剪切力诱导的血小板清除是血小板缺血的一个新机制
Antoine Rauch1,2, Annabelle Dupont1,2, Mickael Rosa1,2
1Inserm, Institut Pasteur de Lille, France (A.R., A.D., M.R., M. Desvages, C.L.T., J.A., M. Didelot, A.U., R.R., E.J., M. Daniel, D.C., H.S., B.P., N.R., M.D.M., A.V., B.S., F.V., E.V.B., S.S.), CHU Lille, University Lille, France.
Circulation research
|October 26, 2023
概括
身体外膜氧化 (ECMO) 通过诱导糖蛋白Iba (GP Ibα) 因剪切力而脱落而导致血小板缺血. 这导致GP Ibα阴性血小板的清除速度更快,这表明抑制脱落可以减少ECMO期间的低血小板数量.
科学领域:
- 心血管科学 心血管科学
- 血液学 血液学 血液学
- 生物医学工程 生物医学工程
背景情况:
- 血小板缺血是体外膜氧化 (ECMO) 患者的常见并发症.
- 驱动ECMO相关血小板缺血的确切机制及其对患者结果的影响尚未完全理解.
- 已经假设ECMO在导致低血小板计数方面与设备相关的作用.
研究的目的:
- 调查ECMO治疗患者中血小板缺血的潜在机制.
- 探索血小板功能和糖蛋白分泌在ECMO诱导的血小板缺血中的作用.
主要方法:
- 在107名ECMO患者的前性队列研究中,分析了血小板计数,功能和糖蛋白分泌.
- 活体模拟循环ECMO循环实验,以评估不同流速下的血小板反应和·维勒布兰德因子-GP Ibα相互作用.
- 在体内输血模型使用免疫缺陷小鼠研究出体外输血血小板的清除.
主要成果:
- 在ECMO患者中观察到血小板数量随时间而下降,在启动后24小时和48小时显著下降.
- 经过ECMO治疗,血小板糖蛋白Ibα (GP Ibα) 的表达减少,可溶性GP Ibα水平增加.
- GP Ibα的分泌取决于风湿学条件 (高流速),并导致GP Ibα阴性血小板在体内清除的速度更快.
结论:
- 与ECMO相关的剪切力诱导GP Ibα脱落,通过GP Ibα阴性血小板的加速清除导致血小板缺血.
- 抑制GP Ibα分泌是一种潜在的治疗策略,可以在ECMO治疗期间减轻血栓塞缩症.
相关概念视频
Formation of the Platelet Plug
6.5K
The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
6.5K
Structure and Function of Platelets
1.2K
The cell fragments known as platelets are disc-shaped, with an average diameter of about 3 μm and a thickness of roughly 1 μm. They play a crucial role in the body's vascular clotting system, which also involves plasma proteins, blood cells, and blood vessel tissues.
Platelets are continually replenished, circulating in the bloodstream for 9-12 days before being removed by phagocytes, primarily in the spleen. A microliter of circulating blood contains between 150,000 and 450,000...
Platelets are continually replenished, circulating in the bloodstream for 9-12 days before being removed by phagocytes, primarily in the spleen. A microliter of circulating blood contains between 150,000 and 450,000...
1.2K
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
537
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
537
Anticoagulant Drugs: Low-Molecular-Weight Heparins
723
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
723
Clot Retraction and Fibrinolysis
6.3K
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
6.3K
Introduction to Hemostasis
8.1K
Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
8.1K


