Van der Planken M G, Vertessen F, Mortelmans E, Van Bockstaele D, Muylle L, Mertens G, Berneman Z N
Antwerp University Hospital, Laboratory of Hematology, Edegem, Belgium.
Ann Hematol. 1999 Jan;78(1):1-7. doi: 10.1007/s002770050463.
Platelets stored as concentrates are gradually activated (storage lesion), a process associated with changes in the expression of platelet procoagulant activity (PPCA). The aim of the present study was to evaluate the evolution of PPCA and the mean platelet volume (MPV) of stored platelets prepared according to the platelet-rich method (PRM) and the buffy coat method (BCM). Using the platelet factor 3 availability clotting test (PF3AT) on appropriately diluted concentrate samples, we found a decrease in PPCA expression of remnant platelets as a function of storage time (0.025 < p < 0.01 between day 1 and 7) in PRM-derived but not in BCM-derived platelet concentrates. Using the PF3AT reduction test we found a more important clotting time reduction in samples obtained from BCM than in samples obtained from PRM platelet concentrates, suggesting a higher PPCA expression of BCM platelets, not significant after 1 day but highly significant after 3 days (p < 0.0005) and after 7 days (p < 0.0005) of storage, as compared with PRM platelets. For both PRM and BCM concentrates there were no significant MPV changes as a function of storage time, but at any storage day the MPV of BCM concentrates was significantly higher (p < 0.0005) than the MPV of PRM concentrates. We conclude that the decrease of PPCA expression in PRM-derived concentrates as a function of storage time is in agreement with the gradual decrease of the platelet activation status in PRM concentrates during storage. There are probably several factors or variables causing platelets of BCM concentrates to express higher PPCA than those of PRM concentrates. Higher PPCA expression in BCM concentrates may be explained by an intrinsic platelet property, such as a difference in MPV between the two kinds of concentrates, or it may be related to an extrinsic factor such as different storage media, e.g., undiluted autologous plasma in PRM concentrates versus Plasmalyte A-diluted autologous plasma in BCM concentrates. Whether the difference in PPCA expression of remnant platelets in PRM and BCM concentrates is just an in vitro laboratory finding or may have consequences for the therapeutic efficiency of the concentrates is an interesting, still unresolved question.
作为浓缩物储存的血小板会逐渐被激活（储存损伤），这一过程与血小板促凝血活性（PPCA）表达的变化相关。本研究的目的是评估根据富血小板法（PRM）和 Buffy 层法（BCM）制备的储存血小板的 PPCA 演变及平均血小板体积（MPV）。通过对适当稀释的浓缩物样本进行血小板因子 3 可用性凝血试验（PF3AT），我们发现 PRM 来源的血小板浓缩物中，残余血小板的 PPCA 表达随储存时间而降低（第 1 天和第 7 天之间 0.025 < p < 0.01），而 BCM 来源的血小板浓缩物中则没有这种情况。使用 PF3AT 还原试验，我们发现从 BCM 获得的样本的凝血时间缩短比从 PRM 血小板浓缩物获得的样本更显著，这表明 BCM 血小板的 PPCA 表达更高，在储存 1 天后不显著，但在储存 3 天（p < 0.0005）和 7 天（p < 0.0005）后与 PRM 血小板相比高度显著。对于 PRM 和 BCM 浓缩物，MPV 均未随储存时间发生显著变化，但在任何储存日，BCM 浓缩物的 MPV 均显著高于 PRM 浓缩物（p < 那么，PRM 和 BCM 浓缩物中残余血小板的 PPCA 表达差异仅仅是体外实验室发现，还是可能对浓缩物的治疗效果产生影响，这是一个有趣但仍未解决的问题。0.0005）。我们得出结论，PRM 来源的浓缩物中 PPCA 表达随储存时间的降低与 PRM 浓缩物在储存期间血小板激活状态的逐渐降低一致。可能有几个因素或变量导致 BCM 浓缩物的血小板比 PRM 浓缩物表达更高的 PPCA。BCM 浓缩物中较高的 PPCA 表达可能由血小板的内在特性解释，例如两种浓缩物之间 MPV 的差异，或者可能与外在因素有关，例如不同的储存介质，例如 PRM 浓缩物中未稀释的自体血浆与 BCM 浓缩物中用 Plasmalyte A 稀释的自体血浆。
