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PubMed1985

Epidemiological characteristics of platelet aggregability.

The epidemiological characteristics of platelet aggregability were established in 958 participants in the Northwick Park Heart Study. The main analyses were based on the dose of adenosine diphosphate at which primary aggregation occurred at half its maximum velocity. Aggregability increased with age in both sexes, was greater in whites than blacks (particularly among men), and tended to decrease with the level of habitual alcohol consumption. Aggregability was, however, greater in women than men and in nonsmokers than smokers. There was no relation between aggregability on the one hand and obesity, current or past oral contraceptive use, menopausal state, or blood cholesterol and triglyceride concentrations on the other. Aggregability was somewhat, though not significantly, higher in men with a history of ischaemic heart disease and in those with electrocardiographic evidence of ischaemia than in those without. There was a strong association between the plasma fibrinogen concentration and aggregability. The widely held concept of platelet aggregability and its implications is probably an oversimplification. In the prevention of thrombosis it may be as useful to consider modifying external influences on platelet behaviour, such as plasma fibrinogen concentration or thrombin production, as it is to rely solely on platelet active agents.

Adenosine Diphosphate↗

PubMed1983

[Role of arachidonic acid in platelet aggregation induced by S. typhimurium endotoxin].

The platelet aggregation reaction was used to assess the influence of arachidonic acid (AA), endotoxin (E) S. typhimurium and ADP on platelet aggregation properties. All the three substances induced platelet aggregation. A higher degree of aggregation was attained by the application of E combined with AA and ADP as compared with the effects produced by E and ADP alone. Prolonged incubation of platelet-rich plasma (PRP) samples with E led to an essential decrease of the aggregation degree on ADP addition. Incubation of PRP samples with E and ADP did not evoke any analogous decrease in the platelet aggregation degree. The data obtained indicate that AA stimulates platelet aggregation induced by E and ADP.

Adenosine Diphosphate↗

PubMed1994

Inhibition of factor Xa-induced platelet aggregation by a selective thrombin inhibitor, argatroban.

In the present study, a direct selective thrombin inhibitor, argatroban, and an indirect non-selective inhibitor, heparin, were examined for the inhibitory effect on factor Xa-induced platelet aggregation. Platelet aggregation was induced by thrombin or factor Xa+prothrombin in the presence of Ca++ using rabbit gel-filtered platelets. IC50 of argatroban on factor Xa-induced aggregation was 5-7 times higher than that on thrombin-induced aggregation, while IC50 of heparin in the presence of antithrombin III on factor Xa-induced aggregation was 90-200 times higher than that on thrombin-induced aggregation. This finding suggests that argatroban inhibits thrombin generating on the platelet surface more efficiently than heparin, and this may be one of the reasons for the higher efficacy of argatroban in arterial thrombosis as compared with heparin.

Animals↗

PubMed1996

The mechanism of platelet aggregation induced by HLA-related antibodies.

Immune-mediated platelet activation is emerging as an important pathogenic mechanism of thrombosis. In vitro studies have suggested two distinct pathways for immune-mediated platelet activation; one involving clustering of platelet Fc gamma RIIa, the other involving platelet-associated complement activation. HLA-related antibodies have been shown to cause platelet aggregation, but the mechanism has not been clarified. We evaluated the mechanism of platelet aggregation induced by HLA-related antibodies from nine patients. Antibody to platelet Fc gamma RIIa failed to block platelet aggregation with 8/9 samples, indicating that engagement of platelet Fc gamma RIIa is not necessary for the platelet aggregation induced by HLA-related antibodies. In contrast, platelet aggregation was blocked by antibodies to human C8 (5/7) or C9 (7/7). F(ab')2 fragments of patient IgG failed to induce platelet activation although they bound to HLA antigen on platelets. Intact patient IgG failed to aggregate washed platelets unless aged serum was added. The activating IgG could be adsorbed by incubation with lymphocytes and eluted from the lymphocytes. These results indicate that complement activation is involved in the aggregation response to HLA-related antibodies. This is the first demonstration of complement-mediated platelet aggregation by clinical samples. Five of the patients developed thrombocytopenia in relationship to blood transfusion and two patients developed acute thromboembolic disease, suggesting that these antibodies and the complement-dependent pathway of platelet aggregation may be of clinical significance.

Adult↗

PubMed1987

Type IIB von Willebrand factor with normal sialic acid content induces platelet aggregation in the absence of ristocetin. Role of platelet activation, fibrinogen, and two distinct membrane receptors.

Three preparations of purified von Willebrand factor (vWF), obtained from unrelated patients affected by type IIB von Willebrand disease, were found to have normal sialic acid content (between 129 and 170 nmol/mg of vWF, as compared with 158 +/- 17 nmol/mg in four normal preparations) and to induce platelet aggregation in the presence of physiologic levels of divalent cations and without addition of ristocetin. A monoclonal antibody that blocks the vWF binding domain of the platelet glycoprotein (GP)Ib caused complete inhibition of IIB vWF-induced aggregation. In contrast, a monoclonal antibody that blocks the receptor for adhesive proteins on the platelet GPIIb/IIIa complex failed to inhibit the initial response of platelets to high concentrations of IIB vWF. Moreover, IIB vWF caused agglutination of formalin-fixed platelets that was blocked only by the anti-GPIb antibody, suggesting that the binding of vWF to GPIb, even in the absence of ristocetin, results in platelet-platelet interaction that is followed by exposure of the GPIIb/IIIa receptors for adhesive proteins. Endogenous ADP, normally active platelet metabolism and fibrinogen binding to GPIIb/IIIa were necessary for maximal and irreversible platelet aggregation. In the absence of fibrinogen, however, aggregation was mediated by vWF binding to GPIIb/IIIa. A 52/48-kD tryptic fragment containing the GPIb binding domain of normal vWF completely blocked the aggregation induced by all three IIB vWF preparations. The present study defines in detail the mechanisms involved in IIB vWF-induced platelet aggregation. Moreover, it establishes that the GPIb binding domain of normal and IIB vWF are closely related and that desialylation is not required for the direct interaction of IIB vWF with GPIb.

Apyrase↗

PubMed1989

Evaluation of the clinical utility of platelet aggregation studies.

To determine the diagnostic importance of platelet aggregation studies, we evaluated the clinical utility of these assays by a retrospective review of 188 adult patients initially studied for bleeding abnormalities with platelet aggregation tests at a tertiary care hospital from 1984 to 1987. The primary indications for requesting the tests in our patient population were for the evaluation of a positive bleeding history or abnormal bleeding time (68%), hypercoagulability (17%), thrombocytosis (9%), or a family history of a bleeding disorder (6%). There was a statistically higher incidence of platelet aggregation test abnormalities in patients with highly abnormal bleeding times (40%), in patients with thrombocytosis from myeloproliferative disorders (65%), and in patients with a family history of a bleeding disorder (58%), compared to the other groups studied (16-29%). Of the 64 platelet aggregation tests performed that were abnormal, the following abnormalities were identified: 19 aspirin-like defects (poor response to arachidonate and decreased second wave responses to weak agonists), which were presumably drug-induced, ten myeloproliferative-type disorder defects (abnormal response to epinephrine predominantly) in patients known to have myeloproliferative disease, 34 abnormal patterns not characterized as aspirin or myeloproliferative disorder related, four of which ultimately led to a diagnosis of storage pool disease, and one spontaneous aggregation defect. Our results suggest that platelet aggregation tests rarely lead to the diagnosis of a specific, previously undiagnosed platelet function disorder. Specific recommendations are given for efficient utilization of platelet aggregation tests.

Bleeding Time↗

PubMed1992

[A new preoperative evaluation of platelet aggregation--Part II].

With the new platelet function test which we reported in the first paper, the platelet aggregation was evaluated in 50 patients, and the comparison with the results of bleeding time was made in 20 cases. There was no statistical correlation between the bleeding time and the platelet aggregation. The bleeding time has been considered as an indicator of platelet function and is included in a preoperative check list. However, its result depends on the amount of platelets and the endothelial factor, and the reliability of bleeding time on platelet function is considered small, especially in patients medicated with antiplatelet drugs. For such patients, the platelet aggregation test is essential. The present study demonstrated that the patient belonging to grade-1 were resistant to hemostasis during the operation. Taking into the surgical and anesthetic depression on the platelet function into consideration, the patients below grade-2 are risky for the surgery.

Adult↗

PubMed1988

Importance of fibrinogen and platelet membrane glycoprotein IIb/IIIa in shear-induced platelet aggregation.

The mechanism of shear-induced platelet aggregation was investigated using a polycarbonate cone and plate viscometer. After exposed to shear stress of 54-90 dyne/cm2 for 2 min. at 37 degrees C, platelets aggregated without a significant amount of serotonin release and lactic dehydrogenase leakage from platelets. Under this conditions, platelets from 2 patients with thrombasthenia and a patient with congenital afibrinogenemia failed to aggregate. When fibrinogen was added to platelet rich plasma from a patient with afibrinogenemia, shear-induced platelet aggregation occurred at the same extent of aggregation as observed in normal platelets. Shear-induced platelet aggregation was inhibited by monoclonal antibody to GPIIb/IIIa (1 microgram/ml) and synthetic peptide, Arg-Gly-Asp-Ser (RGDS) (1 mM). Apyrase and hirudin showed no effect on this aggregation. Indomethacin (100 microM) and thromboxane A2 synthetase inhibitor, OKY-046 (100 microM) markedly inhibited aggregation, while thromboxane A2 competitive inhibitor, ONO-3708 (100 microM) exhibited only partial inhibition. These results indicate that fibrinogen and GPIIb/IIIa are important for shear-induced platelet aggregation and that the induction of fibrinogen receptor on GPIIb/IIIa may partially depend upon thromboxane A2 synthesis in platelets.

Afibrinogenemia↗

PubMed1984

Platelet aggregation defect in megakaryoblastic leukemia.

Platelet aggregation induced in vitro with ADP, adrenalin and ristocetin was tested in 7 patients with megakaryoblastic leukemia (MKL). All patients had normal or high platelet counts and presented with hemorrhagic diathesis including purpura ecchymosis and epistaxis. Platelet morphology was grossly abnormal and electron microscopy revealed few, or absence of, alpha-granules. Platelet aggregation was reduced in all the cases with at least one aggregating agent. Our studies confirm that MKL is often accompanied by a thrombocytopathy which should be taken into account in the management of these patients.

Aged↗

PubMed2003

Crystal structure of the GpIbalpha-thrombin complex essential for platelet aggregation.

Direct interaction between platelet receptor glycoprotein Ibalpha (GpIbalpha) and thrombin is required for platelet aggregation and activation at sites of vascular injury. Abnormal GpIbalpha-thrombin binding is associated with many pathological conditions,including occlusive arterial thrombosis and bleeding disorders. The crystal structure of the GpIbalpha-thrombin complex at 2.6 angstrom resolution reveals simultaneous interactions of GpIbalpha with exosite I of one thrombin molecule,and with exosite II of a second thrombin molecule. In the crystal lattice,the periodic arrangement of GpIbalpha-thrombin complexes mirrors a scaffold that could serve as a driving force for tight platelet adhesion. The details of these interactions reconcile GpIbalpha-thrombin binding modes that are presently controversial,highlighting two distinct interfaces that are potential targets for development of novel antithrombotic drugs.

Binding Sites↗

PubMedDate not supplied

Platelet aggregability in cerebral thrombosis--analyzed for vessel stenosis.

Platelet aggregation in the post-acute phase of 48 patients with cerebral thrombosis was measured to see if any specific type of cerebral infarction is associated with enhanced platelet aggregation. All patients were examined with cerebral angiography and computed tomography (CT). Stenotic lesions in major cranial arteries were analyzed by measuring the apparent diameter. Severe stenosis was defined as 75 per cent constriction or more. Enhanced aggregation of platelets (secondary aggregation at 1 microM ADP or less) was present in 5 of 25 patients (20%) who had severe vessel stenosis or occlusion. CT examination frequently revealed both cortical and deep involvement. On the other hand, 13 of 23 patients (57%) with less stenotic lesions showed enhanced aggregation and that was statistically significant (p less than 0.05). Many patients of this group had persistent hypertension and small deep infarctions. Platelet aggregation was also measured in 20 hypertensive control subjects without stroke. Four of them (20%) showed enhanced aggregation. These findings suggest that a combination of enhanced platelet aggregation and hypertension increases the risk of small deep infarctions accompanied by mild stenotic changes of the major cranial arteries.

Adult↗

PubMed2007

Effect of oversulfated dermatan sulfate derivatives on platelet aggregation.

We have investigated the effect on human platelet aggregation of native dermatan sulfate (DS) and three oversulfated DS derivatives with different sulfur contents, and compared it with that of unfractionated heparin. An inhibitory effect on collagen-induced platelet aggregation was observed only with unfractionated heparin at high concentrations, whereas no inhibitory effect was observed when arachidonic acid was used. Heparin was the most potent inhibitor of the thrombin-induced platelet aggregation in platelet-rich plasma (PRP), whereas the oversulfated DS had a higher potency than the native DS. All these glycosaminoglycans (GAGs) also inhibited thrombin-induced aggregation of washed platelets in the presence of antithrombin (AT) or heparin cofactor II (HCII) but not in their absence. Heparin was by far the most potent inhibitor of washed platelet aggregation in the presence of AT, whereas the inhibitory effects of the DS (native or oversulfated) were lower but dependent on the sulfur content. In the presence of HCII, DSb, a slightly oversulfated DS, had the highest inhibitory effect, whereas heparin and DSd, the most oversulfated derivative, had lower potencies in this case. These data suggest that the inhibition of thrombin-induced platelet aggregation by the oversulfated DS derivatives is related to their ability to potentiate thrombin inactivation by AT or HCII. Hence, the oversulfated DS derivatives may not have an effect per se on the inhibition of platelet aggregation. They may constitute a new class of anticoagulants with enhanced anticoagulant effects in comparison with the native DS, but with only minor side-effects of bleeding in comparison with heparin.

Adult↗

PubMedDate not supplied

Effect of long-term aerobic exercise on helium-neon-laser-induced thrombogenesis in rat mesenteric arterioles and platelet aggregation.

We have previously investigated the antithrombotic effect of aerobic exercise in rat arterioles and venules under conditions of variable exercise load. In the present study, rats were subjected to constant exercise of 90% maximal oxygen uptake for 30 min, 5 times a week for 2, 4, 8 or 18 weeks. Thrombotic tendency was assessed by the He-Ne-laser-induced thrombus formation method. Platelet aggregation, platelet adhesion, whole blood clotting time, fibrinogen levels and blood cell count were also measured. The thrombotic tendency in arterioles decreased significantly after 18 weeks training, but not in venules. Thrombotic tendency increased slightly after 2 weeks training though the differences were not significant. A significant decrease in collagen-induced platelet aggregation was observed after 18 weeks training. The results demonstrated that long-term aerobic training decreased the thrombotic tendency in rat arterioles and that this was partly due to decreased platelet aggregability.

Animals↗

PubMed2001

The prognostic value of small-sized platelet aggregates in unstable angina: detection by a novel laser-light scattering method.

Platelet activation plays a pivotal role in the pathogenesis of acute coronary syndromes. This study was designed to evaluate the platelet aggregability in patients with unstable angina using a new aggregometer with laser-light scattering. We also examined whether there was a relationship between these platelet aggregabilities and unfavorable outcome during in-hospital stay. We measured platelet aggregability, in particular small-sized platelet aggregates in 31 patients with unstable angina, 31 patients with stable exertional angina, and 30 patients with chest pain syndrome. The patients with unstable angina were divided into two groups by their cardiac events during in-hospital stay, cardiac events (+)(n=11) group and cardiac events (-)(n=20) group. On admission, the number of small-sized platelet aggregates (V) was higher in patients with unstable angina (3.0+/-0.5x10(4)) than in those with stable exertional angina (1.4+/-0.3x10(4), P=.017) and chest pain syndrome (0.7+/-0.2x10(4), P=.0003). The number of small-sized platelet aggregates was higher in the cardiac events (+) group than in the cardiac events (-) group (5.5+/-0.9x10(4) vs. 1.6+/-0.4x10(4), P=.0001). A previous study elucidated that small-sized platelet aggregates ultimately developed into medium-sized and large-sized aggregates as platelet aggregation proceeds. Therefore, the production of small-sized platelet aggregates is more sensitive for hyperaggregability. Furthermore, the production of small-sized platelet aggregates increased significantly in patients with unstable angina than in those with stable exertional angina and chest pain syndrome. These findings suggest that a tendency toward thrombus formation increases markedly in patients with unstable angina and increased number of small-sized platelet aggregates on admission predicts poor prognosis during in-hospital stay in patients with unstable angina.

Adult↗

PubMed1985

Effect of latex-stimulated granulocytes on platelet aggregation in man.

The effect of granulocytes on human platelet aggregation was investigated in vitro. Platelet function was assayed by photometric technique. Incubation of platelets with latex-stimulated granulocytes for 1 h at room temperature resulted in total inhibition of arachidonic acid-induced platelet aggregation. ADP-induced platelet aggregation was suppressed, lacked secondary wave and was pursued by swift disaggregation. Platelet aggregates induced by collagen dispersed faster under the influence of stimulated granulocytes. The present results indicate that granulocytes may play a role in the hemostatic mechanism in man.

Adenosine Diphosphate↗

PubMed1990

[Influences of 3,4,5-trihydroxystibene-3-beta-mono-D-glucoside on rabbits' platelet aggregation and thromboxane B2 production in vitro].

Platelet aggregation and thromboxane B2 (TXB2) production induced by arachidonic acid (AA) or Adenosine diphosphate (ADP) were studied by turbidimetry and radioimmunoassay in rabbits. 3,4,5-tri-hydroxystibene-3-beta-mono-D-glucoside (PD) 6.7-107.2 mumol/L inhibited platelet aggregation and the production of TXB2 as well. The inhibitions by PD were dose-dependent: 48-90% (AA-induced) and 43-69% (ADP-induced) for platelet aggregation; 50-87% (AA-induced) and 43-68% (ADP-induced) for TXB2. There were positive correlations between the inhibition of platelet aggregation and production of TXB2.

Animals↗

PubMed1989

Extracts from two frequently consumed spices--cumin (Cuminum cyminum) and turmeric (Curcuma longa)--inhibit platelet aggregation and alter eicosanoid biosynthesis in human blood platelets.

In the traditional Indian system of medicine, Ayurveda, several spices and herbs are claimed to possess medicinal properties, such as being antithrombotic, antiatherosclerotic, hypolipidemic, anti-inflammatory etc. Earlier we have reported that extracts from several spices behave as antiaggregatory agents and inhibit eicosanoid synthesis. Similar studies with extracts prepared from cumin (Cuminum cyminum) and turmeric (Curcuma longa) were undertaken. Ethereal extract of both cumin and turmeric inhibited arachidonate-induced platelet aggregation. Extracts from these spices inhibited thromboxane B2 production from exogenous (14C) arachidonic acid (AA) in washed platelets; a simultaneous increase in the formation of lipoxygenase-derived products was observed. Less TxB2 was produced in blood samples treated with turmeric extract when they were allowed to clot. Turmeric extract inhibited incorporation of (14C)AA into platelet phospholipids and deacylation of AA-labelled phospholipids on stimulation with calcium ionophore A23187. Cumin extract was devoid of such effects. Extracts from the two spices reduced the formation of (14C)TxB2 from AA-labelled platelets when they were challenged with A23187. The anti-inflammatory property of turmeric may, in part, be explained by its effect on eicosanoid biosynthesis.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗

PubMed1990

[Study on the effect of various conditions and age to blood platelet aggregation test].

The result of the platelet aggregation test was affected by various conditions. We performed the platelet aggregation test by changing different conditions, including: 1. adding different anticoagulants 2. interval between sampling and standing 3. platelet count 4. the concentrations of different reagents (ADP, Epinephrine and Collagen) respectively and the aggregation rate of blood platelet were compared among different age groups. The best condition for platelet aggregation rate was obtained as follows: 1) Citric acid of 3.8% is the best anticoagulant. 2) Test should be completed within 4 hours upon sample collection. 3) The optimal incubation temperature is between 25 degrees to 37 degrees C. 4) Platelet count of 2 to 4 x 10(5)/microliters gives the most constant result. 5) The optimal concentration for working solution of ADP, collagen and Epinephrine are 5.0 microns, 5.0 micrograms/ml and 50 microM respectively. 6) The aggregation rate of blood platelet increases with age.

Adenosine Diphosphate↗