PLT,MPV,PDW对单采血小板产品聚集的影响

目的：探讨血小板含量（PLT）,血小板平均分布宽度（PDW）,血小板平均体积（MPV）对单采血小板聚集的影响,方法：随机抽取68例血小板捐献者,均成功捐献单采血小板,分为聚集组和对照组。献血前抽取静脉血,采用麦道尼克CA620血细胞分析仪进行血细胞分析,检测PLT,MPV,PDW。结果：聚集组（%）PDW 17.5±1.8,高于对照组（%）PDW12.1±0.9（P〈0.05）。聚集组（fl）MPV 11.0±0.9高于对照组（fl）MPV 7.8±0.8（P〈0.05）,差异有统计学意义,聚集组PLT（187±13.3）×109,对照组PLT（195±11.0）×109,二者无明显统计学差异（P〉0.05）。MPV,PDW分别与PLT进行相关性分析,PLT与MPV无显著相关（r=0.132,P〉0.05）;PLT与PDW无显著相关（r=0.147,P〉0.05）。结论：单采血小板产品出现聚集,其捐献者PDW,MPV高于单采产品正常捐献者,与献血者PLT计数无明显关系。     

蛋白激酶C在血小板聚集中的作用

利用￣（３２）Ｐ－ＮａＨ２ＰＯ４标记猪血小板,以蛋白激酶Ｃ的４０ｋＤ底物为蛋白激活的标志．用血小板激动剂在聚集浓度范围内处理血小板,结果表明,除了不能使猪血小板聚集的肾上腺素外,凝血酶等激动剂都使血小板４０ｋＤ底物蛋白磷酸化明显增加,同时３８ｋＤ,２６ｋＤ蛋白质磷酸化也明显增加,且４０ｋＤ底物磷酸化与血小板聚集有平行增加关系．蛋白激酶Ｃ在血小板聚集中可能起着重要的调节作用。     

血小板C1q受体

血小板Ｃ１ｑ受体（ＰＱＲ）纯品的分子量为６７０００,沉降系数２．４Ｓ,有链内二硫键。每个血小板约含有４×１０＾３个ＰＱＲ分子,其对Ｃ１ｑ的亲和常数为３．５×１０＾７Ｍ＾＿。ＰＱＲ与Ｃ１ｑ的结合具有特异性、可饱和性和可逆性。ＰＱＲ是不同于血小板胶原受体的膜受体分子,但可与胶原发生交叉反应。单体Ｃ１ｑ抑制胶原或免疫复合物（ＩＣ）诱导的血小板聚集和释放反应,而多聚Ｃ１ｑ则能激活血小板的这些功能。ＰＱＲ…     

丹心Ⅲ号和丹心V号对血小板聚集功能的影响

本文观察了丹心Ⅲ号和丹心Ｖ号对血小板聚集功能的影响,实验结果：丹心Ⅲ号和丹心Ｖ号在体外均可显著抑制ＡＤＰ和花生四烯酸诱导的人血小板聚集,其ＩＣ５０分别为１．６０５ｍｇ／ｍｌ,２．５８９ｍｇ／ｍｌ,８．４ｌ６ｍｇ／ｍｌ和６．６０６ｎｇ／ｍｌ;在体内可抑制连续给药（３５０一７００ｍｇ／ｌｋｇ．ｄ）１０ｄ大鼠血小板对ＡＤＰ和花生烯酸诱导的血小板聚集,但对凝血酶诱导的血小板聚集无明显抑制作用。上述结果提示丹心Ⅲ号和丹心Ⅴ号对血小板聚集功能具有明显的抑制作用。     

运动对大鼠血小板L—精氨酸转运的影响

本工作在游泳大鼠模型上,观察血小板Ｌ－精氨酸（Ｌ－Ａｒｇ）转运特征,并观察凝血酶和ＰＡＦ对血小板Ｌ－Ａｒｇ转运的影响。结果发现,运动大鼠血小板Ｌ－Ａｒｇ转运明显高于未运动对照大鼠,表现在高亲和性最大转运速率（Ｖｍａｘ）明显增高（５０．５６±３．２７ｐｍｏｌ／１０８ｖｓ４５．８４±２．３６ｐｍｏｌ／１０８血小板／ｍｉｎ。Ｐ＜０．０５）,米氏常数亦显著增加（２．１４±０．２３μｍｏｌ／Ｌｖｓ１．４６±０．１３μｍｏｌ／Ｌ,Ｐ＜０．０１）。应用刺激剂凝血酶和ＰＡＦ诱导运动大鼠血小板Ｌ－Ａｒｇ转运速率增加的幅度明显高于未运动对照大鼠（Ｐ＜０．０１）。实验结果表明,运动能增强血小板转运Ｌ－Ａｒｇ的效率。提示,运动可能促进血小板一氧化氮（ＮＯ）生成,抑制血小板聚集,防治血管栓塞性疾病     

大鼠免疫性血小板减少模型的研究

采用注射兔抗大鼠血小板血清（ＡＰＳ）方法,建立了大鼠免疫性血小板减少模型。大鼠腹腔注射１：４稀释的ＡＰＳ（０．７ｍｌ／２００ｇ体重）,连续３ｄ,可使血小板数量显著降低,其降低率为８１±９％（ｎ＝１２）,且其骨随巨核细胞增生活跃,但注射ＡＰＳ后对血中红细胞数和白细胞数无明显影响．在注射ＡＰＳ的同时,给予大鼠灌胃强的松（１ｍｇ／２００ｇ体重）,可抑制ＡＰＳ所致的血小板减少的下降程度,并促进停止注射ＡＰＳ后血小板数的恢复。以上结果表明,该模型符合免疫性血小板减少性紫癜的病理特征。     

天麻醒脑胶囊对家兔血小板聚集和花生四烯酸诱导大鼠脑血栓形成的影响

采用比浊方法测定天麻醒脑胶囊在体内和体外对腺苷二磷酸（ADP）、花生四烯酸（arachidonic acid,AA）和血小板活化因子（platelet activating factor,PAF）诱导家兔血小板活化聚集的影响。采用从经大鼠颈内动脉注射诱发同侧大脑半球脑血栓形成方法评价天麻醒脑胶囊的抗脑血栓形成作用。天麻醒脑胶囊在体外呈浓度依赖性明显抑制从和ADP引起的血小板聚集,其半数抑制浓度（50％of inhibitory concentration,IC50）分别为1．83和3．25g/L。0．5和1g/kg的天麻醒脑胶囊于灌胃后明显抑制从诱导的家兔血小板聚集,本品1g/kg时显著阻抑ADP引起的血小板聚集。天麻醒脑胶囊在体内外对PAF诱导的血小板聚集均无明显影响。1、2g/kg天麻醒脑胶囊组的右侧与左侧脑重差值均显著减小,显著降低右脑伊文思蓝吸光度与右脑重的比值。结果提示,天麻醒脑胶囊具有较强的抗血小板和减轻脑血栓形成作用,有利于血小板聚集性增高的血栓栓塞性疾病的防治。     

Wortmannin对凝血酶诱导的人血小板聚集和磷脂酰肌醇三磷酸累积的影响

 Ｗ ｏｒｔｍ ａｎｎｉｎ 是肌醇磷脂 ３ 激酶的不可逆抑制剂．用比浊法分析血小板聚集;肌醇磷脂用３２ Ｐ 磷酸钠标记,用氯仿和甲醇抽提,用 Ｔ Ｌ Ｃ和放射自显影分析,研究了 Ｗ ｏｒｔｍ ａｎｎｉｎ 对凝血酶诱导的人血小板聚集和磷脂酰肌醇三磷酸（ Ｐ Ｉ Ｐ３）累积的影响．结果显示, Ｗ ｏｒｔｍ ａｎｎｉｎ 对凝血酶（５００ Ｕ／ Ｌ）诱导的人血小板聚集有抑制作用,这种抑制作用在一定范围内呈剂量依赖关系（２０～８０μｍ ｏｌ／ Ｌ）．凝血酶（５００ Ｕ／ Ｌ）诱导人血小板 Ｐ Ｉ Ｐ３ 的累积, Ｗ ｏｒｔｍ ａｎｎｉｎ 对此累积有抑制作用,这种抑制作用在一定范围内呈剂量依赖关系（４０～１６０ μｍ ｏｌ／ Ｌ）．结果提示： Ｗ ｏｒｔｍ ａｎｎｉｎ 可能是潜在的抗血小板药物,抑制凝血酶诱导的人血小板聚集主要与其抑制 Ｐ Ｉ Ｐ３ 的累积有关．结果也提示,肌醇磷脂 ３ 激酶在血小板活化中起重要作用．     

瑞舒伐他汀和阿托伐他汀在急性冠脉综合症中对氯吡格雷抗血小板活性的对比研究

目的：在急性冠脉综合征（acute coronary syndromes,ACS）的治疗中,抗血小板治疗及调脂治疗是最基础的治疗方案。近来有学者提出,氯吡格雷和他汀类药物都经过细胞色素CYP3A4途径代谢,二者因存在竞争性抑制,有可能降低氯吡格雷抗血小板的活性。本试验将针对阿托伐他汀及瑞舒伐他汀进行研究。方法：选择急性冠脉综合症的患者42例,所有患者均接受氯吡格雷治疗（负荷剂量300mg,维持剂量75mg／d）。随机分配为A、B两组,A组（n=20）服用阿托伐他汀治疗（20mg／d）,B组（n=22服用瑞舒伐他汀治疗（10mg／d）。分别于氯吡格雷服用前、服药治疗后3天、服药治疗后7天后采静脉血送检,测定ADP（10μmol／L）诱导的血小板聚集率。结果：阿托伐他汀组（A组）及瑞舒伐他汀组（B组）相比,服用氯吡格雷前ADP诱导的血小板聚集率基线值无统计学差异。服用氯吡格雷3日及7日后,ADP诱导的血小板聚集率明显降低,（3．85±2．58）vs（3．09±2．27）,（0．65±0．88）vs（1．05±0．95）,P〉0．05,无明显统计学差异。结论：氯吡格雷的确可以降低血小板的活性。同时,短期之内氯吡格雷的抗血小板活性未受到他汀类的影响。包括经过CPY3A4途径的他汀,如阿托伐他汀。     

透析式洗涤冰冻红细胞去除白细胞和血小板的方法

目的：用低速离心的方法减少悬浮红细胞中自细胞和血小板的数量,使透析式洗涤机洗涤的冰冻红细胞中白细胞和血小板的残留量小于1％。方法：分别选用低速离心（700和500r／min）和常规离心（3800r／min）全血制备悬浮红细胞,计算白细胞和血小板的清除率;甘油低温冰冻保存,透析式冰冻红细胞洗涤机洗涤冰冻红细胞,对洗涤后的红细胞进行质量检测。结果：500r／min离心后白细胞和血小板的清除率（％）分别为53.82±6.83和85.23±4.21;洗涤后的冰冻红细胞中白细胞和血小板残留量（％）分别为0.843±0.058和0.903±0.035。700r／min离心后白细胞和血小板的清除率（％）分别为23.38±2.36和62.61±3.82;洗涤后的冰冻红细胞中白细胞和血小板残留量（％）分别为0.983±0.024和1.021±0.045。3800r／min离心后白细胞和血小板的清除率（％）分别为9.82±4.12和6.39±3.26;洗涤后的冰冻红细胞中白细胞和血小板残留量（％）分别为3.839±2.896和3.528±2.689。结论：用500r／min离心全血制备的悬浮红细胞,经甘油低温冻存,透析式洗涤机洗涤后,血小板和白细胞的残留量等各项指标均符合国家标准。     

Effect of the thiol group inhibitor monobromobimane and other inhibitors on the composition of the platelet cytoskeletal core and its association with glycoprotein IIIa

SDS-polyacrylamide gel electrophoresis was used to study the effects of the thiol inhibitor monobromobimane (MB), EDTA, and prostaglandin E1 (PGE1) on the formation and composition of the platelet cytoskeletal core (Triton-insoluble residue) and its association with glycoprotein (GP) IIIa. Stimulation or aggregation of platelets in response to ADP or thrombin increased the amount of Triton-insoluble myosin. Aggregation resulted in incorporation of [125I]GP IIIa and a new band at about 210 kDa into the cytoskeletal core. EDTA and PGE1 caused little disaggregation of platelets that were aggregated in PRP with ADP and that had secreted the contents of their granules. In contrast to EDTA, PGE1 decreased the amount of Triton-insoluble residue and its association with GP IIIa. MB added after ADP-induced aggregation caused an increase in the amount of cytoskeletal core despite marked disaggregation and a substantial decrease in core-associated GP IIIa. With aspirin-treated platelets that had not secreted, EDTA, PGE1, and MB all caused disaggregation and loss of cytoskeletal GP IIIa. MB diminished, but did not reverse, thrombin-induced aggregation of washed platelets and arrested GP IIIa incorporation into the cytoskeletal core. Concanavalin A (Con A) cross-links glycoproteins on a single platelet and induces incorporation of GP IIIa into the Triton-insoluble residue in the absence of platelet aggregation. This induction was not inhibited by MB, although this reagent, as well as aspirin, inhibited Con A-induced secretion. Since GP IIIa incorporation caused by ADP-induced aggregation differs from that caused by Con A in its susceptibility to MB, it seems unlikely that thiol groups are directly involved in the association of GP IIIa with the cytoskeletal core.     

Critical roles for the COOH-terminal NITY and RGT sequences of the integrin beta3 cytoplasmic domain in inside-out and outside-in signaling

Bidirectional signaling of integrin alphaIIbbeta3 requires the beta3 cytoplasmic domain. To determine the sequence in the beta3 cytoplasmic domain that is critical to integrin signaling, cell lines were established that coexpress the platelet receptor for von Willebrand factor (vWF), glycoprotein Ib-IX, integrin alphaIIb, and mutants of beta3 with truncations at sites COOH terminal to T741, Y747, F754, and Y759. Truncation at Y759 did not affect integrin activation, as indicated by vWF-induced fibrinogen binding, but affected cell spreading and stable adhesion. Thus, the COOH-terminal RGT sequence of beta3 is important for outside-in signaling but not inside-out signaling. In contrast, truncation at F754, Y747, or T741 completely abolished integrin activation. A point mutation replacing Y759 with alanine also abolished integrin activation. Thus, the T755NITY759 sequence of beta3, containing an NXXY motif, is critical to inside-out signaling, whereas the intact COOH terminus is important for outside-in signaling. In addition, we found that the calcium-dependent protease calpain preferentially cleaves at Y759 in a population of beta3 during platelet aggregation and adhesion, suggesting that calpain may selectively regulate integrin outside-in signaling.     

Apyrase, Ascorbic Acid and Aprotinin Ameliorate the Storage Lesion in Pelleted Platelet Preparations

To evaluate the effect of apyrase, ascorbic acid and aprotinin (AAA) in preventing platelet activation during storage, 12 sets of platelet concentrates (PCs), were treated with AAA and evaluated at days 1, 3, and 5 utilizing platelet functional and morphological assays. Platelets treated with AAA demonstrated significantly enhanced response to ADP-induced platelet aggregation, higher morphology scores, and elevated ATP levels compared to control samples after 5 days of storage. Similarly, platelet specimens treated with AAA had significantly reduced PF4 secretion and P-selectin expression compared to controls. Finally, Western blots of aggregated platelets at day 5 demonstrated that AAA-treated PCs continue to express the platelet membrane GPIb whereas specimens from control PCs do not. These results show that PCs treated with AAA have reduced platelet activation and enhanced functional platelet activity.     

Humanin analogue,HNG, inhibits platelet activation and thrombus formation by stabilizing platelet microtubules

HNG, a highly potent mutant of the anti‐Alzheimer peptide‐humanin, has been shown to protect against ischaemia‐reperfusion (I/R) injury. However, the underlying mechanism related to platelet activation remains unknown. We proposed that HNG has an effect on platelet function and thrombus formation. In this study, platelet aggregation, granule secretion, clot retraction, integrin activation and adhesion under flow conditions were evaluated. In mice receiving HNG or saline, cremaster arterial thrombus formation induced by laser injury, tail bleeding time and blood loss were recorded. Platelet microtubule depolymerization was evaluated using immunofluorescence staining. Results showed that HNG inhibited platelet aggregation, P‐selectin expression, ATP release, and α_IIbβ₃ activation and adhesion under flow conditions. Mice receiving HNG had attenuated cremaster arterial thrombus formation, although the bleeding time was not prolonged. Moreover, HNG significantly inhibited microtubule depolymerization, enhanced tubulin acetylation in platelets stimulated by fibrinogen or microtubule depolymerization reagent, nocodazole, and inhibited AKT and ERK phosphorylation downstream of HDAC6 by collagen stimulation. Therefore, our results identified a novel role of HNG in platelet function and thrombus formation potentially through stabilizing platelet microtubules via tubulin acetylation. These findings suggest a potential benefit of HNG in the management of cardiovascular diseases.     

A massive dose of allogeneic platelet gel for wound hemostatic therapy on patients with giant thoracic aortic aneurysm: report of 2 cases

Autologous platelet-rich plasma (PRP) or platelet gel (PG) has been widely used in clinical treatment. Allogeneic PRP or PG may also become a safe and effective alternative method. In this study, two cases with giant thoracic aortic aneurysm were reported where massive doses of allogeneic PG were used to spray the thoracic aortic aneurysm wall suture wrapped in artificial blood vessels, tumors blood vessel wall anastomotic site, and incision site of surgical operation. The volumes of 220 mL and 250 mL PG were applied on two patients respectively, to clot bleeding and decrease the mediastinal and pericardial drainage days after operation. The drainage tubes were pulled out on the 4^th day after operation. The patients were transferred from ICU to a cardiothoracic surgery ward on the 4^th and 5^th day respectively. This study suggests that allogeneic platelet concentrate, as a source of PRP to prepare PG, may be used to promote and help the clotting and wound healing on surgical operation.     

Platelet lumiaggregation testing: Reference intervals and the effect of acetylsalicylic acid in healthy adults

BackgroundLight transmission aggregometry with lumiaggregometry are methods commonly recommended as a first-line test in platelet dysfunction diagnostic work-up. They are poorly standardized and usually performed in specialized laboratories. For proper interpretation, each laboratory should establish its own diagnostic approach in order to recognize abnormal aggregation patterns. The aim of this study was to measure plasma lumiaggregometry with basic agonists to establish the analyzer-reagent reference intervals (RI) for adults and to test the method response to aspirin.MethodsThe Chrono-Log Model 700 lumiaggregometer using Chrono-Par and Chrono-lume reagents (Chrono-Log Corp., Havertown, PA, USA) was used to measure the maximal aggregation and adenosine triphosphate release using adenosine diphosphate (2 μmol/L), collagen (2 μg/mL), arachidonic acid (1 μmol/L), epinephrine (5.5 μmol/L) and ristocetin (1.25 mg/mL), and thrombin (1 U/mL). The effect of aspirin on platelet aggregation and granule release was inspected.ResultsRIs derived from 40 healthy adults were calculated using the non-parametric approach. Wider intervals and low lower limits were determined for weak agonist as well as absence or impaired aggregation in up to one of 7 healthy controls. The response of platelets to aspirin shows response comparable to previously reported study.ConclusionsLocally established RI in our study enable us to investigate platelet function in patients with a high probability of bleeding disorders. Values are agonist and equipment specific. The variability of the method can be reduced by considering standardized preanalytical and analytical variables. Pathological results must be interpreted in the context of other hemostasis test results and clinical findings.     

大鼠血小板中的神经肽Y及其对血管收缩的影响

特异性放射免疫分析显示大鼠血小板与富血小板血浆(PRP)分别含NPY免疫活性物质90±16ng/10~7血小板与93±19ng/ml,大大高于普通血浆(1.2±0.1ng/ml)与贫血小板血浆(PPP)(1.7±0.3 ng/ml)中的含量(P<0.001)。血小板样品HPLC各馏分的NPY放免活性峰位与标准NPY的峰位相符。PRP经胶原最大程度聚集后,血小板内的NPY浓度降为34±5 ng/10~7血小板,而PPP中的NPY浓度则升高到26±4 ng/ml。1.6 ml PRP经胶原作用产生最大程度聚集,由此分离所得的PPP引起离体灌流大鼠尾动脉收缩,张力上升380±80 mg;上述PPP经NPY抗血清处理后引起尾动脉收缩的幅度显著减小(190±40 mg,P<0.001)。而1 nmol/L人工合成NPY并不引起血管收缩。结果表明大鼠血小板中含有大量NPY,在不可逆聚集时可以释放,释放的NPY可能参与血小板聚集时释放物质的缩血管效应。     

Potentials for prolonging shelf‐life of platelets by near infrared low‐level light

Platelets are uniquely stored at room temperature, during which they gradually loss their quality owing to deteriorating functions of mitochondria over time. Given the well‐documented beneficial effect of near infrared low‐level light (LLL) on mitochondrial functions, we explored a potential for LLL to protect mitochondrial function and extend the shelf‐life of platelets beyond the current 5 days. We found that exposure of a platelet‐containing storage bag to 830 nm light‐emitting diode (LED) light at 0.5 J/cm² prior to storage could significantly retain a pH value and viability of the platelets stored for 8 days with improved quality compared to those stored similarly for 5 days in controls. The LLL inhibited reactive oxygen species (ROS) and lactate production, while sustaining ATP synthesis and mitochondrial membrane potential and morphology in the stored platelets. It also sustained aggregation capacity and in vivo survival of stored platelets, concomitant with no significant activation, as suggested by similar CD62p expression and enhanced agonist‐induced aggregation and recovery following infusion in the presence compared to absence of LLL treatment. This simple, additive‐free, cost‐effective, noninvasive approach can be readily incorporated into the current platelet storage system to potentially improve quality of stored platelets.      

Mcl-1 and Bcl-xL regulate Bak/Bax-dependent apoptosis of the megakaryocytic lineage at multistages

Anti-apoptotic Bcl-2 family proteins, which inhibit the mitochondrial pathway of apoptosis, are involved in the survival of various hematopoietic lineages and are often dysregulated in hematopoietic malignancies. However, their involvement in the megakaryocytic lineage is not well understood. In the present paper, we describe the crucial anti-apoptotic role of Mcl-1 and Bcl-xL in this lineage at multistages. The megakaryocytic lineage-specific deletion of both, in sharp contrast to only one of them, caused apoptotic loss of mature megakaryocytes in the fetal liver and systemic hemorrhage, leading to embryonic lethality. ABT-737, a Bcl-xL/Bcl-2/Bcl-w inhibitor, only caused thrombocytopenia in adult wild-type mice, but further induced massive mature megakaryocyte apoptosis in the Mcl-1 knockout mice, leading to severe hemorrhagic anemia. All these phenotypes were fully restored if Bak and Bax, downstream apoptosis executioners, were also deficient. In-vitro study revealed that the Jak pathway maintained Mcl-1 and Bcl-xL expression levels, preventing megakaryoblastic cell apoptosis. Similarly, both were involved in reticulated platelet survival, whereas platelet survival was dependent on Bcl-xL due to rapid proteasomal degradation of Mcl-1. In conclusion, Mcl-1 and Bcl-xL regulate the survival of the megakaryocytic lineage, which is critically important for preventing lethal or severe hemorrhage in both developing and adult mice.