of platelets and other blood cells, as well as their receptors and mechanisms of regulation, there is also an increasing awareness of the functional overlap between human vascular systems. Together, these studies are redefining the intricate networks linking haemostasis and thrombosis with inflammation, infectious disease, cancer/metastasis and other vascular pathophysiology. The focus of this state-of-the-art review is some of the newer advances relevant to primary haemostasis. Of particular interest, platelet-specific primary adhesion-signalling receptors and associated activation pathways control platelet function in flowing blood and provide molecular links to other systems. Platelet glycoprotein (GP)Ibα of the GPIb-IX-V complex and GPVI not only initiate platelet aggregation and thrombus formation by primary interactions with von Willebrand factor and collagen, respectively, but are also involved in coagulation, leucocyte engagement, bacterial or viral interactions, and are relevant as potential risk markers in a range of human diseases. Understanding these systems in unprecedented detail promises significant advances in evaluation of individual risk, in new diagnostic or therapeutic possibilities and in monitoring the response to drugs or other treatment.
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Affiliation(s)
- M C Berndt
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
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Schattner M. Platelets and galectins. ANNALS OF TRANSLATIONAL MEDICINE 2014; 2:85. [PMID: 25405160 DOI: 10.3978/j.issn.2305-5839.2014.09.02] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 09/11/2014] [Indexed: 01/09/2023]
Abstract
A major function of platelets is keeping the vascular system intact. Platelet activation at sites of vascular injury leads to the formation of a hemostatic plug. Activation of platelets is therefore crucial for normal hemostasis; however, uncontrolled platelet activation may also lead to the formation of occlusive thrombi that can cause ischemic events. Although they are essential for proper hemostasis, platelet function extends to physiologic processes such as tissue repair, wound remodeling and antimicrobial host defense, or pathologic conditions such as thrombosis, atherosclerosis, chronic inflammatory diseases and cancer. Platelets can be activated by soluble molecules including thrombin, thromboxane A2 (TXA2), adenosine diphosphate (ADP), serotonin or by adhesive extracellular matrix (ECM) proteins such as von Willebrand factor (vWF) and collagen. Here we describe recent advances in the activation of platelets by non-canonical platelet agonists such as galectins. By acting either in soluble or immobilized form, these glycan-binding proteins trigger all platelet activation responses through modulation of discrete signaling pathways. We also offer new hypotheses and some speculations about the role of platelet-galectin interactions not only in hemostasis and thrombosis but also in inflammation and related diseases such as atherosclerosis and cancer.
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Affiliation(s)
- Mirta Schattner
- Laboratory of Experimental Thrombosis, Institute of Experimental Medicine-CONICET, National Academy of Medicine, Buenos Aires, Argentina
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Tanju C, Ekrem G, Berksoy Emel A, Nur A. Mean platelet volume as a negative marker of inflammation in children with rotavirus gastroenteritis. IRANIAN JOURNAL OF PEDIATRICS 2014; 24:617-22. [PMID: 25793071 PMCID: PMC4359417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 01/15/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Mean platelet volume (MPV) is a determinant of inflammation. The aim of the present study was to investigate the MPV levels in children with rotavirus gastroenteritis and to evaluate the possible relationship between MPV and severity of gastroenteritis. METHODS Children diagnosed with acute rotavirus gastroenteritis and healthy controls were enrolled in this study. Patients were classified into three disease severity groups based on their Vesikari score (<7 mild, 7-10 moderate and >11 severe). Rotavirus was determined in fresh stool samples using ELISA test. Leukocyte and platelet counts, MPV and C-reactive protein (CRP) levels were assessed for all children. FINDINGS A total of 151 patients with rotavirus gastroenteritis (mean age 2.41± 0.14 years) and 80 healthy controls (mean age 2.63±0.22 years, P=0.129) were enrolled. MPV levels of children with rotavirus gastroenteritis were significantly lower than those of healthy peers (7.48±0.04 vs 7.79±0.07 fl, P=0.000). MPV levels were not significantly different among three gastroenteritis groups. Gastroenteritis score was positively correlated with leukocyte (r=0.670, P<0.01) and platelet count (r=0.159, P<0.05) and CRP level (r=0.256, P<0.01) in patients group. MPV was inversely correlated with platelet count. There was no significant correlation between MPV and gastroenteritis score. CONCLUSION MPV levels were significantly lower in children with rotavirus gastroenteritis compared to controls. MPV can be used as a negative acute phase reactant in children with rotavirus gastroenteritis.
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Affiliation(s)
- Celik Tanju
- Department of Pediatric Emergency, Dr. Behcet Uz Children’s Hospital, Izmir
| | - Güler Ekrem
- Department of Pediatric Emergency, Dr. Sütçü Imam University, Faculty of Medicine, Maras
| | - Atas Berksoy Emel
- Department of Pediatric Emergency, Dr. Behcet Uz Children’s Hospital, Izmir
| | - Arslan Nur
- Division of Pediatric Gastroenterology, Dokuz Eylul University, Faculty of Medicine, Hepatology and Nutrition, Izmir, Turkey
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Hasselbalch HC. The platelet–cancer loop in myeloproliferative cancer. Is thrombocythemia an enhancer of cancer invasiveness and metastasis in essential thrombocythemia, polycythemia vera and myelofibrosis? Leuk Res 2014; 38:1230-6. [DOI: 10.1016/j.leukres.2014.07.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 06/26/2014] [Accepted: 07/14/2014] [Indexed: 02/08/2023]
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Shteinshnaider M, Barchel D, Almoznino-Sarafian D, Tzur I, Tsatsanashvili N, Swarka M, Cohen N, Gorelik O. Clinical characteristics and prognostic significance of changes in platelet count in an internal medicine ward. Eur J Intern Med 2014; 25:646-51. [PMID: 24954704 DOI: 10.1016/j.ejim.2014.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 05/29/2014] [Accepted: 05/31/2014] [Indexed: 12/20/2022]
Abstract
BACKGROUND The clinical characteristics and prognostic significance of changes in platelet count (PC) during hospitalization in internal medicine wards have not been well investigated. METHODS Demographic, clinical and laboratory data were collected from 345 patients admitted to an internal medicine ward. Following discharge, all-cause mortality was recorded. These data were compared, according to deltaPC (PC on discharge minus PC on admission): group 1 (drop in PC, deltaPC -50×10(9)/l), group 2 (no significant PC changes, deltaPC up to 50×10(9)/l) and group 3 (rise in PC, deltaPC +50×10(9)/l). RESULTS Groups 1, 2 and 3 comprised 64 (18.5%), 200 (58%) and 81 (23.5%) patients, respectively. Patients from group 3 were younger, more likely admitted for infection and less likely for cardiovascular disorder, and less often presenting with coronary artery disease, complex nursing care and thrombocytosis on admission or thrombocytopenia on discharge than patients from groups 1 and 2. Mean platelet volume was higher in group 2 on admission and lower in group 3 on discharge. During a median follow-up of 25 months, 146 (42.3%) of 345 patients died. The survival rate was higher for group 3 (65.4%) than for groups 1 (45.3%) and 2 (58.5%), p=0.003. In the entire cohort, each 100×10(9)/l increment of deltaPC was a powerful predictor of lower mortality (p=0.03, relative risk=0.83, 95% confidence interval=0.71-0.98). CONCLUSIONS Increased PC throughout hospitalization was associated with better prognosis than a drop or blunted rise in PC. The assessment of PC changes in an internal medicine ward may provide useful prognostic information.
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Affiliation(s)
- Miriam Shteinshnaider
- Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel
| | - Dana Barchel
- Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel
| | - Dorit Almoznino-Sarafian
- Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel
| | - Irma Tzur
- Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel
| | - Neli Tsatsanashvili
- Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel
| | - Muhareb Swarka
- Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel
| | - Natan Cohen
- Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel
| | - Oleg Gorelik
- Department of Internal Medicine "F," Assaf Harofeh Medical Center (affiliated to Sackler School of Medicine, Tel Aviv University), Zerifin, Israel.
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Abstract
Paraneoplastic thrombocytosis is associated with many solid tumors and often correlates with reduced survival. Recent studies suggest that a pathogenic feed back loop may be operative between platelets and tumor cells, with reciprocal interactions between tumor growth/metastasis and thrombocytosis/platelet activation. Specific molecular pathways have been identified in which tumors can stimulate platelet production and activation; activated platelets can, in turn, promote tumor growth and metastasis. Taken together, these findings provide exciting new potential targets for therapeutic intervention.
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47
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Corken A, Russell S, Dent J, Post SR, Ware J. Platelet glycoprotein Ib-IX as a regulator of systemic inflammation. Arterioscler Thromb Vasc Biol 2014; 34:996-1001. [PMID: 24504734 DOI: 10.1161/atvbaha.113.303113] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The platelet glycoprotein Ib-IX (GP Ib-IX) receptor is a well-characterized adhesion receptor supporting hemostasis and thrombosis via interactions with von Willebrand factor. We examine the GP Ib-IX/von Willebrand factor axis in murine polymicrobial sepsis, as modeled by cecal ligation and puncture (CLP). APPROACH AND RESULTS Genetic absence of the GP Ib-IX ligand, von Willebrand factor, prolongs survival after CLP, but absence of the receptor, GP Ib-IX, does not. Because absence of either von Willebrand factor or GP Ib-IX significantly impairs hemostasis and thrombosis, we sought to define additional GP Ib-IX-dependent pathways impacting survival in the CLP model. We document that the absence of GP Ib-IX leads to reduced platelet-neutrophil and platelet-monocyte interactions. Twenty-four hours after CLP, absence of GP Ib-IX coincides with an alteration in cytokine levels, such as tumor necrosis factor-α secreted by monocytes, and increased macrophage-1 antigen expression by neutrophils. CONCLUSIONS In contrast to the well-characterized proinflammatory properties of platelets, we describe in the CLP model an anti-inflammatory property associated with platelet GP Ib-IX. Thus, a single platelet receptor displays a dual modulatory role in both the thrombotic and inflammatory pathways associated with polymicrobial sepsis. In sharing leucine-rich motifs with toll-like receptors, platelet GP Ib-IX can be considered a multifunctional participant in hemostasis, thrombosis, and the inflammatory cascade. The results highlight a dynamic role for platelets in systemic inflammation and add to the complex pathophysiologic events that occur during the dysregulated coagulation and inflammation associated with sepsis.
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Affiliation(s)
- Adam Corken
- From the Departments of Physiology and Biophysics (A.C., S.R., J.D., J.W.) and Pathology (S.R.P.), University of Arkansas for Medical Sciences, Little Rock
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