Corash L
Department of Laboratory Medicine, University of California School of Medicine, San Francisco 94143.
Blood Cells. 1990;16(1):97-106; discussion 107-8.
Platelet activation is postulated to play a critical role in the pathogenesis of thrombotic and hemorrhagic disorders. Previous assays for detection of activated platelets were cumbersome and provided only nonspecific information with limited sensitivity. The recent introduction of fluorescence-activated flow cytometric techniques for platelet analysis used in combination with monoclonal antibodies for detection of specific platelet-activation antigens has introduced the possibility of improved assays to detect activated platelets. The monoclonal antibody S12, directed against the unique platelet-activation antigen GMP-140, has been used to develop a fluorescence-activated flow cytometric assay. Patient samples for this assay can be easily prepared and maintained until analyzed in batch mode. Peripheral blood obtained from normal subjects exhibited low levels of activated platelets, and the assay had sufficient sensitivity to detect as few as 2% to 3% activated platelets among normal platelets. Patients undergoing cardiopulmonary bypass had transiently increased numbers of circulating activated platelets. Evaluation of standard blood bank platelet concentrates has shown the presence of significant numbers of activated platelets. Other studies have suggested that the degree of platelet activation correlated with poor posttransfusion increments and survival. Thus, this assay may also be useful for quality control of platelet concentrates. Future development of the GMP-140 and other platelet-activation antigen assays should improve detection of disorders characterized by inappropriate platelet activation.
血小板活化被认为在血栓形成和出血性疾病的发病机制中起关键作用。以往检测活化血小板的方法繁琐，且仅提供非特异性信息，灵敏度有限。最近引入的用于血小板分析的荧光激活流式细胞术技术，与用于检测特定血小板活化抗原的单克隆抗体联合使用，为改进活化血小板检测方法带来了可能。针对独特的血小板活化抗原GMP-140的单克隆抗体S12已被用于开发一种荧光激活流式细胞术检测方法。该检测方法的患者样本易于制备并保存，直至以批量模式进行分析。从正常受试者获取的外周血中活化血小板水平较低，该检测方法具有足够的灵敏度，能够检测出正常血小板中低至2%至3%的活化血小板。接受体外循环的患者循环活化血小板数量短暂增加。对标准血库血小板浓缩物的评估显示存在大量活化血小板。其他研究表明，血小板活化程度与输血后血小板增加量少及存活率低相关。因此，该检测方法可能也有助于血小板浓缩物的质量控制。GMP-140和其他血小板活化抗原检测方法的未来发展应能改善对以血小板活化异常为特征的疾病的检测。
