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Glycan-Lectin interactions between platelets and tumor cells drive hematogenous metastasis. 血小板与肿瘤细胞之间的糖蛋白-肌球蛋白相互作用推动了血源性转移。
IF 3.3 3区 医学 Q2 Medicine Pub Date : 2024-12-01 Epub Date: 2024-02-19 DOI: 10.1080/09537104.2024.2315037
Longqiang Shu, Shanyi Lin, Shumin Zhou, Ting Yuan

Glycosylation is a ubiquitous cellular or microenvironment-specific post-translational modification that occurs on the surface of normal cells and tumor cells. Tumor cell-associated glycosylation is involved in hematogenous metastasis. A wide variety of tumors undergo aberrant glycosylation to interact with platelets. As platelets have many opportunities to engage circulating tumor cells, they represent an important avenue into understanding the role glycosylation plays in tumor metastasis. Platelet involvement in tumor metastasis is evidenced by observations that platelets protect tumor cells from damaging shear forces and immune system attack, aid metastasis through the endothelium at specific sites, and facilitate tumor survival and colonization. During platelet-tumor-cell interactions, many opportunities for glycan-ligand binding emerge. This review integrates the latest information about glycans, their ligands, and how they mediate platelet-tumor interactions. We also discuss adaptive changes that tumors undergo upon glycan-lectin binding and the impact glycans have on targeted therapeutic strategies for treating tumors in clinical settings.

糖基化是一种无处不在的细胞或微环境特异性翻译后修饰,发生在正常细胞和肿瘤细胞的表面。肿瘤细胞相关的糖基化参与了血源性转移。各种肿瘤都会发生异常糖基化,从而与血小板相互作用。由于血小板有很多机会与循环中的肿瘤细胞接触,因此它们是了解糖基化在肿瘤转移中所起作用的重要途径。血小板保护肿瘤细胞免受破坏性剪切力和免疫系统的攻击,帮助肿瘤细胞在特定部位通过内皮转移,并促进肿瘤的生存和定植,这些都证明了血小板参与了肿瘤转移。在血小板与肿瘤细胞相互作用的过程中,出现了许多糖配体结合的机会。本综述整合了有关聚糖、聚糖配体以及聚糖如何介导血小板与肿瘤相互作用的最新信息。我们还将讨论肿瘤在与聚糖-选择素结合后发生的适应性变化,以及聚糖对临床上治疗肿瘤的靶向治疗策略的影响。
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引用次数: 0
Molecular insights on Eltrombopag: potential mitogen stimulants, angiogenesis, and therapeutic radioprotectant through TPO-R activation. 关于 Eltrombopag 的分子见解:潜在的有丝分裂原刺激物、血管生成和通过 TPO-R 激活的治疗性放射保护剂。
IF 3.3 3区 医学 Q2 Medicine Pub Date : 2024-12-01 Epub Date: 2024-06-04 DOI: 10.1080/09537104.2024.2359028
Rajasekaran Subbarayan, Dhasarathdev Srinivasan, Salman Shadula Osmania, Dinesh Murugan Girija, Shoeb Ikhlas, Nityanand Srivastav, Ranjith Balakrishnan, Rupendra Shrestha, Ankush Chauhan

The purpose of this study is to investigate the molecular interactions and potential therapeutic uses of Eltrombopag (EPAG), a small molecule that activates the cMPL receptor. EPAG has been found to be effective in increasing platelet levels and alleviating thrombocytopenia. We utilized computational techniques to predict and confirm the complex formed by the ligand (EPAG) and the Thrombopoietin receptor (TPO-R) cMPL, elucidating the role of RAS, JAK-2, STAT-3, and other essential elements for downstream signaling. Molecular dynamics (MD) simulations were employed to evaluate the stability of the ligand across specific proteins, showing favorable characteristics. For the first time, we examined the presence of TPO-R in human umbilical cord mesenchymal stem cells (hUCMSC) and human gingival mesenchymal stem cells (hGMSC) proliferation. Furthermore, treatment with EPAG demonstrated angiogenesis and vasculature formation of endothelial lineage derived from both MSCs. It also indicated the activation of critical factors such as RUNX-1, GFI-1b, VEGF-A, MYB, GOF-1, and FLI-1. Additional experiments confirmed that EPAG could be an ideal molecule for protecting against UVB radiation damage, as gene expression (JAK-2, ERK-2, MCL-1, NFkB, and STAT-3) and protein CD90/cMPL analysis showed TPO-R activation in both hUCMSC and hGMSC. Overall, EPAG exhibits significant potential in treating radiation damage and mitigating the side effects of radiotherapy, warranting further clinical exploration.

本研究的目的是调查 Eltrombopag(EPAG)的分子相互作用和潜在治疗用途,EPAG 是一种激活 cMPL 受体的小分子。研究发现,EPAG 能有效提高血小板水平并缓解血小板减少症。我们利用计算技术预测并确认了配体(EPAG)与血小板生成素受体(TPO-R)cMPL形成的复合物,阐明了RAS、JAK-2、STAT-3和其他下游信号转导基本要素的作用。我们利用分子动力学(MD)模拟评估了配体在特定蛋白上的稳定性,结果显示了良好的特性。我们首次检测了TPO-R在人脐带间充质干细胞(hUCMSC)和人牙龈间充质干细胞(hGMSC)增殖中的存在。此外,经 EPAG 处理后,这两种间充质干细胞的血管生成和内皮系血管形成均得到证实。这也表明了RUNX-1、GFI-1b、VEGF-A、MYB、GOF-1和FLI-1等关键因子的激活。其他实验证实,EPAG 可能是抵御 UVB 辐射损伤的理想分子,因为基因表达(JAK-2、ERK-2、MCL-1、NFkB 和 STAT-3)和蛋白 CD90/cMPL 分析表明 TPO-R 在 hUCMSC 和 hGMSC 中均被激活。总之,EPAG 在治疗辐射损伤和减轻放疗副作用方面具有巨大潜力,值得进一步临床探索。
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引用次数: 0
Neurosurgical bleeding in platelet storage pool disorder: a case report. 血小板贮存池紊乱导致的神经外科出血:病例报告。
IF 2.5 3区 医学 Q3 CELL BIOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-23 DOI: 10.1080/09537104.2024.2380374
Clifford Pierre, Kirsten W Alcorn, Dong Chen, Joanna Fesler, Daniel Landis, Zachary N Litvack, Barbara A Konkle, Livia Hegerova

Dense-granule deficiency (DGD) is an inherited platelet disorder due to the absence of dense granules essential for activation of platelets in the event of vascular injury. Decreased platelet dense granules can be detected by electron microscopy, while other tests of hemostasis, including platelet function analyzer (PFA®) closure times, may be normal. The present case report describes a patient with a lifelong history of mucocutaneous bleeding and excessive hemorrhage with resection of vestibular Schwannoma. After hemostasis was obtained the case was aborted and the neurosurgeon noted bleeding resembled as if patient was on an antiplatelet drug. Subsequent hematologic workup revealed a severe platelet function disorder. There is a paucity of literature on management of intracranial neurosurgery in patients with inherited platelet disorders. Patients undergoing major surgical procedures often receive tranexamic acid (TXA), desmopressin, and/or human-leukocyte antigen (HLA)-matched platelet transfusions. We review the clinical management of intracranial tumor surgery, as well as Cyberknife radiosurgery, in our patient with DGD. After diagnosis was known, thoughtful hemostatic planning with empiric platelet transfusions and TXA prevented recurrent bleeding.

致密颗粒缺乏症(DGD)是一种遗传性血小板疾病,由于缺乏在血管损伤时激活血小板所必需的致密颗粒。电子显微镜可检测到血小板致密颗粒减少,而其他止血测试(包括血小板功能分析仪(PFA®)闭合时间)可能正常。本病例报告描述了一名终生有粘膜出血史的患者,在前庭许旺瘤切除术中出血过多。止血后,病例流产,神经外科医生注意到出血情况与患者服用抗血小板药物相似。随后的血液学检查显示患者存在严重的血小板功能紊乱。有关遗传性血小板功能紊乱患者颅内神经外科手术治疗的文献很少。接受大型外科手术的患者通常会接受氨甲环酸(TXA)、去氨加压素和/或人类白细胞抗原(HLA)匹配的血小板输注。我们回顾了颅内肿瘤手术以及赛博刀放射外科手术对 DGD 患者的临床治疗。确诊后,通过经验性输注血小板和TXA制定了周到的止血计划,防止了复发性出血。
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引用次数: 0
Platelet rich fibrin as a bioactive matrix with proosteogenic and proangiogenic properties on human healthy primary cells in vitro. 富血小板纤维蛋白作为一种生物活性基质,对体外人类健康原代细胞具有促生长和促血管生成特性。
IF 3.3 3区 医学 Q2 Medicine Pub Date : 2024-12-01 Epub Date: 2024-02-23 DOI: 10.1080/09537104.2024.2316744
Eva Dohle, Lena Schmeinck, Kamelia Parkhoo, Robert Sader, Shahram Ghanaati

Blood concentrates like platelet rich fibrin (PRF) have been established as a potential autologous source of cells and growth factors with regenerative properties in the field of dentistry and regenerative medicine. To further analyze the effect of PRF on bone tissue regeneration, this study investigated the influence of liquid PRF matrices on human healthy primary osteoblasts (pOB) and co-cultures composed of pOB and human dermal vascular endothelial cells (HDMEC) as in vitro model for bone tissue regeneration. Special attention was paid to the PRF mediated influence on osteoblastic differentiation and angiogenesis. Based on the low-speed centrifugation concept, cells were treated indirectly with PRF prepared with a low (44 g) and high relative centrifugal force (710 g) before the PRF mediated effect on osteoblast proliferation and differentiation was assessed via gene and protein expression analyses and immunofluorescence. The results revealed a PRF-mediated positive effect on osteogenic proliferation and differentiation accompanied by increased concentration of osteogenic growth factors and upregulated expression of osteogenic differentiation factors. Furthermore, it could be shown that PRF treatment resulted in an increased formation of angiogenic structures in a bone tissue mimic co-culture of endothelial cells and osteoblasts induced by the PRF mediated increased release of proangiogenic growth factors. The effects on osteogenic proliferation, differentiation and vascularization were more evident when low RCF PRF was applied to the cells. In conclusion, PRF possess proosteogenic, potentially osteoconductive as well as proangiogenic properties, making it a beneficial tool for bone tissue regeneration.

在牙科和再生医学领域,富血小板纤维蛋白(PRF)等血液浓缩物已被确定为具有再生特性的细胞和生长因子的潜在自体来源。为了进一步分析富血小板纤维蛋白对骨组织再生的影响,本研究探讨了液态富血小板纤维蛋白基质对人类健康原代成骨细胞(pOB)以及由pOB和人类真皮血管内皮细胞(HDMEC)组成的共培养体(作为骨组织再生的体外模型)的影响。研究人员特别关注了 PRF 对成骨细胞分化和血管生成的影响。根据低速离心概念,用低离心力(44 克)和高相对离心力(710 克)制备的 PRF 间接处理细胞,然后通过基因和蛋白质表达分析及免疫荧光评估 PRF 对成骨细胞增殖和分化的影响。结果表明,PRF 对成骨细胞的增殖和分化具有积极作用,同时成骨生长因子浓度增加,成骨分化因子表达上调。此外,PRF 还能导致血管生成结构的形成,在骨组织模拟内皮细胞和成骨细胞的共培养中,PRF 介导的促血管生成生长因子的释放增加诱导了血管生成结构的形成。当低 RCF PRF 应用于细胞时,对成骨细胞增殖、分化和血管化的影响更为明显。总之,PRF 具有促生长因子、潜在的成骨性和促血管生成特性,使其成为骨组织再生的有利工具。
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引用次数: 0
Impact of thrombocytopenia-associated c.-118C>T and c.-140C>G ANKRD26 5'UTR variants in three-generational pedigree. 三代血统中血小板减少症相关 c.-118C>T 和 c.-140C>G ANKRD26 5'UTR 变异的影响。
IF 2.5 3区 医学 Q3 CELL BIOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-30 DOI: 10.1080/09537104.2024.2388103
Jakub Trizuljak, Paulína Likavcová, Kateřina Staňo Kozubík, Zuzana Vrzalová, Jakub Hynšt, Tereza Deissová, Jiří Štika, Lenka Radová, Marie Prudková, Jana Vaculová, Ivona Blaháková, Petr Smejkal, Jan Kamelander, Šárka Pospíšilová, Michael Doubek

Inherited thrombocytopenias (ITs) encompass a group of rare disorders characterized by diminished platelet count. Recent advancements have unveiled various forms of IT, with inherited thrombocytopenia 2 (THC2) emerging as a prevalent subtype associated with germline variants in the critical 5' untranslated region of the ANKRD26 gene. This region is crucial in regulating the gene expression of ANKRD26, particularly in megakaryocytes. THC2 is an autosomal dominant disorder presenting as mild-to-moderate thrombocytopenia with minimal symptoms, with an increased risk of myeloproliferative malignancies. In our study of a family with suspected IT, three affected individuals harbored the c.-118C>T ANKRD26 variant, while four healthy members carried the c.-140C>G ANKRD26 variant. We performed a functional analysis by studying platelet-specific ANKRD26 gene expression levels using quantitative real-time polymerase-chain reaction. Functional analysis of the c.-118C>T variant showed a significant increase in ANKRD26 expression in affected individuals, supporting its pathogenicity. On the contrary, carriers of the c.-140C>G variant exhibited normal platelet counts and no significant elevation in the ANKRD26 expression, indicating the likely benign nature of this variant. Our findings provide evidence confirming the pathogenicity of the c.-118C>T ANKRD26 variant in THC2 and suggest the likely benign nature of the c.-140C>G variant.

遗传性血小板减少症(ITs)是一组以血小板数量减少为特征的罕见疾病。最近的研究进展揭示了各种形式的遗传性血小板减少症,其中遗传性血小板减少症2(THC2)是一种流行的亚型,与ANKRD26基因关键的5'非翻译区的种系变异有关。该区域对调控 ANKRD26 的基因表达至关重要,尤其是在巨核细胞中。THC2 是一种常染色体显性遗传病,表现为轻度至中度血小板减少,症状轻微,罹患骨髓增生性恶性肿瘤的风险增加。在我们对一个疑似 IT 家族的研究中,3 名患者携带 c.-118C>T ANKRD26 变体,而 4 名健康成员携带 c.-140C>G ANKRD26 变体。我们利用实时定量聚合酶链反应研究了血小板特异性 ANKRD26 基因的表达水平,从而进行了功能分析。对c.-118C>T变异体的功能分析显示,受影响个体的ANKRD26基因表达量显著增加,支持其致病性。相反,c.-140C>G 变体携带者的血小板计数正常,ANKRD26 的表达没有明显升高,这表明该变体可能是良性的。我们的研究结果提供了证据,证实了THC2中c.-118C>T ANKRD26变异体的致病性,并表明c.-140C>G变异体可能是良性的。
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引用次数: 0
Small volume platelet concentrates for neonatal use are more susceptible to shear-induced storage lesion. 用于新生儿的小容量血小板浓缩物更容易受到剪切力引起的储存病变的影响。
IF 2.5 3区 医学 Q3 CELL BIOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-22 DOI: 10.1080/09537104.2024.2389967
Dean Pym, Amanda J Davies, Jessica O Williams, Christine Saunders, Chloë E George, Philip E James

The impact of the biophysical environment on the platelet storage lesion (PSL) has mainly focused on reduced temperature storage, overlooking the significance of storage-induced shear stress. Shear stress in platelet storage refers to the frictional force acting parallel to the bag surface and exists solely through the implementation of agitation. This study investigates whether minimizing exposure to agitation-induced shear stress can alleviate the unexplained loss of function in stored platelet concentrates for neonatal transfusion (neonatal PCs). Using particle tracking analysis, fluid motion was measured in neonatal and adult platelet storage bags under agitation frequencies ranging from 20-60 rpm. Platelets stored at 20-60 rpm agitation over 8 days were examined by biochemical analysis, aggregation, and expression of activation markers. Results indicate that neonatal PCs experience significantly higher storage-induced shear stress compared to adult doses, leading to reduced functionality and increased activation from day 2 of storage. Adjusting the neonatal PC agitation frequency to 20 rpm improved functionality in early storage, while 40 rpm maintains this improvement throughout storage with reduced activation, compared to 60 rpm storage. This study confirms that small volume PC storage for neonatal use contributes to the PSL through the induction of shear stress, suggesting further evaluation of the recommended agitation frequency for neonatal PCs or postponement of the production of neonatal PCs until requested for neonatal transfusion.

生物物理环境对血小板储存病变(PSL)的影响主要集中在低温储存上,忽略了储存引起的剪切应力的重要性。血小板储存中的剪切应力是指平行于袋子表面的摩擦力,仅通过搅拌而存在。本研究探讨了尽量减少搅拌引起的剪切应力是否能减轻新生儿输注用浓缩血小板(新生儿 PC)储存过程中出现的无法解释的功能丧失。利用粒子追踪分析法,测量了新生儿和成人血小板储存袋在 20-60 转/分的搅拌频率下的液体运动。通过生化分析、聚集和活化标记物的表达,对在 20-60 rpm 搅拌下储存 8 天的血小板进行了检测。结果表明,与成人剂量相比,新生儿 PC 所承受的储存诱导剪切应力明显更高,导致其功能降低,并从储存的第 2 天起活化增加。将新生 PC 的搅拌频率调整到 20 转/分钟可改善储存早期的功能,而 40 转/分钟则可在整个储存过程中保持这种改善,同时与 60 转/分钟的储存相比,活化程度降低。这项研究证实,用于新生儿的小容量 PC 存储会通过诱导剪切应力而导致 PSL,因此建议进一步评估推荐的新生儿 PC 搅拌频率,或推迟新生儿 PC 的生产,直到需要用于新生儿输血时再进行。
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引用次数: 0
Phosphorylation of (Ser 291) in the linker insert of Syk negatively regulates ITAM signaling in platelets. Syk 连接插入物中的磷酸化(Ser 291)对血小板中的 ITAM 信号传导有负向调节作用。
IF 2.5 3区 医学 Q3 CELL BIOLOGY Pub Date : 2024-12-01 Epub Date: 2024-06-21 DOI: 10.1080/09537104.2024.2369766
Carol Dangelmaier, Hymavathi Reddy Vari, Dhruv N Vajipayajula, Manal Elzoheiry, Monica Wright, Ashvin Iyer, Alexander Y Tsygankov, Satya P Kunapuli

Receptor-induced tyrosine phosphorylation of spleen tyrosine kinase (Syk) has been studied extensively in hematopoietic cells. Metabolic mapping and high-resolution mass spectrometry, however, indicate that one of the most frequently detected phosphorylation sites encompassed S297 (S291 in mice) located within the linker B region of Syk. It has been reported that Protein kinase C (PKC) phosphorylates Syk S297, thus influencing Syk activity. However, conflicting studies suggest that this phosphorylation enhances as well as reduces Syk activity. To clarify the function of this site, we generated Syk S291A knock-in mice. We used platelets as a model system as they possess Glycoprotein VI (GPVI), a receptor containing an immunoreceptor tyrosine-based activation motif (ITAM) which transduces signals through Syk. Our analysis of the homozygous mice indicated that the knock-in platelets express only one isoform of Syk, while the wild-type expresses two isoforms at 69 and 66 kDa. When the GPVI receptor was activated with collagen-related peptide (CRP), we observed an increase in functional responses and phosphorylations in Syk S291A platelets. This potentiation did not occur with AYPGKF or 2-MeSADP, although they also activate PKC isoforms. Although there was potentiation of platelet functional responses, there was no difference in tail bleeding times. However, the time to occlusion in the FeCl3 injury model was enhanced. These data indicate that the effects of Syk S291 phosphorylation represent a significant outcome on platelet activation and signaling in vitro but also reveals its multifaceted nature demonstrated by the differential effects on physiological responses in vivo.

在造血细胞中,受体诱导的脾酪氨酸激酶(Syk)酪氨酸磷酸化已被广泛研究。然而,代谢图谱和高分辨率质谱分析表明,最常检测到的磷酸化位点之一是位于 Syk 连接器 B 区的 S297(小鼠为 S291)。据报道,蛋白激酶 C(PKC)会使 Syk S297 磷酸化,从而影响 Syk 的活性。然而,相互矛盾的研究表明,这种磷酸化既能增强也能降低 Syk 的活性。为了明确该位点的功能,我们产生了 Syk S291A 基因敲入小鼠。我们使用血小板作为模型系统,因为它们具有糖蛋白VI(GPVI),这是一种含有基于免疫受体酪氨酸的激活基序(ITAM)的受体,它通过Syk传递信号。我们对同卵小鼠的分析表明,基因敲入型血小板只表达一种Syk异构体,而野生型血小板则表达69和66 kDa的两种异构体。当用胶原相关肽(CRP)激活 GPVI 受体时,我们观察到 Syk S291A 血小板的功能反应和磷酸化增加。虽然 AYPGKF 或 2-MeSADP 也能激活 PKC 同工酶,但它们并不能增强血小板的磷酸化。虽然血小板功能反应有增强作用,但尾部出血时间却没有差异。然而,氯化铁损伤模型的闭塞时间却延长了。这些数据表明,Syk S291 磷酸化对体外血小板活化和信号传导的影响是显著的,但同时也揭示了其多面性,这体现在对体内生理反应的不同影响上。
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引用次数: 0
Platelet mass cytometry reveals dysregulation of prothrombotic pathways in essential thrombocythemia. 血小板质控细胞术揭示了原发性血小板增多症的促血栓形成途径失调。
IF 3.3 3区 医学 Q2 Medicine Pub Date : 2024-12-01 Epub Date: 2024-06-07 DOI: 10.1080/09537104.2024.2358244
Veronika Dill, Kilian Kirmes, Jiaying Han, Melissa Klug, Marc Rosenbaum, Giacomo Viggiani, Moritz von Scheidt, Markus List, Peter Herhaus, Jürgen Ruland, Florian Bassermann, Karl-Ludwig Laugwitz, Katharina S Götze, Philipp J Jost, Stefanie Jilg, Conor J Bloxham, Philip W J Raake, Isabell Bernlochner, Dario Bongiovanni

Thromboembolic events are common in patients with essential thrombocythemia (ET). However, the pathophysiological mechanisms underlying the increased thrombotic risk remain to be determined. Here, we perform the first phenotypical characterization of platelet expression using single-cell mass cytometry in six ET patients and six age- and sex-matched healthy individuals. A large panel of 18 transmembrane regulators of platelet function and activation were analyzed, at baseline and after ex-vivo stimulation with thrombin receptor-activating peptide (TRAP). We detected a significant overexpression of the activation marker CD62P (p-Selectin) (p = .049) and the collagen receptor GPVI (p = .044) in non-stimulated ET platelets. In contrast, ET platelets had a lower expression of the integrin subunits of the fibrinogen receptor GPIIb/IIIa CD41 (p = .036) and CD61 (p = .044) and of the von Willebrand factor receptor CD42b (p = .044). Using the FlowSOM algorithm, we identified 2 subclusters of ET platelets with a prothrombotic expression profile, one of them (cluster 3) significantly overrepresented in ET (22.13% of the total platelets in ET, 2.94% in controls, p = .035). Platelet counts were significantly increased in ET compared to controls (p = .0123). In ET, MPV inversely correlated with platelet count (r=-0.96). These data highlight the prothrombotic phenotype of ET and postulate GPVI as a potential target to prevent thrombosis in these patients.

血栓栓塞事件在原发性血小板增多症(ET)患者中很常见。然而,血栓风险增加的病理生理机制仍有待确定。在这里,我们首次使用单细胞质谱法对六名 ET 患者和六名年龄与性别匹配的健康人的血小板表达进行了表型鉴定。我们分析了基线和体内外凝血酶受体活化肽(TRAP)刺激后血小板功能和活化的 18 种跨膜调节因子。我们发现,在未受刺激的 ET 血小板中,活化标志物 CD62P(p-选择素)(p = 0.049)和胶原受体 GPVI(p = 0.044)明显过表达。相比之下,ET 血小板中纤维蛋白原受体 GPIIb/IIIa 的整合素亚基 CD41 (p = .036) 和 CD61 (p = .044) 以及 von Willebrand 因子受体 CD42b (p = .044) 的表达较低。利用 FlowSOM 算法,我们确定了 ET 血小板中具有促血栓形成表达谱的 2 个亚群,其中一个亚群(第 3 群)在 ET 中的比例明显偏高(ET 血小板占血小板总数的 22.13%,对照组为 2.94%,p = .035)。与对照组相比,ET 患者的血小板计数明显增加(p = .0123)。在 ET 中,MPV 与血小板计数成反比(r=-0.96)。这些数据突显了 ET 的促血栓形成表型,并推测 GPVI 是预防这些患者血栓形成的潜在靶点。
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引用次数: 0
The safety and efficacy of indobufen or aspirin combined with clopidogrel in patients with acute myocardial infarction after percutaneous coronary intervention 吲哚布芬或阿司匹林联合氯吡格雷治疗经皮冠状动脉介入治疗后急性心肌梗死患者的安全性和有效性
IF 3.3 3区 医学 Q3 CELL BIOLOGY Pub Date : 2024-06-19 DOI: 10.1080/09537104.2024.2364748
Wen-Bo Dai, Jia-Yi Ren, Su-Tao Hu, Yu-Kun Zhang, Tian-Shu Gu, Xue Wu, Jing-Kun Zhang, Jing-Jin Che, Xiang-Hong Ma, Tong Liu, Guang-Ping Li, Kang-Yin Chen
Currently, the standard treatment for patients who have undergone percutaneous coronary intervention (PCI) following acute myocardial infarction (MI) involves dual antiplatelet therapy (DAPT) with ...
目前,对急性心肌梗死(MI)后接受经皮冠状动脉介入治疗(PCI)的患者的标准治疗方法包括使用...
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引用次数: 0
Inflammation modifies the platelet reactivity among thrombocytopenia patients undergoing percutaneous coronary intervention. 炎症改变了接受经皮冠状动脉介入治疗的血小板减少症患者的血小板反应性。
IF 3.3 3区 医学 Q2 Medicine Pub Date : 2024-04-24 DOI: 10.1080/09537104.2024.2327835
Kailun Yan, Jiawen Li, Yulong Li, P. Zhu, Xiaofang Tang, D. Yuan, Yuejin Yang, Runlin Gao, Jinqing Yuan, Xueyan Zhao
Percutaneous coronary intervention (PCI) patients combined with thrombocytopenia (TP) are usually considered to be at low ischemic risk, receiving less proper antiplatelet therapy. However, recent studies reported a paradoxical phenomenon that PCI patients with TP were prone to experience thrombotic events, while the mechanisms and future treatment remain unclear. We aim to investigate whether inflammation modifies platelet reactivity among these patients. Consecutive 10 724 patients undergoing PCI in Fuwai Hospital were enrolled throughout 2013. High-sensitivity C-reactive protein (hsCRP) ≥2 mg/L was considered inflammatory status. TP was defined as platelet count <150×109/L. High on-treatment platelet reactivity (HTPR) was defined as adenosine diphosphate-induced platelet maximum amplitude of thromboelastogram >47mm. Among 6617 patients finally included, 879 (13.3%) presented with TP. Multivariate logistic regression demonstrated that patients with TP were associated with a lower risk of HTPR (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.53-0.76) than those without TP in the overall cohort. In further analysis, among hsCRP <2 mg/L group, patients with TP exhibited a decreased risk of HTPR (OR 0.53, 95% CI 0.41-0.68); however, in hsCRP ≥2mg/L group, TP patients had a similar risk of HTPR as those without TP (OR 0.83, 95% CI 0.63-1.08). Additionally, these results remain consistent across subgroups, including patients presenting with acute coronary syndrome and chronic coronary syndrome. Inflammation modified the platelet reactivity of PCI patients with TP, providing new insights into the mechanisms of the increased thrombotic risk. Future management for this special population should pay more attention to inflammation status and timely adjustment of antiplatelet therapy in TP patients with inflammation.
合并血小板减少症(TP)的经皮冠状动脉介入治疗(PCI)患者通常被认为缺血风险较低,接受的抗血小板治疗较少。然而,最近的研究报告了一个矛盾的现象:PCI 患者合并血小板减少症容易发生血栓事件,而其机制和未来的治疗方法仍不清楚。我们旨在研究炎症是否会改变这些患者的血小板反应性。我们在 2013 年连续招募了 10 724 名在阜外医院接受 PCI 治疗的患者。高敏C反应蛋白(hsCRP)≥2 mg/L被视为炎症状态。血小板计数达到 47mm 为 TP。在最终纳入的 6617 名患者中,有 879 人(13.3%)出现 TP。多变量逻辑回归显示,在整个队列中,与无 TP 的患者相比,有 TP 的患者发生 HTPR 的风险较低(几率比 [OR] 0.64,95% 置信区间 [CI] 0.53-0.76)。进一步分析发现,在 hsCRP <2mg/L 组中,TP 患者发生 HTPR 的风险降低(OR 0.53,95% CI 0.41-0.68);但在 hsCRP ≥2mg/L 组中,TP 患者发生 HTPR 的风险与无 TP 患者相似(OR 0.83,95% CI 0.63-1.08)。此外,这些结果在包括急性冠状动脉综合征和慢性冠状动脉综合征患者在内的亚组中保持一致。炎症改变了 PCI TP 患者的血小板反应性,为血栓风险增加的机制提供了新的见解。未来对这一特殊人群的管理应更加关注炎症状态,并及时调整有炎症的 TP 患者的抗血小板疗法。
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