Irving Peter M, Macey Marion G, Shah Urooj, Webb Lee, Langmead Louise, Rampton David S
Research Center for Gastroenterology, Institute of Cell and Molecular Sciences, Barts, and The London, Queen Mary's School of Medicine and Dentistry, London, UK.
Inflamm Bowel Dis. 2004 Jul;10(4):361-72. doi: 10.1097/00054725-200407000-00007.
Formation of platelet-leukocyte aggregates (PLAs) is increased in several inflammatory and thrombotic conditions. This may result from and enhance platelet and neutrophil activation and could contribute to the inflammatory process in inflammatory bowel disease (IBD). We investigated platelet-leukocyte aggregation in patients with IBD and its relation to treatment, disease activity and platelet and neutrophil activation.
PLAs, platelet activation (P-selectin expression) and neutrophil activation (L-selectin expression) were assessed 30 and 180 minutes after drawing blood into EDTA/citrate-theophylline-adenosine and dipyridamole, a novel anticoagulant, using fluorescent antibodies to CD45 (for leukocytes), CD42a (for platelets), CD62P (P-selectin) and CD62L (L-selectin) and flow cytometry. Platelet activation was also measured using the ADVIA 120 hematology analyser.
Samples from 67 patients with IBD measured within 30 minutes had a higher platelet count (P < 0.001), more platelets expressing P-selectin (P = 0.01), and more PLAs (P < 0.01) than from 20 healthy controls and more PLAs (P < 0.05) than from 9 controls with inflammatory arthropathies. IBD patients on thiopurines had fewer PLAs than those not taking them (P < 0.05); corticosteroids and aminosalicylates had no such effects. Incubation for 180 minutes increased the number of platelets expressing P-selectin (P < 0.0001), and the number of PLAs (P < 0.0001). The PLAs correlated with the number of platelets expressing P-selectin before (r=+0.40, P < 0.001) and after (r=+0.66, P < 0.0001) incubation.
The number of PLAs is higher in patients with IBD than in healthy and inflammatory controls, but their numbers are lowered by thiopurines. Increased PLA formation may in part be due to increased platelet activation and could be pathogenic in IBD.
在多种炎症和血栓形成性疾病中，血小板 - 白细胞聚集体（PLA）的形成会增加。这可能源于并增强血小板和中性粒细胞的活化，且可能促成炎症性肠病（IBD）的炎症过程。我们研究了IBD患者的血小板 - 白细胞聚集情况及其与治疗、疾病活动度以及血小板和中性粒细胞活化的关系。
将血液采集到含有乙二胺四乙酸/枸橼酸盐 - 茶碱 - 腺苷和双嘧达莫（一种新型抗凝剂）的试管中，30分钟和180分钟后，使用针对CD45（针对白细胞）、CD42a（针对血小板）、CD62P（P - 选择素）和CD62L（L - 选择素）的荧光抗体及流式细胞术评估PLA、血小板活化（P - 选择素表达）和中性粒细胞活化（L - 选择素表达）。还使用ADVIA 120血液分析仪测量血小板活化情况。
67例IBD患者在30分钟内采集的样本与20例健康对照相比，血小板计数更高（P < 0.001），表达P - 选择素的血小板更多（P = 0.01），PLA更多（P < 0.01）；与9例炎症性关节病对照相比，PLA也更多（P < 0.05）。接受硫唑嘌呤治疗的IBD患者的PLA比未接受治疗的患者少（P < 0.05）；皮质类固醇和氨基水杨酸盐无此作用。孵育180分钟后，表达P - 选择素的血小板数量增加（P < 0.0001），PLA数量增加（P < 0.0001）。孵育前后PLA与表达P - 选择素的血小板数量均相关（孵育前r = +0.40，P < 0.001；孵育后r = +0.66，P < 0.0001）。
IBD患者的PLA数量高于健康对照和炎症性对照，但硫唑嘌呤可降低其数量。PLA形成增加可能部分归因于血小板活化增加，并且在IBD中可能具有致病性。
