1
|
Davizon‐Castillo P, Allawzi A, Sorrells M, Fisher S, Baltrunaite K, Neeves K, Nozik‐Grayck E, DiPaola J, Delaney C. Platelet activation in experimental murine neonatal pulmonary hypertension. Physiol Rep 2020; 8:e14386. [PMID: 32163236 PMCID: PMC7066872 DOI: 10.14814/phy2.14386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 11/24/2022] Open
Abstract
Serotonin (5-HT) contributes to the pathogenesis of experimental neonatal pulmonary hypertension (PH) associated with bronchopulmonary dysplasia (BPD). Platelets are the primary source of circulating 5-HT and is released upon platelet activation. Platelet transfusions are associated with neonatal mortality and increased rates of BPD. As BPD is often complicated by PH, we tested the hypothesis that circulating platelets are activated and also increased in the lungs of neonatal mice with bleomycin-induced PH associated with BPD. Newborn wild-type mice received intraperitoneal bleomycin (3 units/kg) three times weekly for 3 weeks. Platelets from mice with experimental PH exhibited increased adhesion to collagen under flow (at 300 s-1 and 1,500 s-1 ) and increased expression of the αIIbβ3 integrin and phosphatidylserine, markers of platelet activation. Platelet-derived factors 5-HT and platelet factor 4 were increased in plasma from mice with experimental PH. Pharmacologic blockade of the 5-HT 2A receptor (5-HT 2A R) prevents bleomycin-induced PH and pulmonary vascular remodeling. Here, platelets from mice with bleomycin-induced PH demonstrate increased 5-HT 2A R expression providing further evidence of both platelet activation and increased 5-HT signaling in this model. In addition, bleomycin treatment increased lung platelet accumulation. In summary, platelets are activated, granule factors are released, and are increased in numbers in the lungs of mice with experimental neonatal PH. These results suggest platelet activation and release of platelet-derived factors may increase vascular tone, promote aberrant angiogenesis, and contribute to the development of neonatal PH.
Collapse
Affiliation(s)
- Pavel Davizon‐Castillo
- Section of Pediatric Hematology, Oncology, and Bone Marrow TransplantUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Ayed Allawzi
- Section of Pediatric Critical Care and Cardiovascular Pulmonary Research LaboratoryUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Matthew Sorrells
- Department of Chemical and Biological EngineeringColorado School of MinesGoldenCOUSA
| | - Susan Fisher
- Section of NeonatologyDepartment of PediatricsUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Kristina Baltrunaite
- Section of NeonatologyDepartment of PediatricsUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Keith Neeves
- Section of Pediatric Hematology, Oncology, and Bone Marrow TransplantUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Department of BioengineeringUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Eva Nozik‐Grayck
- Section of Pediatric Critical Care and Cardiovascular Pulmonary Research LaboratoryUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Jorge DiPaola
- Division of Pediatric Hematology OncologyWashington University in St. LouisSt. LouisMOUSA
| | - Cassidy Delaney
- Section of NeonatologyDepartment of PediatricsUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| |
Collapse
|
2
|
Vrigkou E, Tsangaris I, Bonovas S, Kopterides P, Kyriakou E, Konstantonis D, Pappas A, Anthi A, Gialeraki A, Orfanos SE, Armaganidis A, Tsantes A. Platelet and coagulation disorders in newly diagnosed patients with pulmonary arterial hypertension. Platelets 2018; 30:646-651. [PMID: 30047809 DOI: 10.1080/09537104.2018.1499890] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There is a complex and not fully elucidated association between pulmonary arterial hypertension (PAH) and coagulation disorders. The goal of this study was to evaluate platelet function, coagulation and fibrinolysis in PAH patients at diagnosis, before PAH-specific treatment initiation. We enrolled 20 healthy controls and 30 PAH patients (20 with connective tissue disease (CTD-PAH) and 10 idiopathic (iPAH)). None of the participants was on any antiplatelet or anticoagulation therapy. Blood samples from PAH patients were collected during the initial right heart catheterization. All subjects were assessed with platelet function analyzer-100 (PFA-100), epinephrine (Epi) and ADP-induced light transmission aggregometry (LTA), thromboelastometry (ROTEM) and endogenous thrombin potential (ETP). Our results showed that Epi and ADP-LTA values were significantly lower in newly diagnosed PAH patients compared to controls. Disaggregation was present in 73% of patients, a characteristic not seen in healthy individuals. In ROTEM assay, CT and CFT measurements were significantly higher and a angle lower compared to controls. ETP testing revealed significantly reduced outcomes in AUC, Cmax and Tmax. When CTD-PAH and iPAH patient groups were compared, iPAH ADP-LTA values were significantly decreased compared to CTD-PAH. In conclusion, newly diagnosed PAH patients presented with decreased platelet aggregation, clot propagation and thrombin generation, along with delayed initiation of the coagulation process. These hemostatic deficits could indicate an "exhaustion" of the coagulation process that could be caused by endothelial dysfunction and chronic activation of the procoagulant pathways. Further studies are warranted to confirm these laboratory findings and assess their potential clinical significance.
Collapse
Affiliation(s)
- Eleni Vrigkou
- a Second Department of Critical Care Medicine , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Iraklis Tsangaris
- a Second Department of Critical Care Medicine , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Stefanos Bonovas
- b Humanitas University , Department of Biomedical Sciences , Milan , Italy.,c Humanitas Clinical and Research Center , Milan , Italy
| | - Petros Kopterides
- a Second Department of Critical Care Medicine , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Elias Kyriakou
- d Laboratory of Hematology & Blood Bank Unit , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Dimitrios Konstantonis
- a Second Department of Critical Care Medicine , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Athanasios Pappas
- a Second Department of Critical Care Medicine , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Anastasia Anthi
- a Second Department of Critical Care Medicine , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Argyri Gialeraki
- d Laboratory of Hematology & Blood Bank Unit , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Stylianos E Orfanos
- a Second Department of Critical Care Medicine , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Apostolos Armaganidis
- a Second Department of Critical Care Medicine , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| | - Argyrios Tsantes
- d Laboratory of Hematology & Blood Bank Unit , University Hospital Attikon, School of Medicine, National and Kapodistrian University of Athens , Athens , Greece
| |
Collapse
|
3
|
Lannan KL, Phipps RP, White RJ. Thrombosis, platelets, microparticles and PAH: more than a clot. Drug Discov Today 2014; 19:1230-5. [PMID: 24747560 DOI: 10.1016/j.drudis.2014.04.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 04/02/2014] [Indexed: 12/19/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a progressive disease that involves pathological remodeling, vasoconstriction and thrombosis. Alterations in hemostasis, coagulation and platelet activation are consistently observed in PAH patients. Microparticles derived from platelets, inflammatory cells and the endothelium are an increasingly well-recognized signal in a variety of cardiovascular diseases, including PAH. This review will focus on the roles of coagulation, thrombosis, platelet activation and microparticles in the pathology and progression of PAH.
Collapse
Affiliation(s)
- Katie L Lannan
- Department of Microbiology and Immunology, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Richard P Phipps
- Department of Microbiology and Immunology, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Pathology and Laboratory Medicine, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Environmental Medicine, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - R James White
- Aab Cardiovascular Research Institute and Division of Pulmonary and Critical Care Medicine, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA.
| |
Collapse
|
4
|
Maeda NY, Carvalho JH, Otake AH, Mesquita SM, Bydlowski SP, Lopes AA. Platelet protease-activated receptor 1 and membrane expression of P-selectin in pulmonary arterial hypertension. Thromb Res 2010; 125:38-43. [DOI: 10.1016/j.thromres.2009.04.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2009] [Revised: 04/16/2009] [Accepted: 04/22/2009] [Indexed: 10/20/2022]
|