Simák J, Holada K, Janota J, Stranák Z
Department of Pathophysiology, 1st Medical Faculty, Charles University, Prague, Czech Republic.
Pediatr Res. 1999 Oct;46(4):445-9. doi: 10.1203/00006450-199910000-00014.
Platelets of full-term newborns and those of healthy adult donors were compared for constitutive expression of surface glycoproteins (GP) Ia-IIa, GP Ib, GP IIb-IIIa, and GP IV and for their activation responses to an agonist by detection of surface expression of activation markers P-selectin and CD63. Resting neonatal platelets showed significantly lower expression of GP Ia-IIa, GP Ib, and GP IIb-IIIa. In contrast, the expression of GP IV was significantly higher compared with platelets of adults. The expression of activation markers P-selectin and CD63 was assessed after in vitro activating of platelets with 0-15 microM human thrombin receptor-activating peptide. At low concentrations of thrombin receptor-activating peptide, the extent of surface expression of activation markers did not differ significantly between adult and neonatal platelets. However, after activation with 15 microM thrombin receptor-activating peptide, the extent of surface expression of P-selectin and CD63 was significantly lower in neonatal platelets. Because of ethical reasons, our study was conducted on neonates with a moderate neonatal hyperbilirubinemia. The remote possibility that hyperbilirubinemia could influence the expression of platelet surface receptors and the reactivity of neonatal platelet cannot be excluded. The role of higher expression of GP IV on neonatal platelets, also seen in certain hematologic malignancies in adults, remains to be elucidated. The lower expression of platelet adhesive receptors and the limited ability to up-regulate granular glycoproteins may play a role in the impairment of function of neonatal platelets.
对足月新生儿和健康成年供者的血小板进行比较,检测其表面糖蛋白(GP)Ia-IIa、GP Ib、GP IIb-IIIa和GP IV的组成性表达,以及通过检测活化标志物P-选择素和CD63的表面表达来评估其对激动剂的活化反应。静息新生儿血小板的GP Ia-IIa、GP Ib和GP IIb-IIIa表达显著较低。相比之下,与成人血小板相比,GP IV的表达显著更高。在用0-15微摩尔人凝血酶受体激活肽体外激活血小板后,评估活化标志物P-选择素和CD63的表达。在低浓度凝血酶受体激活肽作用下,成人和新生儿血小板活化标志物的表面表达程度无显著差异。然而,在用15微摩尔凝血酶受体激活肽激活后,新生儿血小板中P-选择素和CD63的表面表达程度显著较低。由于伦理原因,我们的研究是在患有中度新生儿高胆红素血症的新生儿中进行的。不能排除高胆红素血症可能影响血小板表面受体表达和新生儿血小板反应性的极小可能性。新生儿血小板上GP IV表达较高的作用,在成人某些血液系统恶性肿瘤中也可见,仍有待阐明。血小板黏附受体表达较低以及上调颗粒糖蛋白的能力有限,可能在新生儿血小板功能受损中起作用。