Philipps University, Department of Internal Medicine, Division of Endocrinology and Metabolism, Baldingerstrase, W-35033, Marburg/Lahn, Germany.
Platelets. 1994;5(2):70-83. doi: 10.3109/09537109409005516.
Under physiological conditions human blood platelets play a beneficial role in fibrinolysis and regulate the balance with prostacyclin and other factors derived from the endothelium. In response to endothelial injury, adherence of platelets to the denuded arterial surface, platelet aggregation, release of mitogens and subsequent cell proliferation characterize early fibrous plaque lesions. 'Native' atherogenic plasma lipoproteins which are abundant in hypercholesterolemia have been found to play a subtle role in the development of atherosclerosis. In addition, lipoproteins modulate platelet function and alter the susceptibility of platelets to different stimulating agents. The properties of 'modified' atherogenic lipoproteins also seem to be well documented with respect to atherogenesis. After uptake by macrophages, modified atherogenic plasma lipoproteins are thought to contribute to formation of fatty streak lesions. On the other hand, modified atherogenic lipoproteins may directly promote endothelial injury and thus favour enhanced endothelial-platelet interactions. However, the direct effects of modified atherogenic lipoproteins on platelet function have not been revealed in detail. Recent findings have documented that activated platelets themselves may promote modification of atherogenic plasma lipoproteins and thus contribute to enhanced foam cell formation. Therefore stimulation of thrombocytes, and their interaction with native and modified lipoproteins must be considered an important factor in the current concept of atherogenesis.
在生理条件下，人类血小板在纤维蛋白溶解中发挥有益作用，并通过前列腺素和其他源自内皮的因子来调节平衡。在内皮损伤时，血小板黏附于裸露的动脉表面、血小板聚集、释放有丝分裂原以及随后的细胞增殖，这些特征构成了早期纤维斑块病变。在高胆固醇血症中大量存在的“天然”动脉粥样硬化性血浆脂蛋白在动脉粥样硬化的发展中起着微妙的作用。此外，脂蛋白调节血小板功能，并改变血小板对不同刺激剂的敏感性。“修饰”的动脉粥样硬化性脂蛋白的特性似乎也与动脉粥样硬化的发生有很好的记录。被巨噬细胞摄取后，修饰的动脉粥样硬化性血浆脂蛋白被认为有助于形成脂肪条纹病变。另一方面，修饰的动脉粥样硬化性脂蛋白可能直接促进内皮损伤，从而有利于增强内皮-血小板相互作用。然而，修饰的动脉粥样硬化性脂蛋白对血小板功能的直接影响尚未详细揭示。最近的研究结果表明，激活的血小板本身可能促进动脉粥样硬化性血浆脂蛋白的修饰，从而有助于增强泡沫细胞的形成。因此，血小板的激活及其与天然和修饰的脂蛋白的相互作用必须被认为是目前动脉粥样硬化发病机制概念中的一个重要因素。
