Marquardt Lars, Ruf Andreas, Mansmann Ulrich, Winter Ralph, Schuler Matthias, Buggle Florian, Mayer Horst, Grau Armin J
Department of Neurology, University of Heidelberg, Germany.
Stroke. 2002 Nov;33(11):2570-4. doi: 10.1161/01.str.0000034398.34938.20.
The aim of this study was to evaluate the time course of platelet activation after ischemic stroke and to investigate whether platelet activation and inflammation are correlated with each other.
We serially determined expression of p-selectin (CD62p) and lysosome-associated membrane protein (CD63) by platelets using flow cytometry at 10 time points between days 1 and 90 in patients after ischemic stroke (n=50), in healthy subjects (n=30), and in risk factor control subjects (n=20). Furthermore, we correlated leukocyte count, C-reactive protein, and fibrinogen levels with platelet activation markers.
CD62p and CD63 expression was higher on day 1 after stroke than in both control groups (P<0.005 for both). CD62p expression rapidly declined, whereas CD63 expression remained significantly elevated until day 90. Stroke severity and different medication for secondary stroke prevention did not influence CD62p or CD63 expression. Platelet activation markers and inflammatory parameters were not correlated with each other at any time point after stroke.
The initial increase in both CD62p and CD63 expression by platelets is followed by a differential regulation of both parameters after stroke. The rapid decrease in CD62p expression may be caused by shedding from the cell surface. Its persistent elevation makes CD63 a good candidate for studies on predictors for stroke recurrence. Our findings suggest that the expression of CD62p and CD63 by platelets is regulated independently from inflammatory indexes.
本研究旨在评估缺血性卒中后血小板激活的时间进程,并调查血小板激活与炎症是否相互关联。
我们在缺血性卒中患者(n = 50)、健康受试者(n = 30)和危险因素对照受试者(n = 20)中,于第1天至第90天的10个时间点使用流式细胞术连续测定血小板上p-选择素(CD62p)和溶酶体相关膜蛋白(CD63)的表达。此外,我们将白细胞计数、C反应蛋白和纤维蛋白原水平与血小板激活标志物进行关联分析。
卒中后第1天CD62p和CD63的表达高于两个对照组(两者P均<0.005)。CD62p表达迅速下降,而CD63表达在第90天之前一直显著升高。卒中严重程度和二级卒中预防的不同用药对CD62p或CD63表达均无影响。卒中后任何时间点血小板激活标志物与炎症参数均无相关性。
血小板CD62p和CD63表达最初升高后,卒中后这两个参数出现差异调节。CD62p表达迅速下降可能是由于从细胞表面脱落所致。其持续升高使CD63成为卒中复发预测指标研究的良好候选对象。我们的研究结果表明,血小板CD62p和CD63的表达独立于炎症指标进行调节。