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Significance of platelet-derived microparticles and activated platelets in diabetic nephropathy
1Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Abstract:
We measured levels of platelet-derived microparticles (PMP), which have coagulative activity and are produced by platelet activation or physical stimulation, and CD62P/CD63-positive platelets in patients with diabetes mellitus to determine their clinical significance and effects on complications of diabetes including diabetic nephropathy. We also compared these levels before and after administration of the antiplatelet drug cilostazol. Plasma PMP and CD62P/CD63-positive platelet levels were significantly higher in patients with diabetes mellitus than normal controls. CD62P-positive platelet levels were significantly higher in patients with nephropathy than in patients without complications. After administration of cilostazol, PMP and CD62P/CD63-positive platelet levels were significantly decreased. The increases in platelet activity and its related procoagulant activity appear to account in part for the hypercoagulability observed in diabetes mellitus. Our findings suggest that activated platelets might play a role in the development of diabetic nephropathy. Furthermore, antiplatelet therapy with cilostazol for diabetic patients may be useful as antithrombin therapy including antiplatelet therapy, since it suppresses the production of intrinsic coagulants produced by platelet activation.
Insights
Diabetic patients show higher platelet activation markers, linked to complications like nephropathy. Antiplatelet drug cilostazol reduced these markers, suggesting a therapeutic role in managing diabetes-related hypercoagulability.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Hematology
Background:
- Diabetes mellitus is associated with a hypercoagulable state.
- Platelet activation and microparticle formation are implicated in thrombotic complications.
Purpose of the Study:
- To investigate the role of platelet-derived microparticles (PMP) and activated platelets (CD62P/CD63-positive) in diabetes mellitus and its complications, particularly diabetic nephropathy.
- To evaluate the effect of cilostazol on these markers.
Main Methods:
- Quantification of plasma PMP and CD62P/CD63-positive platelets in diabetic patients and healthy controls.
- Comparison of marker levels before and after cilostazol administration.
- Analysis of marker levels in relation to diabetic nephropathy.
Main Results:
- Diabetic patients exhibited significantly elevated levels of PMP and CD62P/CD63-positive platelets compared to controls.
- CD62P-positive platelet levels were higher in patients with diabetic nephropathy.
- Cilostazol treatment led to a significant reduction in PMP and CD62P/CD63-positive platelet levels.
Conclusions:
- Increased platelet activity and procoagulant activity contribute to hypercoagulability in diabetes mellitus.
- Activated platelets may play a role in the pathogenesis of diabetic nephropathy.
- Cilostazol demonstrates potential as an antithrombotic therapy in diabetic patients by suppressing platelet activation.