Madden Leigh A, Vince Rebecca V, Sandström Marie E, Taylor Lee, McNaughton Lars, Laden Gerard
Medical Research Laboratory, Post-Graduate Medical Institute, Wolfson Building, University of Hull, Cottingham Road, Hull, HU6 7RX, UK.
Thromb Haemost. 2008 May;99(5):909-15. doi: 10.1160/TH08-01-0030.
An increased risk of death or severe injury due to late-morning thrombotic events is well established. Tissue factor (TF) is the initiator of the coagulation cascade, and endothelial stresses, coupled with production of pro-coagulant microparticles (MP) are also important factors in loss of haemostasis. TF and vascular cell adhesion molecule-1 (VCAM-1) -positive cell microparticles were assessed periodically over a 24-hour (h) period in healthy human subjects to ascertain if they followed a circadian rhythm. Eleven healthy male subjects were assessed in a temperature-controlled environment with dietary intake consistent between subjects. Blood samples were taken every 4 h by venipuncture, and TF and VCAM-1 positive microparticles were quantified by flow cytometry. A significant circadian rhythm was observed in VCAM-1 MP (p=or<0.0001), and a trend was shown, although not statistically significant (p=0.065) in TF microparticles. A peak was observed at 9 a.m. for VCAM-1 positive MP, followed by a decrease and subsequent peak at 9 p.m. and a minimum at 5 a.m. TF-positive MP followed a strikingly similar trend in both variation and absolute numbers with a delay. A circadian rhythm was observed in VCAM-1 and less so TF-positive MP. This has significant implications in terms of the well known increased risk of cardiovascular thrombotic events matching this data. To our knowledge this is the first such report of quantified measurements of these MP over a 24-h period and the only measurement of a 24-h variation of in-vivo blood-borne TF.
上午晚些时候发生血栓事件导致死亡或重伤的风险增加已得到充分证实。组织因子(TF)是凝血级联反应的启动因子,内皮应激与促凝血微粒(MP)的产生一起,也是止血功能丧失的重要因素。在健康人体受试者中,在24小时内定期评估TF和血管细胞粘附分子-1(VCAM-1)阳性细胞微粒,以确定它们是否遵循昼夜节律。11名健康男性受试者在温度受控的环境中接受评估,受试者之间的饮食摄入一致。通过静脉穿刺每4小时采集一次血样,并通过流式细胞术对TF和VCAM-1阳性微粒进行定量。观察到VCAM-1 MP有显著的昼夜节律(p=或<0.0001),并且在TF微粒中显示出一种趋势,尽管无统计学意义(p=0.065)。VCAM-1阳性MP在上午9点出现峰值,随后下降,接着在晚上9点出现峰值,在凌晨5点出现最小值。TF阳性MP在变化和绝对数量上都遵循非常相似的趋势,但有延迟。观察到VCAM-1存在昼夜节律,而TF阳性MP的昼夜节律不太明显。就与这些数据相符的众所周知的心血管血栓事件风险增加而言,这具有重要意义。据我们所知,这是首次在24小时内对这些MP进行定量测量的此类报告,也是唯一对体内血源性TF的24小时变化进行的测量。