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PubMed1998

Iohexol, platelet activation and thrombosis. I. Iohexol-induced platelet secretion does not affect thrombus formation in native blood.

BACKGROUND: The nonionic monomer iohexol triggers in vitro platelet secretion of beta-thromboglobulin (beta-TG). This iohexol platelet activation may promote intravascular thrombosis. We studied this relationship by employing a human model of collagen-induced platelet thrombus formation at arterial flow. The ionic dimer ioxaglate, the nonionic dimer iodixanol, and glucose were included. METHODS AND RESULTS: In vitro platelet activation as measured by beta-TG secretion following a 1-min incubation of native blood with 50 vol% of iohexol was significant. Glucose solutions of 300, 580 and 825 mosmol, corresponding to the osmolalities of respectively iodixanol, ioxaglate and iohexol, increased the beta-TG secretion in parallel with the osmolalities. Ioxaglate and iodixanol were virtually inert. Continuous infusion of iohexol or 580 or 825 mosmol glucose (40 vol%) into flowing native blood at an arterial wall shear rate of 2600 s-1 in an ex vivo collagen-induced platelet thrombus formation device triggered pronounced secretion of beta-TG. However, the platelet thrombus formation in blood mixed with iohexol was within the same range as that observed with ioxaglate or iodixanol. Increasing glucose osmolality induced increasing beta-TG secretion, which paralleled gradually decreasing platelet thrombus formation. CONCLUSION: Iohexol and 580 or 825 mosmol glucose trigger platelet secretion of beta-TG. This secretion is not associated with enhanced collagen-induced platelet thrombus formation at high arterial shear.

Blood Donors↗
PubMed2006

Localization of a lysosomal enzyme in platelets from patients with the White platelet syndrome.

The White platelet syndrome (WPS) is an autosomal dominant platelet disorder. Platelet structural abnormalities include the presence of Golgi complexes in up to 13% of their cells, frequently accompanied by centrioles, deficient numbers or absent alpha granules in 30-40% of their platelets and masses of dense tubular system (DTS) channels often forming areas of cytoplasmic sequestration. The degradation of cytoplasm and organelles in the sequestered areas suggested the possibility that hydrolytic enzymes remained in the DTS and were being transferred to sequestration vacuoles. The present study has used ultrastructural cytochemistry to localize the sites of a lysosomal enzyme, aryl sulfatase, in normal and WPS platelets. Enzyme reaction product, lead sulfide, was localized to lysosomal organelles in normal platelets, and only in rare examples appeared in the DTS. Aryl sulfatase activity was found in the Golgi complexes, a few lysosomes, much of the DTS and areas of cytoplasmic sequestration in WPS platelets. The findings indicate that aryl sulfatase, and, most likely, proteins destined for alpha granules in WPS platelets are not completely transferred from the endoplasmic reticulum to Golgi complexes, then to Golgi vesicles and finally to lysosomal and alpha granules in the parent cell before the platelets are delivered to the circulation.

Arylsulfatases↗
PubMed1995

Platelet-derived microvesicles and activated platelets express factor Xa activity.

Activated platelets and platelet-derived microvesicles demonstrate procoagulant properties. It is known that following stimulation, negatively charged phospholipids and factor Va become located on their surfaces. The aim of this study was to see whether activated platelets and platelet-derived microvesicles also expressed some factor Xa activity on their surfaces in a system where factor Xa did not come from external sources. In order to study this question, flow cytometry, as well as the use of a chromogenic substrate to factor Xa and a clotting assay in a factor X depleted plasma, were applied. A prothrombinase assay was also applied using prothrombin, CaCl2 and a chromogenic substrate to thrombin. The platelets were gel-filtered or washed, suspended in Tris-buffered saline, and activated by calcium ionophore A23187 or the thrombin receptor agonist peptide SFLLRN. Microvesicles and activated platelets were separated by centrifugation. Flow cytometry using a monoclonal antibody against factor Xa demonstrated the presence of factor Xa on the surface of the activated platelets. In addition, platelet-derived microvesicles and activated platelets demonstrated factor Xa activity on their surfaces detected directly by splitting of the chromogenic substrate to factor Xa, or by the prothrombinase assay. The thrombin generation in the last assay could be inhibited by a selective factor Xa inhibitor (recombinant tick anticoagulant peptide (rTAP)), soybean trypsin inhibitor, and antithrombin III plus LMW-heparin, all inhibiting at the factor Xa level, as well as by leupeptin which also inhibited the thrombin-chromogenic substrate interaction as such.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Coagulation↗
PubMed1990

Platelet activation and aggregation after endothelial injury. Assessment with indium-111-labeled platelets and angiography.

Although platelet activation and aggregation after endothelial injury are well documented, the time course of platelet deposition and the relationship between platelet aggregation and the release of vasoactive products have not been fully clarified in vivo. To study the effect of platelet vasoactive products, a collateral blood supply was induced by ligating the superficial femoral artery in male New Zealand white rabbits. Two weeks later, endothelial injury to the distal abdominal aorta was produced by cytologic brush or mimicked with a metal coil embolus. Platelet aggregation was assessed with indium-111 (111In)-labeled platelets, and scintigraphy demonstrated significant, progressive platelet deposition up to 3 hours after injury and evidence of residual activity 24 hours later. Angiography showed that the time course of peripheral vasoconstriction matched closely that of platelet deposition, indicating release of vasoactive substances from the aggregating platelets. These pathophysiologic changes secondary to endothelial injury may have significant implications for intravascular interventional procedures.

Angiography↗
PubMed1993

Platelets enhance anoxic contraction of rat aortic rings through platelet-activating factor-dependent mechanism.

Previous studies indicate that anoxia results in vascular smooth muscle contraction, and this phenomenon is mediated in part by a decrease in release of endothelium-derived relaxing factor (EDRF). The role of platelets that relax blood vessels by eliciting EDRF release on anoxic contraction is not known. To examine anoxic contraction in the presence of platelets, we exposed norepinephrine (NE)-precontracted rat aortic rings to washed platelets and then induced anoxia (switch from 95% O2 to 95% N2). Platelets transiently relaxed the precontracted aortic rings (decrease in tension 49 +/- 4%, n = 18). The subsequent anoxia-induced contraction was augmented, however (magnitude of contraction 71 +/- 12 vs. 49 +/- 6% in parallel buffer-treated rings, n = 18, p < 0.01). To determine the mechanism of platelet-mediated augmentation of anoxic contraction, vascular rings were treated with indomethacin, the thromboxane A2 (TxA2)/endoperoxide receptor antagonist SQ29,548, lipoxygenase inhibitor U60,257B, free oxygen radical scavengers superoxide dismutase (SOD) plus catalase, serotonin (S2) receptor blocker LY53,857, or the ADP scavenger apyrase. Although apyrase, U60,257B, SQ29,548, LY53,857, and SOD plus catalase had no effect on augmentation of anoxic contraction in the presence of platelets, treatment with indomethacin markedly decreased (p < 0.02) the augmented anoxic vasoconstriction. Because indomethacin decreases the activity of platelet-activating factor (PAF), vascular rings were treated with two different specific PAF receptor antagonists: L-659,989 and WEB 2170 BS. Both these agents blocked the platelet-augmented anoxic vasoconstriction. In addition, synthetic PAF (10(-7) and 10(-6) M) in itself potentiated anoxic contraction, mimicking the activity of platelets.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Platelet rap1B phosphorylation is a sensitive marker for the action of cyclic AMP- and cyclic GMP-increasing platelet inhibitors and vasodilators.

Rap1B, a ras-like protein expressed in high concentrations in human platelets, serves as a substrate for protein kinase A (PKA) and, eventually, protein kinase G (PKG). We measured rap1B phosphorylation by autoradiography of 32P-labeled proteins in platelets prelabeled with [32P]-orthophosphate. Platelets coincubated with histamine-stimulated human umbilical vein endothelial cells (EC) showed increased phosphorylation of the 50-Kd vasodilator-stimulated phosphoprotein (VASP) of 2.6 +/- 0.5-fold maximally and of rap1B of 17.5 +/- 7.1-fold maximally (mean +/- SE, n = 4). Incubation of platelets with prostacyclin (PGI2), the PGI2-analogue iloprost (ILO), the nitric oxide (NO) donors SIN-1 or sodium nitroprusside (SNP) showed greater concentration-dependent phosphorylation of rap1B than of VASP. Phosphorylation of rap1B had a slow time course and was irreversible in contrast to that of VASP, which was rapid and reversible. Phosphorylation of rap1B was dependent on an increase of platelet cyclic AMP and/or cyclic GMP. Very small concentrations of ILO (50 pM), PGI2 (1 nM), and SIN-1 (100 nM) increased rap1B phosphorylation. Rap1B phosphorylation could also be detected by Western blot after incubation of platelet-rich plasma (PRP) with ILO or SIN-1. Measurement of platelet rap1B phosphorylation is a novel tool that allows monitoring of the action of labile (PGI2, NO) and more stable (ILO, SIN-1, SNP) platelet inhibitors and vasodilators that increase intracellular cyclic AMP and cyclic GMP. Determination of rap1B phosphorylation by Western blot opens new possibilities of measuring platelet-EC interactions in clinical studies and of monitoring the action of systemically applied PGI2 analogues and nitrovasodilators in pharmacologic studies.

Arginine↗
PubMed2000

Effect of E5510, a novel antiplatelet agent, on platelet deposition in atherothrombotic lesions: evaluation by 111In platelet scintigraphy.

We evaluated the short-term effects of a novel antiplatelet agent, 4-cyano-5,5-bis(methoxyphenyl)-4-pentenoic acid (E5510), using 111In platelet scintigraphy (PSG) and B-mode ultrasonography (US). Fifteen patients with platelet deposition at either the carotid bifurcation or abdominal aorta on PSG were randomized into two groups: seven were followed without anti-thrombotic medication (Group A) and eight received E5510 (4 mg x day(-1)) (Group B). After 8 weeks, PSG and US were repeated in all patients. Platelet deposition was assessed visually and semi-quantitatively using a platelet accumulation index. Visual analysis showed that seven out of eight patients became negative for platelet deposition after treatment in Group B, while none changed in Group A. The platelet accumulation index of vessels with platelet deposition was significantly reduced after treatment in Group B (12.4+/-3.9% vs 6.0+/-7.1%, p <0.01), while there was no significant change in the vessels without platelet deposition (2.9+/-3.0% vs 2.9+/-4.1%). In Group A, none of the vessels showed any change (8.1+/-6.4% vs 8.9+/-7.3%). However, there was no significant reduction of carotid plaque size in either group. Short-term E5510 therapy inhibited platelet deposition in active atherothrombotic lesions, and the combination of PSG and US was useful for evaluating the effectiveness of anti-thrombotic drugs in vivo.

Aged↗
PubMed2006

Intravenous administration of choline or cdp-choline improves platelet count and platelet closure times in endotoxin-treated dogs.

This study was performed to assess the effects of intravenous choline chloride and cytidine-5'-diphosphate choline (CDP-choline) treatments on circulating platelet, white blood cell, and red blood cell counts and platelet functions in response to endotoxin. Saline (0.2 mL/kg), choline chloride (20 mg/kg), or CDP-choline (70 mg/kg) were given intravenously three times at 4-h intervals, and endotoxemia was induced by endotoxin (E. coli 055:B5, 20 microg/kg) infusion, 5 min after the first treatment. Blood samples were collected before and at multiple time points after the challenge, for a panel of hematologic parameters and platelet closure times measured by PFA-100. In saline-treated dogs, circulating platelet counts decreased by 85% (P < 0.001) at 0.5 h and remained low by 36%-80% (P < 0.5-0.001) 1-12 h after endotoxin. Circulating WBC counts decreased by 80%-90% (P < 0.001) at 0.5-2 h, and increased (P < 0.001) by 190% 12 h after the endotoxin. In response to endotoxin, RBCs increased by 10%-13% (P < 0.05) at 1-12 h. Endotoxin-induced decline in circulating platelets was attenuated at 0.5 h (P < 0.05-0.01) and reversed at 1-12 h (P < 0.05-0.001) by choline. Platelet closure times were shortened from 81 +/- 10 s and 135 +/- 10 s to 29 +/- 5 s (P < 0.001) and 60 +/- 3 s (P < 0.001) at 0.5 h, and prolonged (P < 0.001) at 1-8 h after endotoxin induction. Endotoxin-induced shortening in platelet closure times was attenuated (P < 0.05) and blocked (P < 0.01) by choline and CDP-choline, respectively. These results showed that choline and CDP-choline treatments improved circulating platelet counts and platelet function during endotoxemia in dogs.

Animals↗
PubMed1987

Abnormal phosphoinositide metabolism and protein phosphorylation in platelets from a patient with the grey platelet syndrome.

Washed platelets isolated from one patient suffering from the inherited grey platelet syndrome were studied during thrombin-induced activation. The agonist-induced changes in (i) morphology, (ii) typical functional cell responses, (iii) membrane phospholipid metabolism and protein phosphorylation were studied and compared with the changes obtained with normal platelets. The morphology of the platelets as visualized by electron microscopy confirmed the almost total absence of intracellular alpha-granules and marked vacuolization. During thrombin stimulation the morphological changes were clearly delayed as compared to normal platelets, the granule centralization and aggregation occurred only 15 s after thrombin addition instead of 5 s in normal platelets. After 15 s, however, even though no alpha-granules were observed, a ring-like structure occurred centrally, indicating that they are not a prerequisite for this reaction. The whole release reaction, i.e. liberation of [14C]serotonin from dense granules and beta-N-acetylglucosaminidase activity from lysosomes, and the thromboxane synthesis were delayed and remained lower than in normal platelets. No thrombin-induced phosphatidyl 4,5-bisphosphate breakdown was measurable on 32P-prelabelled platelets although [32P]phosphatidate formation occurred normally. Phosphorylation time courses of myosin light chain (P20) and of protein P43 (mol wt 43,000) markedly differed from those of controls, being less than half of the normal during the first 15 s and remaining subnormal even after complete aggregation. These results suggest that in platelets devoid of alpha-granules a deficient transmembrane signalling system is likely responsible for the impaired physiological responses.

Blood Platelet Disorders↗
PubMed1993

Reversible translocation of glycoprotein Ib in plasmin-treated platelets: consequences for platelet function.

Understanding the effect of fibrinolysis on platelet function is of clinical importance. Plasmin is recognized to affect platelet adhesive function by reducing the interaction of platelet glycoprotein (GP) Ib with von Willebrand factor (vWF) bound to the subendothelium. This platelet function is commonly explored in vitro by the ristocetin-induced agglutination test. Our previous study demonstrated a plasmin-induced redistribution of GP Ib molecules from the platelet surface to the linings of the surface-connected canalicular system (SCCS), a critical mechanism for understanding plasmin-induced GP Ib dysfunction. Here, we demonstrate that neutralization of plasmin by its inhibitors, aprotinin or tripeptide Val-Phe-Lys-CH2Cl, permits a time dependent recovery (within 30 min) of ristocetin-induced agglutination in the platelets which were stimulated by plasmin at < 1 CU ml-1. This functional recovery was accompanied with a restoration of a normal amount of GP Ib on the platelet surface, as measured by the binding of both monoclonal anti-GP Ib antibody SZ 2 and 125I-labelled vWF to the platelets. Cytochalasin D did not inhibit this recovery, suggesting that this process may be due to passive actin depolymerization. These findings were further confirmed by immunoelectron microscopic study. Utilizing the platelets pre-labelled with anti-GP Ib antibody prior to plasmin stimulation, it was demonstrated that the observed recovery is due to a reverse translocation from the SCCS to the plasma membrane of the same GP Ib molecules which were present initially at the cell surface.(ABSTRACT TRUNCATED AT 250 WORDS)

Agglutination↗
PubMed2004

Impaired synthesis and action of antiaggregating cyclic nucleotides in platelets from obese subjects: possible role in platelet hyperactivation in obesity.

BACKGROUND: Subjects with central obesity exhibit platelet hyperactivity, which is involved in the atherosclerotic process and therefore can account for the increased risk of cardiovascular morbidity and mortality. The aim of the study was to evaluate whether alterations of platelet function in obesity involve synthesis and/or action of the two antiaggregating cyclic nucleotides adenosine 3',5'-cyclic monophosphate (cAMP) and guanosine 3',5'-cyclic monophosphate (cGMP). MATERIALS AND METHODS: In platelets from 16 obese and 15 control subjects we investigated the influence on platelet responses to the Adenosine-5-diphosphate sodium salt (ADP) exerted by (i) prostacyclin analogue Iloprost (0.31-5 nmol L(-1)) and the cAMP analogue 8-bromo-cAMP (10-500 micro mol L(-1)); and by (ii) nitric oxide (NO) donor sodium nitroprusside (SNP) (5-100 micro mol L(-1)) and the cGMP analogue 8-bromo-cGMP (10-500 micro mol L(-1)). IC(50) (minimal concentration of each inhibitor necessary to reduce platelet response to ADP by half) was determined. Iloprost and SNP ability to increase cyclic nucleotides was also measured. RESULTS: Significantly greater IC(50) were observed in obese subjects than in healthy controls (1.59 +/- 0.16 vs. 0.80 +/- 0.08 nmol L(-1), P = 0.0001 for Iloprost, and 27.6 +/- 6.5 vs. 7.0 +/- 1.7 micro mol L(-1), P = 0.006, for SNP); when data from control and obese subjects were pooled together, IC(50) of Iloprost and SNP correlated with the homeostasis model assessment (HOMA IR), which is a parameter used to measure the insulin resistance (r = 0.588, P = 0.029 and r = 0.640, P = 0.006, respectively). Also the antiaggregating effect of 8-Br-cAMP and 8-Br-cGMP was smaller in the obese subjects. Finally, the ability of Iloprost to increase platelet cAMP and the ability of SNP to increase both cGMP and cAMP were reduced in obese subjects. CONCLUSIONS: Platelet resistance to the antiaggregating effects of prostacyclin and NO in obesity is attributable to impairment of cyclic nucleotide synthesis and action. As cyclic nucleotides are the main effectors of platelet antiaggregation, the resistance to them can account for platelet hyperactivity in obesity.

Adult↗
PubMed1991

Effect of EDTA on platelet count and other platelet parameters in blood and blood components collected with CPDA-1.

We have shown in this study that addition of dried K2EDTA (1.5 mg/ml) to blood samples anticoagulated with CPDA-1 increases significantly the platelet count and mean platelet volume (MPV) of whole blood, red cell concentrate (RCC) and platelet concentrate (PC), but not of platelet-rich plasma (PRP) or of platelet-poor plasma (PPP). Transmission and scanning electron microscopy illustrated that platelet aggregates which are present in some components are dispersed on mixing of the sample with EDTA and that this is accompanied by a change in platelet morphology. Determination of the platelet distribution width (PDW) indicated that the platelet populations in whole blood and RCC seem to be more uniform in size than the populations in PRP, PPP and PC. The determination of MPV and PDW changes after addition of EDTA may provide a new approach to quality control of PC.

Adenine↗
PubMed1987

Biosynthesis of major platelet proteins in human blood platelets.

We studied de novo protein biosynthesis in platelets of normal adult donors and in newly formed platelets isolated from splenectomized patients with idiopathic thrombocytopenic purpura (ITP). After metabolic labelling of platelet proteins, performed with different radiolabelled amino acids or carbohydrates, a tenfold increase in incorporation of radioactivity into trichloroacetic-acid-precipitable material was obtained with ITP platelets compared to control platelets. Electron microscopic studies of ITP platelets revealed the presence of rough endoplasmic reticulum and polyribosomes, providing morphological evidence for protein synthesis. SDS-PAGE of radiolabelled ITP platelet proteins followed by autoradiography showed that [35S]methionine and [3H]leucine were incorporated into almost all Coomassie-blue-stained proteins whereas [3H]carbohydrates only labelled a few bands. Using crossed-immunoelectrophoresis we identified some of the labelled platelet compounds and demonstrated that major membrane glycoproteins (GPIb, IIb, IIIa) and alpha-granule proteins, such as fibrinogen, thrombospondin, albumin and von Willebrand factor, were synthesized in newly formed circulating platelets.

Adult↗
PubMed1997

Identification and structure of activated-platelet protein-1, a protein with RNA-binding domain motifs that is expressed by activated platelets.

Beyond their critical role in thrombosis, platelets perform important functions in vascular remodeling, inflammation, and wound repair. Many of these functions are executed by molecules expressed by activated platelets. A novel molecule, activated-platelet protein-1 (APP-1), was identified by a monoclonal antibody against activated rabbit platelets. When platelets were stimulated by thrombin, A23187 or ADP, APP-I was expressed on the platelet surface. APP-1 was also detected in whole cell lysates of platelets, but not on the external surfaces of resting platelets. With maximal activation by thrombin, 15 900 +/- 2800 molecules APP-1 were expressed/platelet. A 2.3-kb cDNA fragment containing a partial coding sequence for APP-1 was isolated from a rabbit bone marrow library by expression cloning with the anti-APP-1 monoclonal antibody. When expressed as a recombinant fusion protein in bacteria, APP-1 bound specifically to poly(A)-Sepharose. The full-length cDNA coding for human APP-1, obtained by DNA hybridization techniques, showed 98.7% amino acid sequence identity with the rabbit protein. Northern analysis with human APP-1 identified a 3.7-kb mRNA transcript in megakaryocytic lines that express transcripts for platelet proteins. Human APP-1 has four ribonucleotide binding domains with ribonucleoprotein 1 and 2 motifs. By virtue of its ribonucleotide binding domains, APP-1 is structurally related to polyadenylate-binding protein, which regulates translation initiation and polyadenylate shortening, and to nucleolysin, a specific effector molecule found in the granules of cytotoxic T lymphocytes.

Amino Acid Sequence↗
PubMed1987

The involvement of platelet activating factor in endotoxin-induced pulmonary platelet recruitment in the guinea-pig.

1 Exposure of conscious guinea-pigs to an aerosol of endotoxin (25-100 micrograms ml-1) resulted in a dose-related, progressive accumulation of platelets in the thoracic region. Accumulation of 111indium oxine labelled erythrocytes was not observed following exposure to an aerosol of endotoxin (50 micrograms ml-1). 2 Pretreatment of guinea-pigs with the selective platelet activating factor (Paf)-antagonists. CV-3988 or brotizolam resulted in a dose-related inhibition of endotoxin-induced pulmonary platelet recruitment. Pretreatment of guinea-pigs with the selective Paf-antagonist BN 52021 resulted in significant inhibition of endotoxin-induced pulmonary platelet recruitment, although the effects of BN 52021 were not dose-related. 3 Pretreatment of guinea-pigs with indomethacin at doses known to inhibit cyclo-oxygenase did not inhibit endotoxin-induced pulmonary platelet recruitment, whereas higher doses of indomethacin produced a reduction in platelet recruitment in the lung. 4 Pretreatment of guinea-pigs with the anticoagulant heparin and the prostacyclin analogue ZK 36374 inhibited endotoxin-induced platelet recruitment. 5 These observations suggest that endotoxin-induced pulmonary platelet recruitment in the guinea-pig is secondary to the release of platelet activating factor, but not to cyclo-oxygenase products of arachidonic acid and may also involve activation of the coagulation cascade.

Animals↗
PubMed2006

Patterns of platelet response in idiopathic TTP/HUS: frequency of declining platelet counts with plasma exchange and the recognition and significance of a pseudo refractory state.

For thrombotic thrombocytopenic purpura (TTP), daily plasma exchange (TPE) is typically discontinued when the platelet count normalizes (>150 x 10(9)/L). We observed a decline in platelet count during TPE and in patients who appeared pseudo-refractory because of a platelet count plateau (100-150 10(9)/L range). In the present study, we evaluated platelet count trends in TTP patients. Retrospective review of TTP patients from 01/1999 to 12/2004 was completed. Patients were categorized based on platelet count trends: Group I, counts rose then decreased to levels <100 x 10(9)/L; Group II, counts declined following TPE initiation; Group III, counts rose continuously; Group IV, counts decreased after the count was >100 x 10(9)/L. Additionally, we identified pseudo-refractory patients caused by a platelet count plateau (>100 x 10(9)/L but <150 x 10(9)/L). We identified 60 TTP patients. Within Group I (17 patients/17 series/19.1% of total), the mean decrease in platelet count was 67.3% +/- 22.1% following initial rise. Within Group II (24 patients/25 series/28.1% of total), the mean decrease was 28% +/- 5.3% following presentation. Group III included 31 patients/39 series (43.8% of the total). Within Group IV (seven patients/eight series/9.0% of total), the mean decrease was 17.4% +/- 12.6% following a sustained rise >100 x 10(9)/L. With a declining platelet count and daily TPE, it is generally sufficient to stay the course and the decline will reverse. Our limited experience with pseudo-refractory patients supports discontinuing TPE when counts plateau between 100 and 150 x 10(9)/L when a therapy goal is a platelet count of 150 x 10(9)/L. Recognition of this pseudo-refractory state can minimize the risks of prolonged TPE and the risks of adjunct interventions.

Adolescent↗
PubMed1979

Platelet aggregation studies during transient hypoglycaemia: a potential method for evaluating platelet function.

The effect of acute hypoglycaemia on platelet function was examined in patients undergoing an insulin stress test. Enhanced platelet aggregation was observed in all cases but platelet count, platelet adenine nucleotides, and the plasma level of von Willebrand factor were unchanged overall. The onset of the hypoglycaemia-induced increase in platelet aggregation coincided with the lowest blood glucose levels recorded and with the clinical signs of adrenaline release. Increased platelet aggregation was maintained thereafter for the two-hour test period. There was no apparent correlation with changes in cortisol, growth hormone, and prolactin. No change in platelet function was observed after the administration of L-dopa. We suggest that the measurement of platelet aggregation during a standard insulin stress test may provide a means of evaluating platelet function in vivo and the influence of drugs thereon.

Adenine Nucleotides↗
PubMed1994

Effects of chronic administration of ethanol on platelets from rabbits with diet-induced hypercholesterolemia. Unchanged characteristics and responses to ADP but reduction of enhanced thrombin-induced, TxA2-independent platelet responses.

To investigate the effect on platelet function of the interaction between dietary cholesterol and moderate, chronic doses of ethanol, hypercholesterolemia was induced in rabbits by 8 weeks of administration of a chow diet with added (0.25% wt/wt) cholesterol; during the eighth week, a moderate amount of ethanol (6% in drinking water) was given. Blood alcohol levels were not detectable in ethanol-treated rabbits at the time of exsanguination. Ethanol did not affect plasma cholesterol levels or the cholesterol to phospholipid molar ratio in platelets. Platelet membrane fluidity, which decreased with cholesterol feeding, was not altered further by administration of ethanol. The overall fatty acid composition of platelet phospholipids was not affected by either cholesterol feeding or chronic ethanol intake. Responses of washed platelets stimulated with either ADP or thrombin were studied to determine whether ethanol administration modified platelet functions in hypercholesterolemia. Primary ADP-induced aggregation was not affected by cholesterol feeding or chronic ethanol intake, but thrombin-induced aggregation and secretion of [14C]serotonin from prelabeled platelets, which were enhanced by cholesterol feeding, were diminished by administration of ethanol to hypercholesterolemic rabbits. This reduction in thrombin-induced responses was also observed with aspirin-treated platelets, which cannot form thromboxane A2. Thus, chronic short-term administration of a moderate amount of ethanol inhibited the enhanced responses of platelets from rabbits with diet-induced hypercholesterolemia, via a thrombin-induced, thromboxane A2-independent pathway.

Adenosine Diphosphate↗