Induction of platelet aggregation in vitro by microbubbles of nitrogen

Microbubbles of nitrogen gas act as a platelet agonist, but the biochemical mechanisms involved in bubble-induced platelet activation are not well known. One characteristic property of a platelet agonist is to potentiate the response by another agonist in a synergistic manner at low concentrations. Possible synergism between N2 gas bubbles and the physiologic agonists ADP, epinephrine, and 5-hydroxytryptamine (5-HT) was tested. The interaction with ADP was additive; N2 microbubbles and ADP had different aggregation profiles, and the bubbles made the reversible ADP aggregation irreversible. Epinephrine caused a strong, synergistic stimulation of bubble-induced platelet aggregation. This synergism was only partially inhibited by indomethacin and acetylsalicylic acid, but abolished by yohimbine. 5-HT had an inhibitory effect on N2 microbubble-induced platelet aggregation. This effect was neutralized by the S2-serotonergic receptor blocker ketanserin. Microbubble stimulation of the platelets before stimulation with ADP, epinephrine, and 5-HT seemed to make them more sensitive to epinephrine only. The strong synergism between microbubbles and epinephrine in vitro should be evaluated for possible future use in predive selection of divers.