Shenkman B, Einav Y, Salomon O, Varon D, Savion N
Amalia Biron Research Institute of Thrombosis and Hemostasis, Sheba Medical Center, Tel-Hashomer, Israel.
Platelets. 2008 Sep;19(6):440-6. doi: 10.1080/09537100802082256.
The Impact-R [Cone and plate(let) analyzer (CPA)] is useful to assess platelet adhesion in different diseases and to monitor antiplatelet therapy. The purpose of the present study was to adapt this system to test agonist-induced platelet aggregation. Blood samples were tested by light transmission platelet aggregometry (LTA), Impact-R regular test and Impact-R agonist-response test. In the latter, samples were pre-incubated for 1 min with an agonist leading to platelet activation, micro-aggregates formation and reduced adhesion. Impact-R regular test of ten healthy volunteers demonstrated platelet adhesion (surface coverage, SC) of 11.2 +/- 2.6% while LTA induced by ADP, ristocetin, epinephrine, collagen and arachidonic acid (AA) yielded maximal aggregation (81% to 93%). In the Impact-R agonist-response test, SC was reduced to 2.2 +/- 1.0%, 1.2 +/- 0.9%, 2.3 +/- 1.0%, 2.2 +/- 0.8% and 2.4 +/- 0.4%, respectively. Prostaglandin E(1) treatment weakened SC reduction in response to ADP and epinephrine (SC of 8.8 +/- 1.8% and 9.5 +/- 2.0%, respectively). Inhibition of P2Y(12) receptor with 2MeSAMP resulted in a dose-dependent decrease in maximal aggregation in the ADP-induced test, which inversely correlated to SC in the Impact-R ADP-response test. The Impact-R agonist-response tests detected aggregation defects in patients with storage pool disease, severe von Willebrand disease and epinephrine response deficiency, and may be useful to assess the effect of different agonists on platelet aggregation.
Impact-R[锥板（片）分析仪（CPA）]有助于评估不同疾病中的血小板黏附情况，并监测抗血小板治疗。本研究的目的是对该系统进行调整，以检测激动剂诱导的血小板聚集。通过光透射血小板聚集测定法（LTA）、Impact-R常规检测和Impact-R激动剂反应检测对血样进行检测。在后者中，样本与一种导致血小板活化、微聚集体形成和黏附减少的激动剂预孵育1分钟。对10名健康志愿者进行的Impact-R常规检测显示血小板黏附（表面覆盖率，SC）为11.2±2.6%，而由ADP、瑞斯托霉素、肾上腺素、胶原和花生四烯酸（AA）诱导的LTA产生的最大聚集率为81%至93%。在Impact-R激动剂反应检测中，SC分别降至2.2±1.0%、1.2±0.9%、2.3±1.0%、2.2±0.8%和2.4±0.4%。前列腺素E1治疗减弱了对ADP和肾上腺素反应时SC的降低（分别为8.8±1.8%和9.5±2.0%）。用2MeSAMP抑制P2Y12受体导致ADP诱导检测中的最大聚集率呈剂量依赖性降低，这与Impact-R ADP反应检测中的SC呈负相关。Impact-R激动剂反应检测发现了储存池病、严重血管性血友病和肾上腺素反应缺陷患者的聚集缺陷，可能有助于评估不同激动剂对血小板聚集的影响。
