1
|
Cioce A, Cavani A, Cattani C, Scopelliti F. Role of the Skin Immune System in Wound Healing. Cells 2024; 13:624. [PMID: 38607063 PMCID: PMC11011555 DOI: 10.3390/cells13070624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/21/2024] [Accepted: 03/31/2024] [Indexed: 04/13/2024] Open
Abstract
Wound healing is a dynamic and complex process, characterized by the coordinated activities of multiple cell types, each with distinct roles in the stages of hemostasis, inflammation, proliferation, and remodeling. The cells of the immune system not only act as sentinels to monitor the skin and promote homeostasis, but they also play an important role in the process of skin wound repair. Skin-resident and recruited immune cells release cytokines and growth factors that promote the amplification of the inflammatory process. They also work with non-immune cells to remove invading pathogens and debris, as well as guide the regeneration of damaged host tissues. Dysregulation of the immune system at any stage of the process may lead to a prolongation of the inflammatory phase and the development of a pathological condition, such as a chronic wound. The present review aims to summarize the roles of different immune cells, with special emphasis on the different stages of the wound healing process.
Collapse
Affiliation(s)
| | | | | | - Fernanda Scopelliti
- National Institute for Health, Migration and Poverty INMP/NIHMP, Via di S.Gallicano, 25, 00153 Rome, Italy; (A.C.); (A.C.); (C.C.)
| |
Collapse
|
2
|
Pezzanite LM, Chow L, Dow SW, Goodrich LR, Gilbertie JM, Schnabel LV. Antimicrobial Properties of Equine Stromal Cells and Platelets and Future Directions. Vet Clin North Am Equine Pract 2023; 39:565-578. [PMID: 37442729 DOI: 10.1016/j.cveq.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Increasing antimicrobial resistance in veterinary practice has driven the investigation of novel therapeutic strategies including regenerative and biologic therapies to treat bacterial infection. Integration of biological approaches such as platelet lysate and mesenchymal stromal cell (MSC) therapy may represent adjunctive treatment strategies for bacterial infections that minimize systemic side effects and local tissue toxicity associated with traditional antibiotics and that are not subject to antibiotic resistance. In this review, we will discuss mechanisms by which biological therapies exert antimicrobial effects, as well as potential applications and challenges in clinical implementation in equine practice.
Collapse
Affiliation(s)
- Lynn M Pezzanite
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
| | - Lyndah Chow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Steven W Dow
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA; Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Laurie R Goodrich
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Jessica M Gilbertie
- Department of Microbiology and Immunology, Edward Via College of Osteopathic Medicine, Blacksburg, VA, USA
| | - Lauren V Schnabel
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, North Carolina State University, Raleigh, NC, USA; Comparative Medicine Institute, North Carolina State University, Raleigh, NC, USA.
| |
Collapse
|
3
|
Trivigno SMG, Guidetti GF, Barbieri SS, Zarà M. Blood Platelets in Infection: The Multiple Roles of the Platelet Signalling Machinery. Int J Mol Sci 2023; 24:ijms24087462. [PMID: 37108623 PMCID: PMC10138547 DOI: 10.3390/ijms24087462] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
Platelets are classically recognized for their important role in hemostasis and thrombosis but they are also involved in many other physiological and pathophysiological processes, including infection. Platelets are among the first cells recruited to sites of inflammation and infection and they exert their antimicrobial response actively cooperating with the immune system. This review aims to summarize the current knowledge on platelet receptor interaction with different types of pathogens and the consequent modulations of innate and adaptive immune responses.
Collapse
Affiliation(s)
- Silvia M G Trivigno
- Department of Biology and Biotechnology, University of Pavia, 27100 Pavia, Italy
- University School for Advanced Studies, IUSS, 27100 Pavia, Italy
| | | | - Silvia Stella Barbieri
- Unit of Heart-Brain Axis: Cellular and Molecular Mechanisms, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy
| | - Marta Zarà
- Unit of Heart-Brain Axis: Cellular and Molecular Mechanisms, Centro Cardiologico Monzino IRCCS, 20138 Milano, Italy
| |
Collapse
|
4
|
Yuan H, Liu Y, Zhang J, Dong JF, Zhao Z. Transcription factors in megakaryocytes and platelets. Front Immunol 2023; 14:1140501. [PMID: 36969155 PMCID: PMC10034027 DOI: 10.3389/fimmu.2023.1140501] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023] Open
Abstract
Transcription factors bind promoter or regulatory sequences of a gene to regulate its rate of transcription. However, they are also detected in anucleated platelets. The transcription factors RUNX1, GATA1, STAT3, NFκB, and PPAR have been widely reported to play key roles in the pathophysiology of platelet hyper-reactivity, thrombosis, and atherosclerosis. These non-transcriptional activities are independent of gene transcription or protein synthesis but their underlying mechanisms of action remain poorly defined. Genetic and acquired defects in these transcription factors are associated with the production of platelet microvesicles that are known to initiate and propagate coagulation and to promote thrombosis. In this review, we summarize recent developments in the study of transcription factors in platelet generation, reactivity, and production of microvesicles, with a focus on non-transcriptional activities of selected transcription factors.
Collapse
Affiliation(s)
- Hengjie Yuan
- Tianjin Institute of Neurology, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- BloodWorks Research Institute, Seattle, WA, United States
| | - Yafan Liu
- Tianjin Institute of Neurology, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jianning Zhang
- Tianjin Institute of Neurology, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-fei Dong
- BloodWorks Research Institute, Seattle, WA, United States
- Division of Hematology, Department of Medicine, University of Washington, School of Medicine, Seattle, WA, United States
- *Correspondence: Zilong Zhao, ; Jing-fei Dong,
| | - Zilong Zhao
- Tianjin Institute of Neurology, Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- BloodWorks Research Institute, Seattle, WA, United States
- *Correspondence: Zilong Zhao, ; Jing-fei Dong,
| |
Collapse
|
5
|
Huang YF, Su SC, Chuang HY, Chen HH, Twu YC. Histone deacetylation-regulated cell surface Siglec-7 expression promoted megakaryocytic maturation and enhanced platelet-like particle release. J Thromb Haemost 2023; 21:329-343. [PMID: 36700509 DOI: 10.1016/j.jtha.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Functioning as important hematologic cells for hemostasis, wound healing and immune defense platelets are produced before being released into the blood by cytoplasmic fragmentation at the end of the megakaryocyte (MK) differentiation, during which the involvement of both apoptosis and autophagy has been reported. Inhibitory sialic acid-binding immunoglobulin-like lectin-7 gene (Siglec-7) can be expressed on platelets and induce apoptosis on activation for uncharacterized function. OBJECTIVE We aimed to investigate the regulatory mechanism for Siglec-7 activation along MK differentiation and its physiologic role during the MK maturation and platelet formation. METHODS By using 2 well-established MK differentiation models (HEL and K562) and human primary CD34+ cell, we examined the upregulations of transcript and protein levels of Siglec-7 during MK differentiation, and the effect of Siglec-7 surface presence on MK differentiation and platelet-like particles (PLPs) release. RESULTS We show that both transcripts and surface Siglec-7 were elevated during MK differentiation, and the histone deacetylase 1 (HDAC1) acted as a negative regulator for Siglec-7 activation. By increasing Siglec-7 surface expression, we found that increased presence of Siglec-7 not only enhanced MK maturation but also the release of PLPs by activating caspase 3-dependent signaling, as evidenced in the observation of more CD41, polyploidy, and platelet factor 4 transcript formations. CONCLUSION In this study, we demonstrated that Siglec-7 activation was subjected to epigenetic regulation, and the resulting induced expression of surface Siglec-7 played an important regulatory role in promoting MK differentiation, maturation, and PLP formation.
Collapse
Affiliation(s)
- Yun-Fei Huang
- Department of Biotechnology and Laboratory Science in Medicine, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Chi Su
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Hui-Yu Chuang
- Department of Biotechnology and Laboratory Science in Medicine, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsiao-Han Chen
- Department of Biotechnology and Laboratory Science in Medicine, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yuh-Ching Twu
- Department of Biotechnology and Laboratory Science in Medicine, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| |
Collapse
|
6
|
Cognasse F, Hamzeh Cognasse H, Eyraud MA, Prier A, Arthaud CA, Tiberghien P, Begue S, de Korte D, Gouwerok E, Greinacher A, Aurich K, Noorman F, Dumont L, Kelly K, Cloutier M, Bazin R, Cardigan R, Huish S, Smethurst P, Devine D, Schubert P, Johnson L, Marks DC. Assessment of the soluble proteins HMGB1, CD40L and CD62P during various platelet preparation processes and the storage of platelet concentrates: The BEST collaborative study. Transfusion 2023; 63:217-228. [PMID: 36453841 DOI: 10.1111/trf.17200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/22/2022] [Accepted: 10/24/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Structural and biochemical changes in stored platelets are influenced by collection and processing methods. This international study investigates the effects of platelet (PLT) processing and storage conditions on HMGB1, sCD40L, and sCD62P protein levels in platelet concentrate supernatants (PCs). STUDY DESIGN/METHODS PC supernatants (n = 3748) were collected by each international centre using identical centrifugation methods (n = 9) and tested centrally using the ELISA/Luminex platform. Apheresis versus the buffy coat (BC-PC) method, plasma storage versus PAS and RT storage versus cold (4°C) were investigated. We focused on PC preparation collecting samples during early (RT: day 1-3; cold: day 1-5) and late (RT: day 4-7; cold: day 7-10) storage time points. RESULTS HMGB1, sCD40L, and sCD62P concentrations were similar during early storage periods, regardless of storage solution (BC-PC plasma and BC-PC PAS-E) or temperature. During storage and without PAS, sCD40L and CD62P in BC-PC supernatants increased significantly (+33% and +41%, respectively) depending on storage temperature (22 vs. 4°C). However, without PAS-E, levels decreased significantly (-31% and -20%, respectively), depending on storage temperature (22 vs. 4°C). Contrastingly, the processing method appeared to have greater impact on HMGB1 release versus storage duration. These data highlight increases in these parameters during storage and differences between preparation methods and storage temperatures. CONCLUSIONS The HMGB1 release mechanism/intracellular pathways appear to differ from sCD62P and sCD40L. The extent to which these differences affect patient outcomes, particularly post-transfusion platelet increment and adverse events, warrants further investigation in clinical trials with various therapeutic indications.
Collapse
Affiliation(s)
- Fabrice Cognasse
- Établissement Français du Sang Auvergne-Rhône-Alpes (Dpt scientifique), Saint-Étienne, France.,University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Hind Hamzeh Cognasse
- University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Marie Ange Eyraud
- Établissement Français du Sang Auvergne-Rhône-Alpes (Dpt scientifique), Saint-Étienne, France.,University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Amélie Prier
- Établissement Français du Sang Auvergne-Rhône-Alpes (Dpt scientifique), Saint-Étienne, France.,University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Charles Antoine Arthaud
- Établissement Français du Sang Auvergne-Rhône-Alpes (Dpt scientifique), Saint-Étienne, France.,University of Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 SAINBIOSE, Saint-Étienne, France
| | - Pierre Tiberghien
- Etablissement Français du Sang (headquarters Dpt), La Plaine, St Denis, France.,UMR RIGHT 1098, Inserm, Etablissement Français du Sang, Université de Franche-Comté, Besançon, France
| | - Stephane Begue
- Etablissement Français du Sang (headquarters Dpt), La Plaine, St Denis, France
| | - Dirk de Korte
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands
| | - Eric Gouwerok
- Department of Product and Process Development, Sanquin Blood Bank, Amsterdam, The Netherlands.,Blood Cell Research, Sanquin Research and Landsteiner Laboratory, University of Amsterdam, Amsterdam, The Netherlands
| | - Andreas Greinacher
- Institut für Immunologie und Transfusionsmedizin (Institute for Immunology and Transfusion Medicine), Universitätsmedizin Greifswald (Greifswald School of Medicine), Greifswald, Germany
| | - Konstanze Aurich
- Institut für Immunologie und Transfusionsmedizin (Institute for Immunology and Transfusion Medicine), Universitätsmedizin Greifswald (Greifswald School of Medicine), Greifswald, Germany
| | - Femke Noorman
- Military Blood Bank, Ministry of Defence, Utrecht, The Netherlands
| | - Larry Dumont
- Vitalant Research Institute, Denver, Colorado, USA.,School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Kathleen Kelly
- Vitalant Research Institute, Denver, Colorado, USA.,School of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Marc Cloutier
- Héma-Québec, Affaires Médicales et Innovation (Medical Affairs and Innovation), Quebec, Quebec, Canada
| | - Renée Bazin
- Héma-Québec, Affaires Médicales et Innovation (Medical Affairs and Innovation), Quebec, Quebec, Canada
| | - Rebecca Cardigan
- Component Development Laboratory, NHS Blood and Transplant and Department of Haematology, University of Cambridge, Cambridge, UK
| | - Sian Huish
- Component Development Laboratory, NHS Blood and Transplant and Department of Haematology, University of Cambridge, Cambridge, UK
| | - Peter Smethurst
- Component Development Laboratory, NHS Blood and Transplant and Department of Haematology, University of Cambridge, Cambridge, UK
| | - Dana Devine
- Centre for Innovation, Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Schubert
- Centre for Innovation, Canadian Blood Services, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lacey Johnson
- Research & Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | - Denese C Marks
- Research & Development, Australian Red Cross Lifeblood, Alexandria, New South Wales, Australia
| | | |
Collapse
|
7
|
Scopelliti F, Cattani C, Dimartino V, Mirisola C, Cavani A. Platelet Derivatives and the Immunomodulation of Wound Healing. Int J Mol Sci 2022; 23:ijms23158370. [PMID: 35955503 PMCID: PMC9368989 DOI: 10.3390/ijms23158370] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 02/01/2023] Open
Abstract
Besides their primary role in hemostasis, platelets contain a plethora of immunomodulatory molecules that profoundly affect the entire process of wound repair. Therefore, platelet derivatives, such as platelet-rich plasma or platelet lysate, have been widely employed with promising results in the treatment of chronic wounds. Platelet derivatives provide growth factors, cytokines, and chemokines targeting resident and immigrated cells belonging to the innate and adaptive immune system. The recruitment and activation of neutrophils and macrophages is critical for pathogen clearance in the early phase of wound repair. The inflammatory response begins with the release of cytokines, such as TGF-β, aimed at damping excessive inflammation and promoting the regenerative phase of wound healing. Dysregulation of the immune system during the wound healing process leads to persistent inflammation and delayed healing, which ultimately result in chronic wound. In this review, we summarize the role of the different immune cells involved in wound healing, particularly emphasizing the function of platelet and platelet derivatives in orchestrating the immunological response.
Collapse
|
8
|
Sarkar S, Thapa R, Naushin F, Gupta S, Bhar B, De R, Bhattacharya J. Antibiotic-Loaded Smart Platelet: A Highly Effective Invisible Mode of Killing Both Antibiotic-Sensitive and -Resistant Bacteria. ACS OMEGA 2022; 7:24102-24110. [PMID: 35874209 PMCID: PMC9301723 DOI: 10.1021/acsomega.1c07249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Microbial pathogenesis is considered one of the most critical health challenges worldwide. Although several antibiotics have been procured and used, the microbes often manage to escape and become resistant to antibiotics. Thus, the discovery of new antibiotics and designing smart approaches toward their delivery are of great importance. In many cases, the delivery agents using foreign chemicals like lipids or polymers induce immunogenic responses of varying degrees and are limited to a shorter circulatory time and burst release. In the current work, we have designed a novel antibiotic delivery system where the antibiotic is encapsulated into a blood component-platelet. Platelets have been previously reported as efficient drug delivery vehicles for targeting cancer cells. On the other hand, during platelet-bacterial interaction, platelets can act as covercytes. Keeping this in mind, smart antibiotic-loaded platelets have been used for killing bacterial cells. The loading of the antibiotic was done using its typical nature of engulfing surrounding small molecules. The water-soluble antibiotics were loaded directly into the platelet, whereas the hydrophobic antibiotics were preloaded in polycaprolactone (FDA-approved polymer)-based nanovesicles to make them solubilized prior to loading inside the platelets. The antibiotic-loaded platelets (containing hydrophilic antibiotics or hydrophobic antibiotic -encapsulated polymer nanoparticles) were found to be stable when studied through platelet aggregometry. The carrier showed bactericidal effects at a significantly lower concentration at which the free antibiotic has negligible efficacy. This could be attributed to the molecular confinement of the antibiotics inside the platelets, therefore causing localization of the drug and leading to efficient activity against bacteria. Interestingly, the smart antibiotic-loaded platelets were capable of killing the resistant strains too at the same lower concentration regime. Therefore, the antibiotic-loaded platelet could emerge as a potential strategy for efficient delivery of antibiotics with a significant reduction of the dose required to achieve the intended antibacterial efficacy. Moreover, this antibiotic delivery method can be very useful to minimize immunogenic responses due to antibiotic administration and to avoid the development of drug resistance due to the invisible mode of delivery.
Collapse
Affiliation(s)
- Sounik Sarkar
- School
of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
| | - Roshni Thapa
- School
of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
- Special
Centre for Molecular Medicine, Jawaharlal
Nehru University, New Delhi 110067, India
| | - Farzana Naushin
- School
of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
| | - Saurabh Gupta
- School
of Biotechnology, Jawaharlal Nehru University, New Delhi 110067, India
| | - Biswajit Bhar
- Institute
of Hematology & Transfusion Medicine, Medical College and Hospital, Kolkata 700073, India
| | - Rajib De
- Haematology
Department, NRS Medical College, Kolkata 700014, India
| | | |
Collapse
|
9
|
Jeon GW. Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants. Clin Exp Pediatr 2022; 65:182-187. [PMID: 34665959 PMCID: PMC8990953 DOI: 10.3345/cep.2021.00864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/18/2021] [Indexed: 11/27/2022] Open
Abstract
We frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older children or adults. The production of megakaryocytes (megakaryopoiesis) and platelets (thrombopoiesis) is mainly regulated by thrombopoietin (TPO). Increased TPO levels during infection or inflammation can stimulate megakaryopoiesis, resulting in thrombopoiesis. TPO concentrations are higher in newborn infants than in adults. Levels increase after birth, peak on the second day after birth, and start decreasing at 1 month of age. Initial platelet counts at birth increase with gestational age. Thus, preterm infants have lower initial platelet counts at birth than late-preterm or term infants. Postnatal thrombocytosis is more frequently observed in preterm infants than in term infants. A high TPO concentration and low TPO receptor expression on platelets leading to elevated plasma-free TPO, increased sensitivity of megakaryocyte precursor cells to TPO, a decreased red blood cell count, and immaturity of platelet regulation are speculated to induce thrombocytosis in preterm infants. Thrombocytosis in newborn infants is considered a reactive process (secondary thrombocytosis) following infection, acute/chronic inflammation, or anemia. Thrombocytosis in newborn infants is benign, resolves spontaneously, and, unlike in adults, is rarely associated with hemorrhagic and thromboembolic complications.
Collapse
Affiliation(s)
- Ga Won Jeon
- Department of Pediatrics, Inha University Hospital, Inha University College of Medicine, Incheon, Korea
| |
Collapse
|
10
|
Marinescu EA, Nica O, Cojocaru A, Liliac IM, Ciurea AM, Ciurea ME, Ciurea ME. Treatment of skin defects with PRP enriched with hyaluronic acid - histological aspects in rat model. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:439-447. [PMID: 36374149 PMCID: PMC9804070 DOI: 10.47162/rjme.63.2.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Tissue healing is a complex, dynamic process, characterized by the replacement of devitalized and absent cell and tissue structures. This can be obtained by different methods, these being found in the "reconstructive scale", which although it is very rich does not offer a universally valid solution for closing skin wounds. In plastic surgery, platelet-rich plasma (PRP) has proven effective in the treatment of skin graft donor areas, burn wounds, skin grafts, tendons, or varicose ulcers. Also, hyaluronic acid (HA) has found its utility in different areas of medicine, other than the esthetics field, with satisfactory results after its use in various lesions. The aim of our study was to find a method of healing wounds with skin defect that shortens the time of complete epithelialization compared to native healing, which is accessible to any patient both by its simplicity and by the lowest possible costs. So, we decided to test a preparation consisting of PRP and granular HA in this type of wounds on a group of 30 Wistar rats. Corroborating the macroscopic data with the microscopic ones, an important similarity can be observed between the healing of the adjuvant-treated lesion at 14 days postoperatively and the healing of the lesion left to natural healing at 21 days, thus shortening the healing period by seven days.
Collapse
Affiliation(s)
| | - Oliviu Nica
- Department of Plastic Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | - Anca Cojocaru
- Department of Plastic Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | - Ilona Mihaela Liliac
- PhD Student, Department of Histology, University of Medicine and Pharmacy of Craiova, Romania
| | - Ana-Maria Ciurea
- Department of Oncology, University of Medicine and Pharmacy of Craiova, Romania
| | - Marius Eugen Ciurea
- Department of Plastic Surgery, University of Medicine and Pharmacy of Craiova, Romania
| | | | | | | | | | | | | |
Collapse
|
11
|
Montague SJ, Patel P, Martin EM, Slater A, Quintanilla LG, Perrella G, Kardeby C, Nagy M, Mezzano D, Mendes PM, Watson SP. Platelet activation by charged ligands and nanoparticles: platelet glycoprotein receptors as pattern recognition receptors. Platelets 2021; 32:1018-1030. [PMID: 34266346 DOI: 10.1080/09537104.2021.1945571] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/10/2021] [Accepted: 06/15/2021] [Indexed: 02/08/2023]
Abstract
Charge interactions play a critical role in the activation of the innate immune system by damage- and pathogen-associated molecular pattern receptors. The ability of these receptors to recognize a wide spectrum of ligands through a common mechanism is critical in host defense. In this article, we argue that platelet glycoprotein receptors that signal through conserved tyrosine-based motifs function as pattern recognition receptors (PRRs) for charged endogenous and exogenous ligands, including sulfated polysaccharides, charged proteins and nanoparticles. This is exemplified by GPVI, CLEC-2 and PEAR1 which are activated by a wide spectrum of endogenous and exogenous ligands, including diesel exhaust particles, sulfated polysaccharides and charged surfaces. We propose that this mechanism has evolved to drive rapid activation of platelets at sites of injury, but that under some conditions it can drive occlusive thrombosis, for example, when blood comes into contact with infectious agents or toxins. In this Opinion Article, we discuss mechanisms behind charge-mediated platelet activation and opportunities for designing nanoparticles and related agents such as dendrimers as novel antithrombotics.
Collapse
Affiliation(s)
- Samantha J Montague
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Pushpa Patel
- School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, UK
- Centre of Membrane Proteins and Receptors, Universities of Birmingham and Nottingham, UK
| | - Eleyna M Martin
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Alexandre Slater
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Lourdes Garcia Quintanilla
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Gina Perrella
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Caroline Kardeby
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Magdolna Nagy
- Departments of Biochemistry and Internal Medicine, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
| | - Diego Mezzano
- Laboratorio de Trombosis y Hemostasia, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Paula M Mendes
- School of Chemical Engineering, College of Engineering and Physical Sciences, University of Birmingham, Birmingham, UK
- Centre of Membrane Proteins and Receptors, Universities of Birmingham and Nottingham, UK
| | - Steve P Watson
- Institute of Cardiovascular Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Centre of Membrane Proteins and Receptors, Universities of Birmingham and Nottingham, UK
| |
Collapse
|
12
|
Association between platelet count and multiorgan dysfunction and outcomes in patients with sepsis in the pediatric intensive care unit in Saudi Arabia. J Infect Public Health 2021; 14:1585-1589. [PMID: 34627055 DOI: 10.1016/j.jiph.2021.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/12/2021] [Accepted: 09/14/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Sepsis is one of the leading causes of morbidity and mortality in the pediatric population worldwide. This study aimed to establish a correlation between platelet count and outcomes of severe sepsis/septic shock in pediatric patients. METHODS This retrospective cohort study was conducted in the pediatric intensive care unit (PICU) in a pediatric tertiary care medical hospital. Pediatric patients from newborns to 14-year-olds with a diagnosis of sepsis or septic shock who were admitted to the PICU between April 2015 and February 2018 were enrolled. Patients were classified into two groups based on the presence of thrombocytopenia: thrombocytopenia group (TG) with a platelet count <150,000/μL during the first seven days after admission, and non-thrombocytopenia group (NTG) with a platelet count >150,000/μL. RESULTS Overall, 206 children were enrolled, including 82 (39.8%) in the TG and 124 (60.2%) in the NTG. Thrombocytopenia was more common in patients with a negative bacterial blood culture (93.9%, P = 0.007). NTG was associated with a higher mortality rate (29%) than the TG (12.2%, P = 0.005). Multiorgan dysfunction syndrome (MODS) at the onset of sepsis (time zero) was found to be more prevalent in NTG than in TG (P = 0.001), while the progression of MODS over the three days remained the same in both groups. CONCLUSION Thrombocytopenia was more associated with non-bacterial sepsis/septic shock, and it may indicate a better outcome of sepsis in pediatric patients.
Collapse
|
13
|
Scopelliti F, Caterina C, Valentina D, Gianfranco C, Concetta M, Andrea C. Platelet lysate converts M (IFNγ+LPS) macrophages in CD206 + TGF-β + arginase + M2-like macrophages that affect fibroblast activity and T lymphocyte migration. J Tissue Eng Regen Med 2021; 15:788-797. [PMID: 34311512 DOI: 10.1002/term.3229] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 01/06/2023]
Abstract
Macrophages, thanks to their extreme plasticity, exert critical roles in wound healing by orchestrating tissue defenses in the early inflammatory phase, and by promoting tissue regeneration and angiogenesis at a later time point. In parallel, platelets release a large number of preformed molecules that could affect immunocyte functions. Platelet-rich plasma and platelet lysate (PL) have been widely used as a therapeutic preside for ulcers, although little is known about the effects of platelet-derived biomolecules on macrophage functions during wound healing. In this study, we analyze the effects of PL on macrophages phenotype and functions. Monocyte-derived macrophages were cultured in the presence of interferon-γ and lipopolysaccharides to induce the M1 polarization and were further exposed to 10% PL. PL treatment reduced CD80, CD86, and PDL-1 and enhanced CD206 and CD200R expression on macrophages analyzed by cytofluorimetry. Additionally, macrophage cultures show reduced TNF-α and CXCL10, while increased arginase protein, PPAR, TGF-β, and VEGF. TGF-β secretion was paralleled by the decrease of NFkB and increase of STAT3, STAT6, and SMAD2 and SMAD4. Supernatants of PL-treated macrophages induced a significant increase of type-I collagen and to a lesser extent of type-III collagen production by fibroblasts. Finally, the supernatant of PL-treated macrophages showed significantly reduced capacity to induce the in vitro migration of T lymphocytes. Our results demonstrate that PL dampens the macrophage secretion of pro-inflammatory cytokines and induces the release of arginase, TGF-β, and VEGF that may affect angiogenesis and tissue regeneration, thus facilitating the wound healing process.
Collapse
Affiliation(s)
- Fernanda Scopelliti
- National Institute for Health, Migration and Poverty INMP/NIHMP, Rome, Italy
| | - Cattani Caterina
- National Institute for Health, Migration and Poverty INMP/NIHMP, Rome, Italy
| | - Dimartino Valentina
- National Institute for Health, Migration and Poverty INMP/NIHMP, Rome, Italy
| | - Costanzo Gianfranco
- National Institute for Health, Migration and Poverty INMP/NIHMP, Rome, Italy
| | - Mirisola Concetta
- National Institute for Health, Migration and Poverty INMP/NIHMP, Rome, Italy
| | - Cavani Andrea
- National Institute for Health, Migration and Poverty INMP/NIHMP, Rome, Italy
| |
Collapse
|
14
|
Al Saleh K, AlQahtani RM. Platelet count patterns and patient outcomes in sepsis at a tertiary care center: Beyond the APACHE score. Medicine (Baltimore) 2021; 100:e25013. [PMID: 33950914 PMCID: PMC8104228 DOI: 10.1097/md.0000000000025013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 02/12/2021] [Indexed: 01/04/2023] Open
Abstract
Acute physiology and chronic health evaluation II (APACHE-II) scoring system is used to classify disease severity of patients in the intensive care unit. However, several limitations render the scoring system inadequate in identifying risk factors associated with outcomes. Little is known about the association of platelet count patterns, and the timing of platelet count and other hematologic parameters in predicting mortality in patients with sepsis.This retrospective observational study included 205 septic shock patients, with an overall mortality of 47.8%, enrolled at a tertiary care hospital in Riyadh, Kingdom of Saudi Arabia between 2018 and 2020. Bivariate and multivariate regression analyses were used to identify hematologic risk factors associated with mortality. We used the bivariate Pearson Correlation test to determine correlations between the tested variables and APACHE-II score.Two platelet count patterns emerged: patients with a decline in platelet count after admission (group A pattern, 93.7%) and those with their lowest platelet count at admission (group B pattern, 6.3%). The lowest mean platelet count was significantly lower in nonsurvivors (105.62 ± 10.67 × 103/μL) than in survivors (185.52 ± 10.81 × 103/μL), P < .001. Bivariate Pearson correlation revealed that the lowest platelet count and platelet count decline were significantly correlated with APACHE-II score (r = -0.250, P < .01), (r = 0.326, P < .001), respectively. In multiple logistic regression analysis, the independent mortality risk factors were degree of platelet count decline in group A (odds ratio, 1.028 [95% confidence interval: 1.012-1.045], P = .001) and platelet pattern in group B (odds ratio, 6.901 [95% confidence interval: 1.446-32.932], P = .015). The patterns, values, subsets, and ratios of white blood cell count were not significantly associated with mortality.Nadir platelet count and timing, and degree of platelet count decline are useful markers to predict mortality in early septic shock. Therefore, platelet count patterns might enhance the performance of severity scoring systems in the intensive care unit.
Collapse
Affiliation(s)
| | - Rakan M. AlQahtani
- Department of Critical Care, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia
| |
Collapse
|
15
|
Messerer DAC, Schmidt H, Frick M, Huber-Lang M. Ion and Water Transport in Neutrophil Granulocytes and Its Impairment during Sepsis. Int J Mol Sci 2021; 22:1699. [PMID: 33567720 PMCID: PMC7914618 DOI: 10.3390/ijms22041699] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022] Open
Abstract
Neutrophil granulocytes are the vanguard of innate immunity in response to numerous pathogens. Their activity drives the clearance of microbe- and damage-associated molecular patterns, thereby contributing substantially to the resolution of inflammation. However, excessive stimulation during sepsis leads to cellular unresponsiveness, immunological dysfunction, bacterial expansion, and subsequent multiple organ dysfunction. During the short lifespan of neutrophils, they can become significantly activated by complement factors, cytokines, and other inflammatory mediators. Following stimulation, the cells respond with a defined (electro-)physiological pattern, including depolarization, calcium influx, and alkalization as well as with increased metabolic activity and polarization of the actin cytoskeleton. Activity of ion transport proteins and aquaporins is critical for multiple cellular functions of innate immune cells, including chemotaxis, generation of reactive oxygen species, and phagocytosis of both pathogens and tissue debris. In this review, we first describe the ion transport proteins and aquaporins involved in the neutrophil ion-water fluxes in response to chemoattractants. We then relate ion and water flux to cellular functions with a focus on danger sensing, chemotaxis, phagocytosis, and oxidative burst and approach the role of altered ion transport protein expression and activity in impaired cellular functions and cell death during systemic inflammation as in sepsis.
Collapse
Affiliation(s)
- David Alexander Christian Messerer
- Institute of Clinical and Experimental Trauma-Immunology, University Hospital of Ulm, 89081 Ulm, Germany;
- Department of Anesthesiology and Intensive Care Medicine, University Hospital of Ulm, 89081 Ulm, Germany
| | - Hanna Schmidt
- Institute of General Physiology, Ulm University, 89081 Ulm, Germany; (H.S.); (M.F.)
- Department of Pediatrics and Adolescent Medicine, University Hospital of Ulm, 89081 Ulm, Germany
| | - Manfred Frick
- Institute of General Physiology, Ulm University, 89081 Ulm, Germany; (H.S.); (M.F.)
| | - Markus Huber-Lang
- Institute of Clinical and Experimental Trauma-Immunology, University Hospital of Ulm, 89081 Ulm, Germany;
| |
Collapse
|
16
|
Fu G, Deng M, Neal MD, Billiar TR, Scott MJ. Platelet-Monocyte Aggregates: Understanding Mechanisms and Functions in Sepsis. Shock 2021; 55:156-166. [PMID: 32694394 PMCID: PMC8008955 DOI: 10.1097/shk.0000000000001619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
ABSTRACT Platelets have been shown to play an important immunomodulatory role in the pathogenesis of various diseases through their interactions with other immune and nonimmune cells. Sepsis is a major cause of death in the United States, and many of the mechanisms driving sepsis pathology are still unresolved. Monocytes have recently received increasing attention in sepsis pathogenesis, and multiple studies have associated increased levels of platelet-monocyte aggregates observed early in sepsis with clinical outcomes in sepsis patients. These findings suggest platelet-monocyte aggregates may be an important prognostic indicator. However, the mechanisms leading to platelet interaction and aggregation with monocytes, and the effects of aggregation during sepsis are still poorly defined. There are few studies that have really investigated functions of platelets and monocytes together, despite a large body of research showing separate functions of platelets and monocytes in inflammation and immune responses during sepsis. The goal of this review is to provide insights into what we do know about mechanisms and biological meanings of platelet-monocyte interactions, as well as some of the technical challenges and limitations involved in studying this important potential mechanism in sepsis pathogenesis. Improving our understanding of platelet and monocyte biology in sepsis may result in identification of novel targets that can be used to positively affect outcomes in sepsis.
Collapse
Affiliation(s)
- Guang Fu
- Department of General Surgery, The 3rd Xiangya Hospital, Central South University, Changsha, Hunan, China (visiting scholar in Pittsburgh 2018-09/2020-09)
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Meihong Deng
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Matthew D. Neal
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Pittsburgh Trauma Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Timothy R. Billiar
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Pittsburgh Trauma Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Melanie J. Scott
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Pittsburgh Trauma Research Center, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
17
|
Gao L, Shi Q, Li H, Guo Q, Yan J, Zhou L. Prognostic value of the combined variability of mean platelet volume and neutrophil percentage for short-term clinical outcomes of sepsis patients. Postgrad Med 2020; 133:604-612. [PMID: 32912023 DOI: 10.1080/00325481.2020.1823137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In this single center retrospective cohort study, 784 patients with sepsis were enrolled and followed up for at least 30 days. The selected endpoint was an all-cause mortality event. METHOD The relationship between MPV-CV + NEU%-CV and all-cause mortality (in-hospital and 30-day) was analyzed by categorizing the patients into four groups according to MPV-CV and NEU%-CV values. For in-hospital mortality, a significantly higher risk of mortality was observed in patients with an MPV-CV ≥ 15.00% + NEU%-CV ≥ 16.00% than in patients of the other groups (P < 0.001). After adjustment for age, sex, body mass index (BMI), infection site, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, use of vasoactive drugs, mechanical ventilation and renal replacement therapy (RRT), hematocrit, albumin, procalcitonin (PCT), and lactate, logistic regression analysis revealed that an MPV-CV ≥ 15.00% + NEU%-CV ≥ 16.00% was an independent predictive factor for in-hospital mortality [adjusted model: odds ratio (OR) = 4.48, 95% CI = 2.92-6.88, P = 0.001]. RESULTS After adjustment for age, sex, BMI, infection site, APACHE II score, SOFA score, hematocrit, albumin, PCT, lactate, and the use of vasoactive drugs, mechanical ventilation, and RRT, Cox proportional-hazards regression model revealed that an MPV-CV ≥ 15.00% + NEU%-CV ≥ 16.00% was an independent predictive factor for 30-day mortality [adjusted model 1: hazard ratio (HR) = 7.69, 95% CI = 4.15-14.24, P < 0.001; adjusted model 2: HR = 4.07, 95% CI = 2.50-6.62, P < 0.001]. CONCLUSION The combination of MPV-CV and NEU%-CV provides a good prognostic value and is a strong independent predictor of short-term clinical outcomes in patients with sepsis. An MPV-CV ≥ 15.00% + NEU%-CV ≥ 16.00% is significantly associated with adverse short-term clinical outcomes.Trial registration number is XJTU2AF2016LSY-04, the registration date is December 2018.
Collapse
Affiliation(s)
- Lan Gao
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qindong Shi
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Hao Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qinyue Guo
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jinqi Yan
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Linjing Zhou
- Department of Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
18
|
Platelet Indices as the Predictor of Antibiotics Response in Surgical Wound Infections Following Total Abdominal Hysterectomy. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 53:132-136. [PMID: 32377071 PMCID: PMC7199835 DOI: 10.14744/semb.2019.46693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/01/2019] [Indexed: 12/04/2022]
Abstract
Objectives: The mean platelet volume (MPV) and the MPV-to-platelet (PLT) count ratio have long been reported as inflammation markers. In this study, we aimed to investigate the predictive value of the MPV and the MPV-to-PLT ratio on surgical wound healing in patients who underwent abdominal hysterectomy and experienced infections at the surgical site following surgery, despite adequate antimicrobial treatment. Methods: A total of 100 patients who encountered surgical wound infection (SWI) after abdominal hysterectomy were enrolled retrospectively. Samples for complete blood count were drawn the day before the operation. All patients received preoperative and postoperative antibiotic prophylaxis and proper antimicrobial treatment following the SWI development. Patients’ condition resolved after standard care and antimicrobial agents were classified as the standard care group. Others, in whom an improvement despite the standard care was not observed, underwent delayed primary closure and were classified as the delayed primary closure group. Results: The PLT count was decreased (319.5±66 103/µL vs. 392±121 103/µL; p<0.05), MPV(9.2±1.3 fL vs. 8.2±1.5 fL; p<0.05), and the MPV-to-PLT ratio (0.030±0.006 vs. 0.024±0.014; p<0.05) was increased in the delayed primary closure group compared to the standard care group. A receiver operating characteristic curve analysis was performed to determine the predictive value of these parameters on the response to standard care measures providing 8.28fL as a cut-off value for MPV (AUC=0.647, 72% sensitivity and 52% specificity) and 0.025 as a cut-off value for the MPV-to-PLT ratio (AUC=0.750, 75% sensitivity and 67% specificity) for predicting nonresponsiveness. Conclusion: An increased preoperative MPV and the MPV-to-PLT ratio may predict poor wound healing following total abdominal hysterectomy.
Collapse
|
19
|
Cavaillon J, Singer M, Skirecki T. Sepsis therapies: learning from 30 years of failure of translational research to propose new leads. EMBO Mol Med 2020; 12:e10128. [PMID: 32176432 PMCID: PMC7136965 DOI: 10.15252/emmm.201810128] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 12/13/2022] Open
Abstract
Sepsis has been identified by the World Health Organization (WHO) as a global health priority. There has been a tremendous effort to decipher underlying mechanisms responsible for organ failure and death, and to develop new treatments. Despite saving thousands of animals over the last three decades in multiple preclinical studies, no new effective drug has emerged that has clearly improved patient outcomes. In the present review, we analyze the reasons for this failure, focusing on the inclusion of inappropriate patients and the use of irrelevant animal models. We advocate against repeating the same mistakes and propose changes to the research paradigm. We discuss the long-term consequences of surviving sepsis and, finally, list some putative approaches-both old and new-that could help save lives and improve survivorship.
Collapse
Affiliation(s)
| | - Mervyn Singer
- Bloomsbury Institute of Intensive Care MedicineUniversity College LondonLondonUK
| | - Tomasz Skirecki
- Laboratory of Flow Cytometry and Department of Anesthesiology and Intensive Care MedicineCentre of Postgraduate Medical EducationWarsawPoland
| |
Collapse
|
20
|
Ezer E, Schrick D, Tőkés-Füzesi M, Szapary L, Bogar L, Molnar T. A novel approach of platelet function test for prediction of attenuated response to clopidogrel. Clin Hemorheol Microcirc 2020; 73:359-369. [PMID: 31156147 PMCID: PMC6971826 DOI: 10.3233/ch-190580] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Elevated mean platelet volume (MPV) and immature platelet fraction (IPF) are predictive for vascular risk. Both can be associated with residual platelet reactivity. We aimed to explore associations among platelet characteristics and responder status in stroke patients on clopidogrel. METHODS Blood samples from 46 patients and 15 healthy subjects were analyzed for platelet count, MPV, IPF, large cell ratio (LCR) and high-fluorsecent immature platelet fraction (H-IPF). As a novelty, not only whole blood, but upper and lower half blood samples after 1-hour gravity sedimentation were analyzed. Platelet aggregometry was used for the whole blood and separated samples to explore area under the curve (AUC) in patients and controls. RESULTS The AUC of the whole blood showed significant differences compared to the upper and lower samples separated after 1-hour sedimentation in patients and controls (p < 0.001 and p = 0.005 respectively). Remarkably, AUC measured in the upper samples in 59% of patients on clopidogrel were exceeding the therapeutic range suggesting that ascending platelets exert aggregation in the presence of ADP. This observation was associated with increased MPV and LCR in the upper samples (both p = 0.04). Patients on clopidogrel were characterized as responders and non-responders and the percentage of H-IPF was significantly higher among non-responders compared to controls in the upper samples (p = 0.04). CONCLUSIONS The modified platelet function test may help to stratify patients with high residual platelet reactivity.
Collapse
Affiliation(s)
- Erzsebet Ezer
- Department of Anesthesiology and Intensive Care, University of Pecs, Medical School, Pecs, Hungary
| | - Diana Schrick
- Department of Anesthesiology and Intensive Care, University of Pecs, Medical School, Pecs, Hungary
| | - Margit Tőkés-Füzesi
- Department of Laboratory Medicine, University of Pecs, Medical School, Pecs, Hungary
| | - Laszlo Szapary
- Department of Neurology, University of Pecs, Medical School, Pecs, Hungary
| | - Lajos Bogar
- Department of Anesthesiology and Intensive Care, University of Pecs, Medical School, Pecs, Hungary
| | - Tihamer Molnar
- Department of Anesthesiology and Intensive Care, University of Pecs, Medical School, Pecs, Hungary
| |
Collapse
|
21
|
The Use of High Dose Eltrombopag in the Management of Sepsis-Associated Thrombocytopenia in Critically Ill Patients. ACTA ACUST UNITED AC 2019; 5:123-129. [PMID: 31915717 PMCID: PMC6942450 DOI: 10.2478/jccm-2019-0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/05/2019] [Indexed: 12/19/2022]
Abstract
Introduction Sepsis is a life-threatening condition, and sepsis-associated thrombocytopenia (SAT) is a common consequence of the disease where platelet count falls drastically within a very short time. Multiple key factors may cause platelet over-activation, destruction and reduction in platelet production during the sepsis. Eltrombopag is a thrombopoietin receptor agonist and is the second-line drug of choice in the treatment of chronic immune thrombocytopenia (ITP). Aim of the study The objective of this study was to observe the therapeutic outcome of high dose eltrombopag in SAT management in critically ill patients. Material and Methods This 6-month-long single group, observational study was conducted on seventeen ICU patients with SAT. Eltrombopag 100 mg/day in two divided doses was given to each patient. Platelet counts were monitored. A low platelet blood count returning to 150 K/μL or above, is taken as indicative of a successful reversal of a thrombocytopenia event. Results The mean Apache II score of patients (n= 17) was 18.71 (p-value: >0.05). No eltrombopag-induced adverse event was observed among the patients during the study period. Thrombocytopenia events were reversed successfully in 64.71% of patients (11; n= 17) within eight days of eltrombopag therapy. Conclusions The therapeutic potentiality of high dose eltrombopag regime in the management of sepsis-associated thrombocytopenia was found clinically significant in over two-thirds of critically ill adult patients enrolled in the study. These data may point to a new strategy in the management of acute type of thrombocytopenia in septic patients.
Collapse
|
22
|
Evidence of CD40L/CD40 pathway involvement in experimental transfusion-related acute lung injury. Sci Rep 2019; 9:12536. [PMID: 31467410 PMCID: PMC6715651 DOI: 10.1038/s41598-019-49040-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/05/2019] [Indexed: 01/04/2023] Open
Abstract
Platelet transfusions can cause adverse reactions in their recipients, including transfusion-related acute lung injury (TRALI). The pathophysiology of TRALI depends on a number of signaling pathways and the inflammatory role played by blood platelets remains controversial. Platelets are important in inflammation, particularly via the immunomodulator complex CD40/CD40L. We studied the specific function of the CD40/CD40L interaction in regulating an experimental TRALI Two-hit model. A mouse model of immune TRALI was triggered by injection of LPS and an anti-MHC I antibody, and the effect of injection of a neutralizing anti-CD40L antibody before induction of TRALI investigated. The characteristics of TRALI were decreased body temperature, pulmonary lesions, and immune cell infiltration into the alveolar space. Pulmonary infiltration was evaluated by blood counts of specific immune cells and their detection in lung sections. Inhibition of the CD40/CD40L immunomodulator interaction significantly reduced communication between immune and/or endothelial cells and the development of pulmonary edema. Hence, our results indicate that targeting of the CD40/CD40L interaction could be an important method to prevent TRALI. While considering that our work concerned a mouse model, we postulate that improvement of the conditions under which platelet concentrates are prepared/stored would assist in alleviating the risk of TRALI.
Collapse
|
23
|
Garraud O, Cognasse F, Moncharmont P. Immunological Features in the Process of Blood Platelet-Induced Alloimmunisation, with a Focus on Platelet Component Transfusion. Diseases 2019; 7:E7. [PMID: 30646515 PMCID: PMC6473846 DOI: 10.3390/diseases7010007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 01/06/2019] [Accepted: 01/09/2019] [Indexed: 12/12/2022] Open
Abstract
Alloimmunisation to platelet antigens is not uncommon; a large number of females, having had pregnancies, developed antibodies to Human Leukocyte Antigen (HLA) moieties harboured on their foetuses' cells (inherited from the father(s)) that may conflict with further pregnancies and transfused Platelet Components occasionally. This is possible since platelets constitutionally express HLA class I molecules (though in copy numbers that consistently differ among individuals). Platelets also express HPA moieties that are variants of naturally expressed adhesion and aggregation molecules; HPA differences between mothers and foetuses and between donors and recipients explain alloimmune conflicts and consequences. Lastly, platelets express ABO blood group antigens, which are rarely immunising, however transfusion mismatches in ABO groups seem to be related to immunisation in other blood and tissue groups. Transfusion also brings residual leukocytes that may also immunise through their copious copy numbers of HLA class I (rarely class II on activated T lymphocytes, B cells, and dendritic cells). In addition, residual red blood cells in platelet concentrates may induce anti-red blood cell allo-antibodies. This short review aims to present the main mechanisms that are commonly reported in alloimmunisation. It also critically endeavours to examine paths to either dampen alloimmunisation occurrences or to prevent them.
Collapse
Affiliation(s)
- Olivier Garraud
- EA_3064, Faculty of Medicine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.
- Institut National de la Transfusion Sanguine, 75015 Paris, France.
| | - Fabrice Cognasse
- EA_3064, Faculty of Medicine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.
- Établissement Français du Sang Auvergne-Rhône-Alpes, 69150 Décines, France.
| | - Pierre Moncharmont
- Établissement Français du Sang Auvergne-Rhône-Alpes, 69150 Décines, France.
| |
Collapse
|
24
|
Garraud O, Cognasse F, Laradi S, Hamzeh-Cognasse H, Peyrard T, Tissot JD, Fontana S. How to mitigate the risk of inducing transfusion-associated adverse reactions. Transfus Clin Biol 2018; 25:262-268. [DOI: 10.1016/j.tracli.2018.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
25
|
Sut C, Tariket S, Aloui C, Arthaud C, Eyraud M, Fagan J, Chavarin P, Hamzeh‐Cognasse H, Laradi S, Garraud O, Cognasse F. Soluble CD40L and CD62P levels differ in single‐donor apheresis platelet concentrates and buffy coat–derived pooled platelet concentrates. Transfusion 2018; 59:16-20. [DOI: 10.1111/trf.14974] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 04/06/2018] [Accepted: 04/06/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Caroline Sut
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| | - Sofiane Tariket
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| | - Chaker Aloui
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| | | | - Marie‐Ange Eyraud
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
| | - Jocelyne Fagan
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
| | - Patricia Chavarin
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
| | | | - Sandrine Laradi
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| | - Olivier Garraud
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
- Institut National de la Transfusion Sanguine (INTS) Paris France
| | - Fabrice Cognasse
- Etablissement Français du Sang Auvergne‐Rhône‐Alpes Saint‐Etienne France
- Université de Lyon, GIMAP‐EA3064 Saint Etienne France
| |
Collapse
|
26
|
Hyland IK, O'Toole RF, Smith JA, Bissember AC. Progress in the Development of Platelet-Activating Factor Receptor (PAFr) Antagonists and Applications in the Treatment of Inflammatory Diseases. ChemMedChem 2018; 13:1873-1884. [DOI: 10.1002/cmdc.201800401] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/08/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Isabel K. Hyland
- School of Natural Sciences Chemistry; University of Tasmania; Hobart Australia
| | | | - Jason A. Smith
- School of Natural Sciences Chemistry; University of Tasmania; Hobart Australia
| | - Alex C. Bissember
- School of Natural Sciences Chemistry; University of Tasmania; Hobart Australia
| |
Collapse
|
27
|
Salter L, Offiah AC, Bishop N. Elevated platelet counts in a cohort of children with moderate-severe osteogenesis imperfecta suggest that inflammation is present. Arch Dis Child 2018. [PMID: 29535113 DOI: 10.1136/archdischild-2017-313859] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Elevated platelet counts are observed in cancer, autoimmunity and inflammation with concurrent illness. Proinflammatory cytokines are elevated in murine osteogenesis imperfecta (OI) models. We hypothesised that platelet counts might be elevated in children with moderate-severe OI. METHODS We reviewed the hospital records of 71 children with moderate-severe OI, treated in the Sheffield Children's Hospital's Severe, Complex and Atypical Osteogenesis Imperfecta Highly Specialised Service. Data relating platelet count (below/above average, above upper limit) to prior and concurrent events were summarised as event proportions per child. Additionally, we created platelet SD scores to assess age and time-related trends, and relationship with OI type. RESULTS 1206 platelet counts were recorded. Platelet SD scores were right-shifted by 0.89 SD overall. 49 of 71 (69%) patients had at least one platelet count above the normal range and 246 (20.4%) of all counts were above the upper limit of normal. Of these, 101 (41%) were high despite no confounding factors being present. For the 47 children with data at age less than 2 years, 89 (30.0%) platelet counts were above the upper limit of normal and 39 (44%) had no associated confounding factor. Elevated platelet counts were recorded most often for children with new or existing vertebral fractures. CONCLUSIONS Raised platelet counts were observed in association with new and healing vertebral fractures, but also (41%-44%) in the absence of identified proinflammatory factors or events. We speculate that these findings are evidence for a proinflammatory component to OI that could be a target for therapeutic intervention.
Collapse
Affiliation(s)
- Lois Salter
- Academic Unit of Child Health, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Children's Hospital, Sheffield, UK
| | - Amaka C Offiah
- Academic Unit of Child Health, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Children's Hospital, Sheffield, UK
| | - Nicholas Bishop
- Academic Unit of Child Health, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Children's Hospital, Sheffield, UK
| |
Collapse
|
28
|
Garraud O, Sut C, Haddad A, Tariket S, Aloui C, Laradi S, Hamzeh-Cognasse H, Bourlet T, Zeni F, Aubron C, Ozier Y, Laperche S, Peyrard T, Buffet P, Guyotat D, Tavernier E, Cognasse F, Pozzetto B, Andreu G. Transfusion-associated hazards: A revisit of their presentation. Transfus Clin Biol 2018; 25:118-135. [PMID: 29625790 DOI: 10.1016/j.tracli.2018.03.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
As a therapy or a support to other therapies, despite being largely beneficial to patients in general, transfusion it is not devoid of some risks. In a moderate number of cases, patients may manifest adverse reactions, otherwise referred to as transfusion-associated hazards (TAHs). The latest French 2016 haemovigilance report indicates that 93% of TAHs are minor (grade 1), 5.5% are moderate (grade 2) and 1.6% are severe (grade 3), with only five deaths (grade 4) being attributed to transfusion with relative certainty (imputability of level [or grade] 1 to 3). Health-care providers need to be well aware of the benefits and potential risks (to best evaluate and discuss the benefit-risk ratio), how to prevent TAHs, the overall costs and the availability of alternative therapeutic options. In high-income countries, most blood establishments (BEs) and hospital blood banks (HBBs) have developed tools for reporting and analysing at least severe transfusion reactions. With nearly two decades of haemovigilance, transfusion reaction databases should be quite informative, though there are four main caveats that prevent it from being fully efficient: (ai) reporting is mainly declarative and is thus barely exhaustive even in countries where it is mandatory by law; (aii) it is often difficult to differentiate between the different complications related to transfusion, diseases, comorbidities and other types of therapies in patients suffering from debilitating conditions; (aiii) there is a lack of consistency in the definitions used to describe and report some transfusion reactions, their severity and their likelihood of being related to transfusion; and (aiv) it is difficult to assess the imputability of a particular BC given to a patient who has previously received many BCs over a relatively short period of time. When compiling all available information published so far, it appears that TAHs can be analysed using different approaches: (bi) their pathophysiological nature; (bii) their severity; (biii) the onset scheme; (biv) a quality assessment (preventable or non-preventable); (bv) their impact on ongoing therapy. Moreover, TAHs can be reported either in a non-integrative or in an integrative way; in the latter case, presentation may also differ when issued by a blood establishment or a treating ward. At some point, a recapitulative document would be useful to gain a better understanding of TAHs in order to decrease their occurrence and severity and allow decision makers to determine action plans: this is what this review attempts to make. This review attempts to merge the different aspects, with a focus on the hospital side, i.e., how the most frequent TAHs can be avoided or mitigated.
Collapse
Affiliation(s)
- O Garraud
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Institut National de la Transfusion Sanguine, 75017 Paris, France.
| | - C Sut
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - A Haddad
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Sacré-Cœur University Hospital, Beirut, Lebanon
| | - S Tariket
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - C Aloui
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - S Laradi
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Sacré-Cœur University Hospital, Beirut, Lebanon
| | | | - T Bourlet
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Department of Microbiology, University Hospital, 42023 Saint-Etienne, France
| | - F Zeni
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Department of Critical Care, University Hospital, 29200 Saint-Etienne, France
| | - C Aubron
- Université de Bretagne Occidentale, 29200 Brest, France; Department of Critical Care, University Hospital, 75005 Brest, France
| | - Y Ozier
- Université de Bretagne Occidentale, 29200 Brest, France; Department of Critical Care, University Hospital, 75005 Brest, France
| | - S Laperche
- Institut National de la Transfusion Sanguine, 75017 Paris, France
| | - T Peyrard
- Institut National de la Transfusion Sanguine, 75017 Paris, France; Inserm S_1134, 75015 Paris, France
| | - P Buffet
- Institut National de la Transfusion Sanguine, 75017 Paris, France; Inserm S_1134, 75015 Paris, France; University Paris-Descartes, Paris, France
| | - D Guyotat
- UMR_5229, University of Lyon, 69675 Lyon, France; Institut du Cancer Lucien Neuwirth, 42023 Saint-Etienne, France
| | - E Tavernier
- UMR_5229, University of Lyon, 69675 Lyon, France; Institut du Cancer Lucien Neuwirth, 42023 Saint-Etienne, France
| | - F Cognasse
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Sacré-Cœur University Hospital, Beirut, Lebanon
| | - B Pozzetto
- EA3064, University of Lyon/Saint-Etienne, Saint-Etienne, France; Department of Microbiology, University Hospital, 42023 Saint-Etienne, France
| | - G Andreu
- Institut National de la Transfusion Sanguine, 75017 Paris, France
| |
Collapse
|
29
|
Sut C, Tariket S, Aubron C, Aloui C, Hamzeh-Cognasse H, Berthelot P, Laradi S, Greinacher A, Garraud O, Cognasse F. The Non-Hemostatic Aspects of Transfused Platelets. Front Med (Lausanne) 2018. [PMID: 29536007 PMCID: PMC5835084 DOI: 10.3389/fmed.2018.00042] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Platelets transfusion is a safe process, but during or after the process, the recipient may experience an adverse reaction and occasionally a serious adverse reaction (SAR). In this review, we focus on the inflammatory potential of platelet components (PCs) and their involvement in SARs. Recent evidence has highlighted a central role for platelets in the host inflammatory and immune responses. Blood platelets are involved in inflammation and various other aspects of innate immunity through the release of a plethora of immunomodulatory cytokines, chemokines, and associated molecules, collectively termed biological response modifiers that behave like ligands for endothelial and leukocyte receptors and for platelets themselves. The involvement of PCs in SARs—particularly on a critically ill patient’s context—could be related, at least in part, to the inflammatory functions of platelets, acquired during storage lesions. Moreover, we focus on causal link between platelet activation and immune-mediated disorders (transfusion-associated immunomodulation, platelets, polyanions, and bacterial defense and alloimmunization). This is linked to the platelets’ propensity to be activated even in the absence of deliberate stimuli and to the occurrence of time-dependent storage lesions.
Collapse
Affiliation(s)
- Caroline Sut
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Etablissement Français du Sang, Auvergne-Rhône-Alpes, Saint-Etienne, France
| | - Sofiane Tariket
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Etablissement Français du Sang, Auvergne-Rhône-Alpes, Saint-Etienne, France
| | - Cécile Aubron
- Médecine Intensive Réanimation, Centre Hospitalier Régionale et Universitaire de Brest, Université de Bretagne Occidentale, Brest, France
| | - Chaker Aloui
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France
| | | | | | - Sandrine Laradi
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Etablissement Français du Sang, Auvergne-Rhône-Alpes, Saint-Etienne, France
| | - Andreas Greinacher
- Institute for Immunology and Transfusion Medicine, University of Greifswald, Greifswald, Germany
| | - Olivier Garraud
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Institut National de Transfusion Sanguine (INTS), Paris, France
| | - Fabrice Cognasse
- GIMAP-EA3064, Université de Lyon, Saint-Étienne, France.,Etablissement Français du Sang, Auvergne-Rhône-Alpes, Saint-Etienne, France
| |
Collapse
|
30
|
Dewitte A, Lepreux S, Villeneuve J, Rigothier C, Combe C, Ouattara A, Ripoche J. Blood platelets and sepsis pathophysiology: A new therapeutic prospect in critically [corrected] ill patients? Ann Intensive Care 2017; 7:115. [PMID: 29192366 PMCID: PMC5709271 DOI: 10.1186/s13613-017-0337-7] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 11/12/2017] [Indexed: 02/06/2023] Open
Abstract
Beyond haemostasis, platelets have emerged as versatile effectors of the immune response. The contribution of platelets in inflammation, tissue integrity and defence against infections has considerably widened the spectrum of their role in health and disease. Here, we propose a narrative review that first describes these new platelet attributes. We then examine their relevance to microcirculatory alterations in multi-organ dysfunction, a major sepsis complication. Rapid progresses that are made on the knowledge of novel platelet functions should improve the understanding of thrombocytopenia, a common condition and a predictor of adverse outcome in sepsis, and may provide potential avenues for management and therapy.
Collapse
Affiliation(s)
- Antoine Dewitte
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France. .,Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, CHU Bordeaux, 33000, Bordeaux, France.
| | - Sébastien Lepreux
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France.,Department of Pathology, CHU Bordeaux, 33000, Bordeaux, France
| | - Julien Villeneuve
- Cell and Developmental Biology Department, Centre for Genomic Regulation, The Barcelona Institute for Science and Technology, 08003, Barcelona, Spain
| | - Claire Rigothier
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France.,Department of Nephrology, Transplantation and Haemodialysis, CHU Bordeaux, 33000, Bordeaux, France
| | - Christian Combe
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France.,Department of Nephrology, Transplantation and Haemodialysis, CHU Bordeaux, 33000, Bordeaux, France
| | - Alexandre Ouattara
- Department of Anaesthesia and Critical Care II, Magellan Medico-Surgical Center, CHU Bordeaux, 33000, Bordeaux, France.,INSERM U1034, Biology of Cardiovascular Diseases, Univ. Bordeaux, 33600, Pessac, France
| | - Jean Ripoche
- INSERM U1026, BioTis, Univ. Bordeaux, 33000, Bordeaux, France
| |
Collapse
|
31
|
Greco E, Lupia E, Bosco O, Vizio B, Montrucchio G. Platelets and Multi-Organ Failure in Sepsis. Int J Mol Sci 2017; 18:ijms18102200. [PMID: 29053592 PMCID: PMC5666881 DOI: 10.3390/ijms18102200] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/13/2017] [Accepted: 10/17/2017] [Indexed: 12/11/2022] Open
Abstract
Platelets have received increasing attention for their role in the pathophysiology of infectious disease, inflammation, and immunity. In sepsis, a low platelet count is a well-known biomarker for disease severity and more recently authors have focused their attention on the active role of platelets in the pathogenesis of multi-organ failure. Septic shock is characterised by a dysregulated inflammatory response, which can impair the microcirculation and lead to organ injury. Being at the crossroads between the immune system, clotting cascade, and endothelial cells, platelets seem to be an appealing central mediator and possible therapeutic target in sepsis. This review focuses on the pathogenic role of platelets in septic organ dysfunction in humans and animal models.
Collapse
Affiliation(s)
- Elisabetta Greco
- Department of Medical Science, University of Turin, 10126 Turin, Italy.
| | - Enrico Lupia
- Department of Medical Science, University of Turin, 10126 Turin, Italy.
| | - Ornella Bosco
- Department of Medical Science, University of Turin, 10126 Turin, Italy.
| | - Barbara Vizio
- Department of Medical Science, University of Turin, 10126 Turin, Italy.
| | | |
Collapse
|
32
|
Acetylsalicylic acid differentially limits the activation and expression of cell death markers in human platelets exposed to Staphylococcus aureus strains. Sci Rep 2017; 7:5610. [PMID: 28717145 PMCID: PMC5514152 DOI: 10.1038/s41598-017-06024-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 06/07/2017] [Indexed: 12/14/2022] Open
Abstract
Beyond their hemostatic functions, platelets alter their inflammatory response according to the bacterial stimulus. Staphylococcus aureus is associated with exacerbated inflammation and thrombocytopenia, which is associated with poor prognosis during sepsis. Acetylsalicylic acid and statins prevent platelet aggregation and decrease the mortality rate during sepsis. Therefore, we assessed whether these two molecules could reduce in vitro platelet activation and the inflammatory response to S. aureus. Platelets were exposed to clinical strains of S. aureus in the presence or absence of acetylsalicylic acid or fluvastatin. Platelet activation, aggregation, and release of soluble sCD62P, sCD40 Ligand, RANTES and GROα were assessed. Platelet cell death was evaluated by analyzing the mitochondrial membrane potential, phosphatidylserine exposure, platelet microparticle release and caspase-3 activation. All S. aureus strains induced platelet activation but not aggregation and decreased the platelet count, the expression of cell death markers and the release of RANTES and GROα. Acetylsalicylic acid but not fluvastatin limited platelet activation and inflammatory factor release and restored the platelet count by protecting platelets from Staphylococcus-induced expression of cell death markers. This study demonstrates that acetylsalicylic acid limits S. aureus-induced effects on platelets by reducing cell death, revealing new strategies to reduce the platelet contribution to bacteremia-associated inflammation.
Collapse
|
33
|
Spinelli SL, Lannan KL, Loelius SG, Phipps RP. In Vitro and Ex Vivo Approaches to Evaluate Next-Generation Tobacco and Non-Tobacco Products on Human Blood Platelets. ACTA ACUST UNITED AC 2017; 3:110-120. [PMID: 28337466 PMCID: PMC5338183 DOI: 10.1089/aivt.2016.0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Human blood platelets are major hemostatic regulators in the circulation and important in the mediation of chronic inflammation and immunomodulation. They are key elements that promote cardiovascular pathogenesis that leads to atherosclerosis, thrombosis, myocardial infarction, and stroke. New information on tobacco use and platelet dysregulation shows that these highly understudied vascular cells are dysregulated by tobacco smoke. Thus, platelet function studies should be an important consideration for the evaluation of existing and next-generation tobacco and non-tobacco products. Novel in vitro approaches are being sought to investigate these products and their influence on platelet function. Platelets are ideally suited for product assessment, as robust and novel in vitro translational methods are available to assess platelet function. Furthermore, the use of human biological systems has the advantage that risk predictions will better reflect the human condition.
Collapse
Affiliation(s)
- Sherry L Spinelli
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry , Rochester, New York
| | - Katie L Lannan
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry , Rochester, New York
| | - Shannon G Loelius
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry , Rochester, New York
| | - Richard P Phipps
- Department of Pathology and Laboratory Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.; Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York.; Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York
| |
Collapse
|
34
|
Affiliation(s)
- Abdulgabar Salama
- Charité - Universitätsmedizin Berlin, Germany - Institute of Transfusion Medicine, Berlin, Germany
| |
Collapse
|
35
|
Chao CT, Tsai HB, Chiang CK, Huang JW. Thrombocytopenia on the first day of emergency department visit predicts higher risk of acute kidney injury among elderly patients. Scand J Trauma Resusc Emerg Med 2017; 25:11. [PMID: 28187736 PMCID: PMC5303206 DOI: 10.1186/s13049-017-0355-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 01/30/2017] [Indexed: 12/31/2022] Open
Abstract
Background Few studies have addressed risk factors for acute kidney injury (AKI) in geriatric patients. We investigated whether thrombocytopenia was a risk factor for AKI in geriatric patients with medical illnesses. Methods A prospective cohort study was conducted, by recruiting elderly (≥65 years) patients who visited the emergency department (ED) for medical illnesses during 2014. They all received hemogram for platelet count determination, and were stratified according to the presence of thrombocytopenia (platelets, <150 K/μL) during their initial ED evaluation. They were prospectively followed up during their ED stay. We analyzed the relationship between the diagnosis of thrombocytopenia and subsequent AKI after ED stay, using Cox proportional hazard modeling, with platelet count as a continuous variable or thrombocytopenia as a categorical variable. Results Of 136 elderly patients (mean age of 80.7 ± 8.2 years, 40% with chronic kidney disease, and 39% with diabetes) enrolled, 22.8% presented with thrombocytopenia, without differences in baseline renal function. After a mean ED stay of 4.4 ± 2.1 days, 41.9% developed AKI (52.6% Kidney Disease Improving Global Outcomes [KDIGO] grade 1, 24.6% grade 2, and 22.8% grade 3). Patients with higher AKI severity had stepwise lower platelet counts compared to those without AKI. The Cox proportional hazard model revealed that lower platelet count as a continuous variable (hazard ratio [HR] 0.984, 95% confidence interval [CI] 0.975–0.994) and as a categorical variable (presence of thrombocytopenia) (HR 1.86, 95% CI 1.06–3.27) increased the risk of AKI. The sensitivity analyses accounting for nephrotoxic medications use, including non-steroidal anti-inflammatory drugs, vancomycin, and contrast, yielded similar results. Discussion Thrombocytopenia is common among ED-visiting elderly, and the potential relationship between platelet counts and the risk of AKI suggests the utility of checking hemogram for those at-risk ofdeveloping adverse renal events. Conclusion Thrombocytopenia on initial presentation might indicate an increased risk of AKI among elderly patients with medical illnesses.
Collapse
Affiliation(s)
- Chia-Ter Chao
- Department of Medicine, National Taiwan University Hospital Jinshan Branch, New Taipei City, Taiwan.,Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan.,Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, 100, Taiwan
| | - Hung-Bin Tsai
- Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Kang Chiang
- Graduate Institute of Toxicology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Integrative Diagnostics and Therapeutics, National Taiwan University Hospital, Taipei, Taiwan
| | - Jenq-Wen Huang
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, 100, Taiwan.
| | | |
Collapse
|
36
|
Schmid W, Novacek G, Vogelsang H, Papay P, Primas C, Eser A, Panzer S. Platelets Toll-like receptor-4 in Crohns disease. Eur J Clin Invest 2017; 47:109-116. [PMID: 27714784 DOI: 10.1111/eci.12686] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 10/04/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Platelets are activated in Crohn's disease (CD) and interplay with leukocytes. Engagement of Toll-like receptor-4 (TLR-4), which is expressed in human platelets, may be involved in crosstalks between platelets and leukocytes leading to their mutual activation for host defense. MATERIALS AND METHODS Human neutrophil peptides (HNPs), lipoprotein binding peptides, and sCD14 were determined by enzyme-linked immunosorbent assays in 42 patients with active CD, in 43 patients with CD in remission, and in 30 healthy individuals. Neutrophil-platelet aggregates and binding of the TLR-4 monoclonal antibody to platelets were determined by flow cytometry. RESULTS Levels of HNPs were higher in patients with CD than in controls (P = 0.0003 vs. active CD and P = 0.01 vs. CD in remission). Likewise, neutrophils with adhering platelets were higher in patients with active CD than in controls (P = 0.004). Binding of the TLR-4 antibody in patients with active CD was similar to that in controls, while patients in remission had significantly higher binding capacities (P = 0.59 and P = 0.003). Incubation of plasma from patients with active disease or patients in remission with platelets from healthy controls confirmed lower binding of the TLR-4 antibody in the presence of plasma from active diseased patients compared to controls (P = 0.039), possibly due to high levels of lipopolysaccharides, as suggested by high levels of sCD14 and lipoprotein binding protein. CONCLUSION Our study indicates involvement of platelet TLR-4 in enhancing the secretion of antimicrobial peptides from neutrophils. While platelet aggregation can be due to a variety of mechanisms in inflammatory disease, the mutual activation of platelets and neutrophils may augment host defense.
Collapse
Affiliation(s)
- Werner Schmid
- Division of Cardiothoracic and Vascular Anesthesia and Intensive Care, Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria
| | - Gottfried Novacek
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Harald Vogelsang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Pavol Papay
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Christian Primas
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alexander Eser
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Simon Panzer
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
37
|
Circulating IL-27 Is Elevated in Rheumatoid Arthritis Patients. Molecules 2016; 21:molecules21111565. [PMID: 27869736 PMCID: PMC6273926 DOI: 10.3390/molecules21111565] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/04/2016] [Accepted: 11/14/2016] [Indexed: 02/04/2023] Open
Abstract
Cytokines are key immunoregulatory molecules that regulate T lymphocyte-mediated immune responses and inflammatory reactions. We determined whether there is aberrant expression of interleukin-27 (IL-27) in rheumatoid arthritis (RA) patients and investigated the clinical significance of these changes. IL-27 is a key cellular factor that regulates the differentiation of CD4+ T cells, which can secrete interleukin-10 (IL-10) and interleukin-17 (IL-17) in vivo. Concentrations of serum IL-27 in 67 RA patients, and 36 sex- and age-matched control subjects were measured by enzyme-linked immunosorbent assay (ELISA). Results showed that concentrations of serum IL-27 in all RA patients were significantly higher than in healthy control subjects, and there was a significant and positive correlation between serum IL-27 levels and disease activity in all RA patients. Levels of serum IL-27 in RA patients were significantly correlated with disease activity score in 28 joints (DAS28). Moreover, immunosuppressive treatment with leflunomide downregulated the levels of IL-27 in active RA patients. Therefore, the elevated production of circulating T cell inflammatory factors contributes to the pathogenesis of RA, and serum IL-27 could potentially serve as a new biomarker of RA disease activity.
Collapse
|
38
|
Aboud N, Depré F, Salama A. Is Autoimmune Thrombocytopenia Itself the Primary Disease in the Presence of Second Diseases Data from a Long-Term Observation. Transfus Med Hemother 2016; 44:23-28. [PMID: 28275330 DOI: 10.1159/000449038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 08/01/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Dependent on the absence or presence of associated diseases, autoimmune thrombocytopenia (ITP) can be classified as primary or secondary form. The manifestation of the associated diseases is not temporally defined and may occur during observation. Thus the question which disease is the primary one remains unanswered. METHODS All 386 patients included in this study were treated by a single primary physician between 1996 and 2015 at the Charité Berlin and met current ITP criteria. Medical records and investigations were reviewed to assess diseases associated with ITP. RESULTS Initially, the vast majority of patients presented with primary ITP (isolated disease). Based on our findings, ITP was found to be associated with other abnormalities in most cases. These abnormalities included: positive direct antiglobulin test in 49 of 386 tested patients (13%), affections of the thyroid gland in 41 of 386 tested patients (11%), infections in 30 (8%), solid malignancies in 20 (5%) and hematological malignancies in 10 patients (3%), as well as many other miscellaneous diseases. Moreover, of 160 patients who did not receive prior intravenous immunoglobulin treatment, 40 (25%) showed antibody deficiency. CONCLUSION In conclusion, the incidence of 'true' ITP as a primary disease is less common than has yet been suggested. Additionally, there is evidence that ITP itself predispose affected subjects toward development of other diseases.
Collapse
Affiliation(s)
- Nasra Aboud
- Institute of Transfusion Medicine, Charité Unversitätsmedizin Berlin, Germany
| | - Fabian Depré
- Institute of Transfusion Medicine, Charité Unversitätsmedizin Berlin, Germany; Department of Cardiology and Pneumology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Germany
| | - Abdulgabar Salama
- Institute of Transfusion Medicine, Charité Unversitätsmedizin Berlin, Germany
| |
Collapse
|
39
|
Garraud O, Cognasse F, Hamzeh-Cognasse H, Pozzetto B. Platelets and their immune role in anti-infective immunity. Future Microbiol 2016; 11:167-70. [PMID: 26849458 DOI: 10.2217/fmb.15.146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Olivier Garraud
- Institut National de la Transfusion Sanguine, 75015, Paris, France.,EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France
| | - Fabrice Cognasse
- EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.,Etablissement Français du Sang Auvergne-Loire, 42023 Saint-Etienne, France
| | - Hind Hamzeh-Cognasse
- EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France
| | - Bruno Pozzetto
- EA3064, Faculty of Medicine of Saint-Etienne, University of Lyon, 42023 Saint-Etienne, France.,Laboratoire des Agents infectieux et d'Hygiène, University-Hospital of Saint-Etienne, 42055 Saint-Etienne, France
| |
Collapse
|
40
|
Rasid O, Cavaillon JM. Recent developments in severe sepsis research: from bench to bedside and back. Future Microbiol 2016; 11:293-314. [PMID: 26849633 DOI: 10.2217/fmb.15.133] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Severe sepsis remains a worldwide threat, not only in industrialized countries, due to their aging population, but also in developing countries where there still are numerous cases of neonatal and puerperal sepsis. Tools for early diagnosis, a prerequisite for rapid and appropriate antibiotic therapy, are still required. In this review, we highlight some recent developments in our understanding of the associated systemic inflammatory response that help deciphering pathophysiology (e.g., epigenetic, miRNA, regulatory loops, compartmentalization, apoptosis and synergy) and discuss some of the consequences of sepsis (e.g., immune status, neurological and muscular alterations). We also emphasize the challenge to better define animal models and discuss past failures in clinical investigations in order to define new efficient therapies.
Collapse
Affiliation(s)
- Orhan Rasid
- Unit Cytokines & Inflammation, Institut Pasteur, 28 rue Dr. Roux, Paris, France
| | - Jean-Marc Cavaillon
- Unit Cytokines & Inflammation, Institut Pasteur, 28 rue Dr. Roux, Paris, France
| |
Collapse
|
41
|
Improving platelet transfusion safety: biomedical and technical considerations. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:109-22. [PMID: 26674828 DOI: 10.2450/2015.0042-15] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/16/2015] [Indexed: 12/25/2022]
Abstract
Platelet concentrates account for near 10% of all labile blood components but are responsible for more than 25% of the reported adverse events. Besides factors related to patients themselves, who may be particularly at risk of side effects because of their underlying illness, there are aspects of platelet collection and storage that predispose to adverse events. Platelets for transfusion are strongly activated by collection through disposal equipment, which can stress the cells, and by preservation at 22 °C with rotation or rocking, which likewise leads to platelet activation, perhaps more so than storage at 4 °C. Lastly, platelets constitutively possess a very large number of bioactive components that may elicit pro-inflammatory reactions when infused into a patient. This review aims to describe approaches that may be crucial to minimising side effects while optimising safety and quality. We suggest that platelet transfusion is complex, in part because of the complexity of the "material" itself: platelets are highly versatile cells and the transfusion process adds a myriad of variables that present many challenges for preserving basal platelet function and preventing dysfunctional activation of the platelets. The review also presents information showing--after years of exhaustive haemovigilance--that whole blood buffy coat pooled platelet components are extremely safe compared to the gold standard (i.e. apheresis platelet components), both in terms of acquired infections and of immunological/inflammatory hazards.
Collapse
|
42
|
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.
Collapse
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
| |
Collapse
|
43
|
Garraud O, Hamzeh-Cognasse H, Laradi S, Pozzetto B, Cognasse F. Transfusion et inflammation : hier – aujourd’hui – demain. Transfus Clin Biol 2015; 22:168-77. [DOI: 10.1016/j.tracli.2015.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Indexed: 12/11/2022]
|
44
|
Nguyen KA, Hamzeh-Cognasse H, Laradi S, Pozzetto B, Garraud O, Cognasse F. Specific activation, signalling and secretion profiles of human platelets following PAR-1 and PAR-4 stimulation. Platelets 2015; 26:795-8. [PMID: 26083907 DOI: 10.3109/09537104.2015.1050585] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Blood platelets play a central haemostatic function; however, they also play a role in inflammation and are capable of secreting various cytokines, chemokines and related products. The purpose of this study was to identify subtle variations in platelet physiology using proteomics. We compared the levels of membrane proteins (n = 3), α and δ granule proteins (n = 18), and signalling proteins (n = 30) from unstimulated platelets with those of protease-activated receptor (PAR)-1- and PAR-4-stimulated platelets (n = 10). The vast majority of these proteins responded similarly to PAR-1 or PAR-4 engagement. However, differences were observed within membrane CD40L expressed, and α granule GRO-α and MDC secreted proteins.
Collapse
Affiliation(s)
| | | | - Sandrine Laradi
- a Université de Lyon , Saint Etienne , France .,b Etablissement Français du Sang - Auvergne-Loire , Saint-Etienne , France , and
| | | | - Olivier Garraud
- a Université de Lyon , Saint Etienne , France .,c INTS - Institut National de la Transfusion Sanguine , Paris , France
| | - Fabrice Cognasse
- a Université de Lyon , Saint Etienne , France .,b Etablissement Français du Sang - Auvergne-Loire , Saint-Etienne , France , and
| |
Collapse
|
45
|
|
46
|
Wu Q, Ren J, Hu D, Jiang P, Li G, Anjum N, Wang G, Gu G, Chen J, Wu X, Liu S, Li Y, Zhao Y, Li J. An elevated percentage of reticulated platelet is associated with increased mortality in septic shock patients. Medicine (Baltimore) 2015; 94:e814. [PMID: 25984667 PMCID: PMC4602582 DOI: 10.1097/md.0000000000000814] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Microcirculatory changes and coagulation disturbances are thought to play a key role in sepsis. Some evidence suggests that the percentage of reticulated platelets (RP%) may be a valuable and cost-effective sepsis screening parameter. This was a prospective study in surgical patients to investigate the potential value of RP% as a predictor of mortality in septic shock patients.This was a prospective study conducted in a surgical critical care center of a Chinese tertiary care hospital. Consecutive septic shock patients were enrolled at admission. Age- and sex-matched non-septic patients were recruited as control patients. RP% was determined by flow cytometry in 68 septic shock patients and 68 controls.Compared with survivors, septic patients who died presented with a significantly higher RP% (P < 0.001). The area under the receiver-operating characteristic curve for the RP% association with mortality was 0.867 (95 % CI 0.780-0.953, P < 0.001). Kaplan-Meier survival curves showed that mortality risk was significantly different when patients were stratified based on RP% (P < 0.001). This association was preserved in a multi-logistic regression analysis that included clinical confounders (P < 0.014).This prospective study demonstrates that increased RP% identifies septic shock patients who have a high risk of death. RP% has the potential to act as a marker for patient stratification in future clinical trials.
Collapse
Affiliation(s)
- Qin Wu
- From the Department of General Surgery, Jinling Hospital, Medical School of Nanjing University (QW, JR, DH, GL, NA, GW, GG, JC, XW, SL, YL, YZ, JL); and Department of Hematology, First Affiliated Hospital of Nanjing University of Medicine, Nanjing, China (PJ)
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock. PLoS One 2015; 10:e0119437. [PMID: 25742300 PMCID: PMC4350997 DOI: 10.1371/journal.pone.0119437] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/13/2015] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Mean platelet volume (MPV) is suggested as an index of inflammation, disease activity, and anti-inflammatory treatment efficacy in chronic inflammatory disorders; however, the effect of MPV on sepsis mortality remains unclear. Therefore, we investigated whether the change in MPV between hospital admission and 72 hours (ΔMPV72h-adm) predicts 28-day mortality in severe sepsis and/or septic shock. METHODS We prospectively enrolled 345 patients admitted to the emergency department (ED) who received standardized resuscitation (early goal-directed therapy) for severe sepsis and/or septic shock between November 2007 and December 2011. Changes in platelet indices, including ΔMPV72h-adm, were compared between survivors and non-survivors by linear mixed model analysis. The prognostic value of ΔMPV72h-adm for 28-day mortality was ascertained by Cox proportional hazards model analysis. RESULTS Thirty-five (10.1%) patients died within 28 days after ED admission. MPV increased significantly during the first 72 hours in non-survivors (P = 0.001) and survivors (P < 0.001); however, the rate of MPV increase was significantly higher in non-survivors (P = 0.003). Nonetheless, the difference in the platelet decline rate over the first 72 hours did not differ significantly between groups (P = 0.360). In multivariate analysis, ΔMPV72h-adm was an independent predictor of 28-day mortality, after adjusting for plausible confounders (hazard ratio, 1.44; 95% confidence interval, 1.01-2.06; P = 0.044). CONCLUSIONS An increase in MPV during the first 72 hours of hospitalization is an independent risk factor for adverse clinical outcomes. Therefore, continuous monitoring of MPV may be useful to stratify mortality risk in patients with severe sepsis and/or septic shock.
Collapse
|
48
|
Cognasse F, Nguyen KA, Damien P, McNicol A, Pozzetto B, Hamzeh-Cognasse H, Garraud O. The Inflammatory Role of Platelets via Their TLRs and Siglec Receptors. Front Immunol 2015; 6:83. [PMID: 25784910 PMCID: PMC4345914 DOI: 10.3389/fimmu.2015.00083] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 02/12/2015] [Indexed: 12/16/2022] Open
Abstract
Platelets are non-nucleated cells that play central roles in the processes of hemostasis, innate immunity, and inflammation; however, several reports show that these distinct functions are more closely linked than initially thought. Platelets express numerous receptors and contain hundreds of secretory products. These receptors and secretory products are instrumental to the platelet functional responses. The capacity of platelets to secrete copious amounts of cytokines, chemokines, and related molecules appears intimately related to the role of the platelet in inflammation. Platelets exhibit non-self-infectious danger detection molecules on their surfaces, including those belonging to the “toll-like receptor” family, as well as pathogen sensors of other natures (Ig- or complement receptors, etc.). These receptors permit platelets to both bind infectious agents and deliver differential signals leading to the secretion of cytokines/chemokines, under the control of specific intracellular regulatory pathways. In contrast, dysfunctional receptors or dysregulation of the intracellular pathway may increase the susceptibility to pathological inflammation. Physiological vs. pathological inflammation is tightly controlled by the sensors of danger expressed in resting, as well as in activated, platelets. These sensors, referred to as pathogen recognition receptors, primarily sense danger signals termed pathogen associated molecular patterns. As platelets are found in inflamed tissues and are involved in auto-immune disorders, it is possible that they can also be stimulated by internal pathogens. In such cases, platelets can also sense danger signals using damage associated molecular patterns (DAMPs). Some of the most significant DAMP family members are the alarmins, to which the Siglec family of molecules belongs. This review examines the role of platelets in anti-infection immunity via their TLRs and Siglec receptors.
Collapse
Affiliation(s)
- Fabrice Cognasse
- Etablissement Français du Sang Auvergne-Loire , Saint-Etienne , France ; GIMAP-EA3064, Université de Lyon , Saint Etienne , France
| | - Kim Anh Nguyen
- GIMAP-EA3064, Université de Lyon , Saint Etienne , France
| | - Pauline Damien
- GIMAP-EA3064, Université de Lyon , Saint Etienne , France
| | - Archibald McNicol
- Faculty of Health Sciences, Colleges of Pharmacy and Medicine, University of Manitoba , Winnipeg, MB , Canada
| | - Bruno Pozzetto
- GIMAP-EA3064, Université de Lyon , Saint Etienne , France
| | | | - Olivier Garraud
- GIMAP-EA3064, Université de Lyon , Saint Etienne , France ; Institut National de Transfusion Sanguine (INTS) , Paris , France
| |
Collapse
|
49
|
Dewitte A, Tanga A, Villeneuve J, Lepreux S, Ouattara A, Desmoulière A, Combe C, Ripoche J. New frontiers for platelet CD154. Exp Hematol Oncol 2015; 4:6. [PMID: 25763299 PMCID: PMC4355125 DOI: 10.1186/s40164-015-0001-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 02/03/2015] [Indexed: 02/07/2023] Open
Abstract
The role of platelets extends beyond hemostasis. The pivotal role of platelets in inflammation has shed new light on the natural history of conditions associated with acute or chronic inflammation. Beyond the preservation of vascular integrity, platelets are essential to tissue homeostasis and platelet-derived products are already used in the clinics. Unanticipated was the role of platelets in the adaptative immune response, allowing a renewed conceptual approach of auto-immune diseases. Platelets are also important players in cancer growth and dissemination. Platelets fulfill most of their functions through the expression of still incompletely characterized membrane-bound or soluble mediators. Among them, CD154 holds a peculiar position, as platelets represent a major source of CD154 and as CD154 contributes to most of these new platelet attributes. Here, we provide an overview of some of the new frontiers that the study of platelet CD154 is opening, in inflammation, tissue homeostasis, immune response, hematopoiesis and cancer.
Collapse
Affiliation(s)
- Antoine Dewitte
- INSERM U1026, and Université de Bordeaux, F-33000 Bordeaux, France ; Service d'Anesthésie-Réanimation II, CHU de Bordeaux, F-33600 Pessac, France
| | - Annabelle Tanga
- INSERM U1026, and Université de Bordeaux, F-33000 Bordeaux, France
| | - Julien Villeneuve
- Cell and Developmental Biology Programme, Centre for Genomic Regulation, 08003 Barcelona, Spain ; Department of Molecular and Cell Biology, Howard Hughes Medical Institute, University of California, Berkeley, CA 94720-3200 USA
| | | | - Alexandre Ouattara
- Service d'Anesthésie-Réanimation II, CHU de Bordeaux, F-33600 Pessac, France
| | | | - Christian Combe
- INSERM U1026, and Université de Bordeaux, F-33000 Bordeaux, France ; Service de Néphrologie Transplantation Dialyse, CHU de Bordeaux, F-33076 Bordeaux, France
| | - Jean Ripoche
- INSERM U1026, and Université de Bordeaux, F-33000 Bordeaux, France
| |
Collapse
|
50
|
Hamzeh-Cognasse H, Damien P, Chabert A, Pozzetto B, Cognasse F, Garraud O. Platelets and infections - complex interactions with bacteria. Front Immunol 2015; 6:82. [PMID: 25767472 PMCID: PMC4341565 DOI: 10.3389/fimmu.2015.00082] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 02/11/2015] [Indexed: 12/29/2022] Open
Abstract
Platelets can be considered sentinels of vascular system due to their high number in the circulation and to the range of functional immunoreceptors they express. Platelets express a wide range of potential bacterial receptors, including complement receptors, FcγRII, Toll-like receptors but also integrins conventionally described in the hemostatic response, such as GPIIb–IIIa or GPIb. Bacteria bind these receptors either directly, or indirectly via fibrinogen, fibronectin, the first complement C1q, the von Willebrand Factor, etc. The fate of platelet-bound bacteria is questioned. Several studies reported the ability of activated platelets to internalize bacteria such as Staphylococcus aureus or Porphyromonas gingivalis, though there is no clue on what happens thereafter. Are they sheltered from the immune system in the cytoplasm of platelets or are they lysed? Indeed, while the presence of phagolysosome has not been demonstrated in platelets, they contain antimicrobial peptides that were shown to be efficient on S. aureus. Besides, the fact that bacteria can bind to platelets via receptors involved in hemostasis suggests that they may induce aggregation; this has indeed been described for Streptococcus sanguinis, S. epidermidis, or C. pneumoniae. On the other hand, platelets are able to display an inflammatory response to an infectious triggering. We, and others, have shown that platelet release soluble immunomodulatory factors upon stimulation by bacterial components. Moreover, interactions between bacteria and platelets are not limited to only these two partners. Indeed, platelets are also essential for the formation of neutrophil extracellular traps by neutrophils, resulting in bacterial clearance by trapping bacteria and concentrating antibacterial factors but in enhancing thrombosis. In conclusion, the platelet–bacteria interplay is a complex game; its fine analysis is complicated by the fact that the inflammatory component adds to the aggregation response.
Collapse
Affiliation(s)
| | - Pauline Damien
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France
| | - Adrien Chabert
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France
| | - Bruno Pozzetto
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France
| | - Fabrice Cognasse
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France ; Etablissement Français du Sang Auvergne-Loire , Saint-Etienne , France
| | - Olivier Garraud
- GIMAP-EA3064, Université de Lyon , Saint-Etienne , France ; Institut National de la Transfusion Sanguine , Paris , France
| |
Collapse
|