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Increased aggregation and arachidonic acid transformation by psoriatic platelets: evidence that platelet-derived 12-hydroxy-eicosatetraenoic acid increases keratinocyte DNA synthesis in vitro.

Certain arachidonic metabolites may play a pathogenic role in psoriasis. Platelets are rich sources of 12-hydroxy-eicosatetraenoic acid (12-HETE) and thromboxane A2, mediators of skin inflammation and platelet aggregation, respectively. We have studied untreated psoriatic patients without a history of diabetes mellitus and smoking. In psoriatics, platelet aggregation elicited by thrombin, ADP, and ristocetin was significantly enhanced as compared with healthy adult volunteers. Enhancement of platelet aggregation was detected in patients with both minimal and widespread disease. The formation of 12-hydroxy-5,8,10-heptadecatrienoic acid (HHT), a cyclooxygenase product, and 12-HETE, a 12-lipoxygenase product, was increased in psoriatics with widespread disease but not in those with minimal disease. Formation of 12-HETE was stimulated to a higher degree (125%) than HHT (98%) in psoriasis (P less than 0.05). Addition of platelet-derived 12-HETE to cultured human epidermal keratinocytes resulted in a stimulation of the DNA synthesis (68% at 10(-7) M). These data suggest that platelet activation occurs in psoriasis, and that release of inflammatory and mitogenic compounds by activated platelets may play a role in the pathophysiology of psoriasis. Whether enhanced platelet aggregation in psoriasis is associated with occlusive vascular disease needs further investigation.

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

Platelet fibrinogen in the patients with idiopathic bleeding platelet disorder.

The changes of platelet fibrinogen in patients with obscure cutaneous mucosal bleeding and their relation with disease were evaluated. By using flow cytometry and Western blot, the platelet binding site of fibrinogen and the expression of platelet fibrinogen in 8 cases of obscure bleeding were detected. The results showed that platelet surface binding sites of fibrinogen were 65.38 +/- 3.62 in the resting state and 65.25 +/- 5.78 after activated by adenosine diphosphate, showing no significant difference as compared with control group (P > 0.05). The expression of platelet fibrinogen was obviously decreased in 4 patients and increased in one case as compared with control group. It was concluded that the binding sites of fibrinogen on the platelet surface were normal in the patients with idiopathic bleeding platelet disorder. The abnormal of platelet fibrinogen might be one of hemorrhagic reasons in partial patients.

Adult↗

An epidemic of maternal thrombocytopenia associated with elevated antiplatelet antibody. Platelet count and antiplatelet antibody in 116 consecutive pregnancies: relationship to neonatal platelet count.

Twenty-eight (24%) of 116 pregnant women studied prospectively during an 8-month period in 1983 had platelet counts of less than 150,000/mm3 at least once during pregnancy. Thirteen of these were thrombocytopenic in both the prenatal and the peripartum period. Eighteen were restudied 3 to 12 months after delivery. One woman, who was pregnant again, had a platelet count of 140,000/mm3. In the others, platelet counts were in the normal range. Platelet-associated immunoglobulin G and serum antiplatelet antibody levels were elevated in 79% and 61%, respectively, of these 28 women on at least one occasion. However, 59% of 73 pregnant nonthrombocytopenic women had increased platelet-associated immunoglobulin G levels and 59% had positive serum antiplatelet antibody test results. Twenty women who had increased platelet-associated immunoglobulin G levels and positive serum antiplatelet antibody test results were normal 6 to 10 months after delivery. Of 105 infants studied, 10 were thrombocytopenic. Neonatal thrombocytopenia was not predicted by maternal platelet count, platelet-associated immunoglobulin G, or serum antiplatelet antibody. By the fall of 1984, the incidence of thrombocytopenia had dropped to two in 280 consecutive pregnancies. We conclude that (1) epidemics of thrombocytopenia can occur in pregnant women and (2) if a women is found to be thrombocytopenic for the first time during pregnancy, she should not be subjected to the measures advocated for the management of pregnancy in women with autoimmune thrombocytopenic purpura.

Adult↗

Inhibition of platelet aggregation by synthetic phosphatidylcholines: possible involvement of vesiculation of platelet plasma membranes.

Synthetic phosphatidylcholines inhibited thrombin-induced aggregation of rabbit platelets. The inhibitory effect of the phosphatidylcholines increased with an increase in the chain-length of the constituent fatty acids up to 12, and then decreased, and C14:0PC and C16:0PC did not inhibit platelet aggregation. The activity of synthetic phosphatidylcholines as to induction of vesiculation of platelet plasma membranes (Kobayashi, T., Okamoto, H., Yamada, J.-I., Setaka, M. and Kwan, T. (1984) Biochim. Biophys. Acta 778, 210-218) and the inhibitory effect of these phosphatidylcholines on platelet aggregation showed the same dependence on the constituent fatty acids of the phosphatidylcholines. The amounts of phosphatidylcholines required for 50% inhibition of platelet aggregation correspond very well to those required for 15% exfoliation of acetylcholinesterase activity, suggesting that there is a close relationship between platelet aggregation and vesiculation of the platelet plasma membrane. The possible mechanism of inhibition of platelet aggregation by synthetic phosphatidylcholines is discussed.

Acetylcholinesterase↗

Rat platelet arachidonate metabolism in the presence of Ca2+, Sr2+ and Ba2+: studies using intact platelets and semi-purified phospholipase A2.

To document further the involvement of external Ca2+ in the platelet-induced activation process, we have studied the arachidonate metabolism of intact washed rat platelets in the presence of different concentrations of Ca2+, Sr2+ or Ba2+. The thrombin-induced mobilization of radiolabeled arachidonate preincorporated into platelet phospholipids was followed as well as the subsequent formation of labeled cyclooxygenase and lipoxygenase products. Results indicate that upon thrombin stimulation (0.2 U/ml), the release of endogenous arachidonate and the formation of its metabolites are reduced by 50-90% only by omission of Ca2+ as compared to 1 mM Ca2+ in the suspending medium. At higher Ca2+ concentrations (5 mM), the arachidonate mobilization and metabolite formation are inhibited and the data are thus close to those obtained in the absence of Ca2+. In the presence of Sr2+ or Ba2+, the results indicate that these cations can substitute for Ca2+. As for Ca2+, an optimum concentration is found for Sr2+ and Ba2+ (3-5 mM), and higher concentrations inhibit the metabolism of arachidonic acid. As the above data might be compatible with the possible entry of Sr2+ and Ba2+ into platelets upon stimulation, we also studied the activity of a semi-purified preparation of phospholipase A2 from rat platelets. This activity was assayed (pH 9.2) using heat-denatured [3H]arachidonate-prelabeled phospholipids as substrate. The results show that this phospholipase A2 activity was strongly Ca2+-dependent. In addition, we found that unlike Mg2+, Sr2+ and Ba2+ are able to greatly enhance this activity. Relative efficiency (Vmax) was in the order Ca2+ greater than Sr2+ greater than Ba2+. Taken together, these findings suggest that external Ca2+ may play a major role in the regulation of rat platelet activity. Our interpretation is in line with the view that Sr2+ or Ba2+ could enter the platelet through a mechanism common to Ca2+ (a Ca2+ channel). Although direct evidence is awaited from the results of further studies which are in progress, it can reasonably be considered that Sr2+ or Ba2+ might cause platelet-induced activation mimicking a rise in the cytosolic Ca2+ and subsequent activation of Ca2+-dependent enzymes.

Animals↗

Synergistic phosphorylation of the focal adhesion-associated vasodilator-stimulated phosphoprotein in intact human platelets in response to cGMP- and cAMP-elevating platelet inhibitors.

The mechanism underlying the synergistic inhibition of platelet activation by cGMP- and cAMP-elevating vasodilators was investigated using washed human platelets and platelet-rich plasma. With both types of human platelet preparations, low concentrations of sodium nitroprusside increased the cAMP-elevating potency of low concentrations of prostaglandin E1 (PG-E1). Using threshold concentrations of both sodium nitroprusside and PG-E1, the NO-donor potentiated the effect of PG-E1 with respect to the phosphorylation of the focal adhesion-associated vasodilator-stimulated phosphoprotein (VASP) at serine157. In contrast, threshold concentrations of cell-membrane permeant selective activators of the platelet cGMP-dependent protein kinase or the cAMP-dependent protein kinase had only additive effects on VASP serine157 phosphorylation in washed human platelets. The data demonstrate that low intracellular levels of cGMP effectively inhibit type III cGMP-inhibited phosphodiesterase in human platelets despite the high levels of cGMP-dependent protein kinase present in this cell type. This study provides the first evidence that the simultaneous activation of both cGMP- and cAMP-dependent protein kinase results in additive effects on VASP serine157 phosphorylation, whereas the supra-additive effects observed with the combination of sodium nitroprusside and PG-E1 are due to cGMP-mediated inhibition of type III phosphodiesterase. VASP phosphorylation at serine157 may be an important component underlying the synergistic inhibition of human platelets by cGMP-and cAMP-elevating agents.

Alprostadil↗

An enzyme-linked immunosorbent assay for the detection of platelet antibodies using detergent-solubilized platelets immobilized on nitrocellulose discs.

A method is detailed for the solubilization of human platelets using a dialyzable detergent, decanoyl-N-methylglucamide (Mega-10). At a detergent/protein ratio of 1:12, the efficiency of solubilization was 27%. This platelet lysate (PLy) was then bound to nitrocellulose (NC) discs to assay retention of the native immunological functions of the platelet membrane antigens. Using alkaline phosphatase-coupled anti-IgG, the major platelet membrane glycoproteins GPIb, GPIIb, and GPIIb/IIIa were detectable with as little as 20 ng of monoclonal antibody. Antisera to the class I histocompatibility antigens HLA-A1, B7, B8, the PlA1 allodeterminant, and serum from multiply transfused, alloimmunized patients were reactive even after 100 days storage of the discs at 4 degrees C, and with as little as 1.0 micrograms of NC-bound PLy. The binding of the same antisera to intact, immobilized platelets as well as specific complement-mediated lymphocytotoxicity was also inhibited by PLy. PLy from HLA-A3- or B44-positive donors, however, did not inhibit cytotoxicity of lymphocytes expressing either antigen using several different antisera. Our results indicate that Mega-10 is an excellent solubilizing agent for the immunological study of platelet membranes. The fact that clinically relevant platelet membrane antigens are preserved, immunologically reactive, and stable over long periods of storage, makes this assay amenable to a routine crossmatching procedure for platelet transfusions.

Autoantibodies↗

Association of factor V activity with membranous vesicles released from human platelets: requirement for platelet stimulation.

The membrane-associated factor V-like activity (platelet factor 1, PF1) and the phospholipid-like catalytic surface activity (platelet factor 3, PF3) were studied in human platelets from normal and two factor V-deficient donors. Collagen stimulation or mechanical disruption of gel-filtered platelets was necessary for the expression of significant amounts of PF1 and PF3. Stimulation was also necessary for the uptake of factor V or Va by PF1-deficient platelets from the factor V-deficient donors. The activity of PF1 was also generated by association of factor V or Va with membrane-rich fractions obtained by gel filtration of the supernatant from collagen-stimulated or frozen-thawed PF1-deficient platelets. The amount of PF1 obtained by such all-or-none binding experiments was directly proportional to the amount of PF3 already expressed in the platelet preparation. These data have been summarized in terms of a hypothesis which views PF1 and PF3 to be activities associated with membranous vesicles released from platelets only after stimulation.

Blood Coagulation Factors↗

Demonstration of labile platelet desaggregation-promoting substance(s) in human blood, using the donor's own blood platelets ("DOP assay") as indicator cells, with special reference to the possibility of measuring diet-induced alterations.

A method is described for the semi-quantitative biological determination of labile platelet desaggregation-promoting substance(s) in human platelet suspensions and in platelet-free fresh plasma by using the donor's own platelets ("DOP assay"). Using the donor as his own control it is possible to demonstrate a dose-related increase of the platelet desaggregation-promoting potency in response to cod-liver oil. The labile platelet desaggregation-promoting activity can also be observed in fresh platelet-free plasma. Circumstantial evidence is presented for the prostaglandin-like nature of these labile platelet desaggregation-promoting substance(s).

Adenosine Diphosphate↗

The effect of fish oil consumption on platelet aggregation responses in washed human platelet suspensions.

Although the biochemical mechanisms relating to the inhibitory action of eicosapentaenoic acid on platelet function have previously been investigated in washed platelet suspensions, there is little existing evidence in washed platelet suspensions to indicate that dietary fish oil consumption reduces platelet aggregation responses. In the present work, eight healthy male volunteers consumed 20 fish oil capsules (MaxEPA) per day for a period of six weeks followed by a six week "dry-out" period during which no fish oil was consumed. Washed platelet suspensions were prepared and aggregation responses to collagen, platelet activating factor (PAF), and thrombin were assessed initially at week 0 and subsequently at 3, 6, 9, and 12 weeks of the experimental period. Three weeks of fish oil consumption did not produce any marked alterations in aggregation responses; however, six weeks of dietary fish oil supplementation resulted in decreased maximum aggregation responses to collagen and PAF by 50.1% and 27.2%, respectively. These results provide evidence, in washed platelet suspensions, that dietary fish oil consumption significantly diminishes platelet responses to collagen and PAF. The significance of these observations remains to be explored and interpreted.

Adult↗

Human platelet phospholipase A2 activity is responsive in vitro to pH and Ca2+ variations which parallel those occurring after platelet activation in vivo.

Secretion of human platelet dense granule contents in response to epinephrine and other weak agonists requires the prior liberation of membrane-esterified arachidonic acid by a phospholipase A2 enzyme species whose activity is regulated by Na+/H+ exchange (e.g., Sweatt et al. (1986) J. Biol. Chem. 261, 8660-8673 and Banga et al. (1986) Proc. Natl. Acad. Sci. USA 83, (197-9201). Based on our earlier findings in intact platelets, we postulated that the alkalinization of the platelet interior that accompanies accelerated activity of the Na+/H+ antiporter enables the phospholipase A2 enzyme to function at ambient or low concentrations of intraplatelet Ca2+. To test the hypothesis that the Ca2+ dependence of platelet phospholipase A2 activity is influenced by changes in intraplatelet pH that occur following platelet activation, we characterized the Ca2+ dependence of this enzyme as a function of changes in pH (from pH 6.8-8.0), since it is within this range that intraplatelet pH changes occur following platelet activation. Phospholipase A2 enzymatic activity in platelet particulate preparations was detectable in the presence of micromolar concentrations of Ca2+ (EC50 1-2 microM) and plateaued above 10 microM Ca2+. Enzymatic activity measured at 4.8 microM Ca2+ was increased by raising the pH from 5.5 to 8.0 (EC50 7.4), was optimal at pH 8.0 and declined at more alkaline values. Furthermore, increases in pH from pH 6.8 to pH 8.0 not only increased maximal enzymatic activity but also enabled detection of enzymatic activity at lower Ca2+ concentrations. The interdependent regulation of phospholipase A2 activity by changes in pH and Ca2+ suggests that phospholipase A2 could serve to integrate changes in intracellular pH and available Ca2+ that occur subsequent to activation of human platelets by epinephrine and other weak agonists.

Binding, Competitive↗

Influence of anti-platelet drugs on platelet-vessel wall interactions.

The influence of in vitro treatment of platelets with antiplatelet drugs on the interaction of these cells with the subendothelium was studied using citrated human blood obtained from normal control donors. Reconstituted blood following drug treatment was circulated through a special chamber which housed everted segments of de-endothelialized rabbit aorta. The wall shear rate used in these studies was 800 sec-1. Surface coverage of platelets on the subendothelium were morphometrically evaluated. Aspirin, Ibuprofen, Prostaglandin E1 and 13-Azaprostanoic acid significantly reduced platelet thrombi on exposed subendothelium. The calcium antagonists, Quin 2 and Diltiazem, exerted similar inhibitory effects, whereas Verapamil was a poor inhibitor. Aspirin treatment significantly enhanced platelet adhesion to the exposed vascular surface. Salicylate and Salicylamide did not enhance platelet adherence. Only Aspirin enhanced the formation of lipoxygenase metabolites of radiolabeled arachidonate. Results suggest that drugs which inhibit platelet aggregation and secretion of granule contents reduce formation of platelet thrombi. However, these drugs may or may not have a similar influence on platelet interaction with the subendothelium leading to spreading, adherence or formation of aggregates.

Aspirin↗

Acetyltransferase activity in human platelet microsomes and washed platelets.

It has been demonstrated that human platelets form platelet-activating factor (PAF) when stimulated by thrombin, collagen and ionophore A-23187, but the mechanism of its formation has not been elucidated. In this study we demonstrated increased acetyltransferase activity (i.e., transfer of the acetyl moiety of [3H]acetyl-CoA to lyso-PAF (1-alkyl-sn-glycero-3-phosphocholine) to form PAF) occurring in human platelet microsomes made from platelets stimulated by thrombin or ionophore A-23187. This stimulation resulted in a 2-4-fold increase in acetyltransferase activity over unstimulated platelets. Acetyltransferase activity was also demonstrated by incubating [3H]acetate with whole platelets and stimulating with thrombin or ionophore A-23187. Radioactive PAF was detected when the platelets were stimulated. None was formed without stimulation. These findings indicate that acetyltransferase may play a role in the biosynthesis of PAF by human platelets.

Acetates↗

Protein synthesis and storage in human platelets: a defective storage of fibrinogen in platelets in Glanzmann's thrombasthenia.

In vivo metabolic labelling experiments were performed to investigate the ability of human platelets to synthesize and store fibrinogen and thrombospondin. Newly synthesized proteins were analyzed by SDS-polyacrylamide gel electrophoresis. Results were compared with those obtained for the platelets of a patient with Glanzmann's thrombasthenia where endogenous fibrinogen levels were severely reduced. Normal human platelets were able to synthesize the different subunits of fibrinogen and thrombospondin and to assemble them into native fibrinogen and thrombospondin molecules. This synthesis was inhibited by cycloheximide. Synthesis of both fibrinogen and thrombospondin was observed in the platelets of the Glanzmann's thrombasthenia patient. However, radiolabelled fibrinogen was no longer detected after an 18-h non-radioactive chase, although it was retained in the control platelets. Neosynthesized thrombospondin of the patient was normally preserved during the same chase period. When the fate of the radioactive fibrinogen was studied, it was found to be degraded in Glanzmann's thrombasthenia platelets to the same extent as neosynthesized cytoplasmic proteins, whereas in control platelets less degradation had occurred. We conclude that human platelets maintain a residual capacity to synthesize fibrinogen and that its deficiency in Glanzmann's thrombasthenia results from a storage abnormality and not from a synthesis defect.

Blood Platelet Disorders↗

Influence of glucose concentration on the effects of aspirin, ticlopidine and clopidogrel on platelet function and platelet-subendothelium interaction.

Clinical studies have shown that the ability of aspirin to prevent cerebrovascular accidents is weaker in patients with diabetes. The aim of this study was to determine whether high concentrations of glucose modified the effect of aspirin, ticlopidine and clopigodrel on platelet function and platelet-subendothelium interactions. This in vitro study tested three different concentrations of glucose. The effects were analyzed by comparing platelet aggregometry in whole blood, nitric oxide and prostacyclin production in cultures of human endothelial cells, and by quantitative analysis of morphological features of the platelet-subendothelium interaction under flow conditions. High concentrations of glucose increased platelet aggregation (13.9 Omega with 5 mM glucose vs. 21.6 Omega with 16.6 mM) and platelet-subendothelium interactions (28.9% with 5 mM glucose vs.35.2% with 16.6 mM), and decreased nitric oxide and prostacyclin production. In the presence of high concentrations of glucose, the antiaggregant effect of aspirin and its influence on nitric oxide production were diminished (IC50 54 microM with 5 mM glucose vs.556 microM with 16.6 mM glucose), and its effect on the platelet-subendothelium interaction was reduced (10.5% platelet occupancy with 5 mM glucose vs.23% with 16.6 mM glucose). The effects of ticlopidine and clopidogrel were not significantly modified.

Adult↗

A comparison of the effects of membrane and bubble oxygenators on platelet counts and platelet size in elective cardiac operations.

To compare the effects of membrane and bubble oxygenators on platelet counts and the size of circulating platelets, serial hematocrits, platelet counts, and platelet sizing were measured in 23 patients undergoing elective cardiac operations. In 10 patients a bubble oxygenator was used and in 13, a SciMed membrane oxygenator. The two groups were statistically similar with respect to age, weight, time on bypass, and mean blood flow rates during bypass. It was found that platelet counts, when corrected for hemodilution, did not fall from control levels during or up to 24 hours after cardiopulmonary bypass in either group. In both groups, the relative number of platelets per gram of hemoglobin increased slightly during and after bypass, and this increase was significant in the bubble oxygenator group. The average size of circulating platelets increased only in the bubble oxygenator group, and then only in the one-day postoperative sample. These findings suggest that the membrane oxygenator offers no advantage with respect to preservation of platelets during cardiopulmonary bypass lasting up to 2 to 3 hours.

Adult↗

Aggregation and disaggregation kinetics of human blood platelets: Part II. Shear-induced platelet aggregation.

A population balance equation (PBE) mathematical model for analyzing platelet aggregation kinetics was developed in Part I (Huang, P. Y., and J. D. Hellums. 1993. Biophys. J. 65: 334-343) of a set of three papers. In this paper, Part II, platelet aggregation and related reactions are studied in the uniform, known shear stress field of a rotational viscometer, and interpreted by means of the model. Experimental determinations are made of the platelet-aggregate particle size distributions as they evolve in time under the aggregating influence of shear stress. The PBE model is shown to give good agreement with experimental determinations when either a reversible (aggregation and disaggregation) or an irreversible (no disaggregation) form of the model is used. This finding suggests that for the experimental conditions studied disaggregation processes are of only secondary importance. During shear-induced platelet aggregation, only a small fraction of platelet collisions result in the binding together of the involved platelets. The modified collision efficiency is approximately zero for shear rates below 3000 s-1. It increases with shear rates above 3000 s-1 to about 0.01 for a shear rate of 8000 s-1. Addition of platelet chemical agonists yields order of magnitude increases in collision efficiency. The collision efficiency for shear-induced platelet aggregation is about an order of magnitude less at 37 degrees C than at 24 degrees C. The PBE model gives a much more accurate representation of aggregation kinetics than an earlier model based on a monodispersed particle size distribution.

Adult↗

Increased platelet surface expression of P-selectin and thrombospondin as markers of platelet activation in essential thrombocythaemia.

Essential thrombocythaemia (ET) is a clonal myeloproliferative disorder associated with an increased risk of both thromboembolic and bleeding complications. Platelet activation plays a crucial role in the pathogenesis of prethrombotic conditions. The platelet surface expression of p-selectin (CD62p) and thrombospondin (TSP) has been shown to correlate with platelet activation. In the present study, we used a flow cytometric assay to study whether the fraction of platelets expressing CD62p and TSP is increased in newly diagnosed ET. Thirty-four patients with newly diagnosed ET and 25 healthy control subjects were investigated. The proportion of platelets expressing the activation-dependent antigens CD62p and TSP was higher in patients with ET (CD62p: 14.7+/-15.0%; TSP: 12.4+/-9.9%) as compared with healthy control subjects (CD62p: 3.0+/-4.0%; TSP: 3.2+/-3.2%; p< 0.001). In ET, there was a linear correlation between platelet surface expression of CD62p and TSP (p<0.0001, r=0.83). At diagnosis of ET, 20 patients were symptomatic and 14 asymptomatic. Compared with asymptomatic ET patients there was no difference in the expression of CD62p (18.3+/-16.2% vs. 14.5+/-13.4%) and TSP (14.4+/-9.8% vs. 12.8+/-9.5%) in symptomatic ET patients. In conclusion, increased expression of platelet neoantigens is present at the diagnosis of ET. Both activation-dependent epitopes CD62p and TSP are increasingly expressed on the platelet surface in newly diagnosed ET patients.

Aspirin↗