Cieslar P, Dyr J, Suttnar J, Matousová O, Friedmann B
I. interní klinika fakulty vseobecného lékarství, Univerzity Karlovy, Praha.
Vnitr Lek. 1990 Aug;36(8):729-37.
The authors present a clinical description, detailed platelet function analysis, and certain biochemical parameters in two siblings with Glanzmann thrombasthenia (G. t.). The isolated occurrence of this disorder in the family corresponds with its autosomal recessive inheritance. In both cases blood platelets completely failed to aggregate. In contrast, the platelet interaction with ristocetin, reflecting their ability to adhere to the subendothelium, the so-called "shape change", the storage granule contents and their release and arachidonic acid metabolism were unaffected. Further, the aggregation abnormality was accompanied by marked procoagulant activity and clot retraction defects; these functions, similarly as aggregation, are implemented on the platelet surface. The analysis of blood platelet proteins, using two dimensional polyacrylamide electrophoresis, confirmed the absence of glycoprotein GP IIb and IIIa and a decrease of the fibrinogen content. The analysis of these findings in G. t. led to the contemporary concept that GP IIb and IIIa on the platelet surface act as receptors for platelet aggregation.
作者介绍了两名患有Glanzmann血小板无力症(G.t.)的同胞的临床描述、详细的血小板功能分析以及某些生化参数。该疾病在家族中单独出现符合其常染色体隐性遗传。在这两个病例中,血小板完全无法聚集。相比之下,血小板与瑞斯托菌素的相互作用(反映其黏附于内皮下的能力)、所谓的“形态改变”、储存颗粒内容物及其释放以及花生四烯酸代谢均未受影响。此外,聚集异常伴有明显的促凝血活性和凝块回缩缺陷;这些功能与聚集一样,都是在血小板表面实现的。使用二维聚丙烯酰胺凝胶电泳对血小板蛋白进行分析,证实了糖蛋白GP IIb和IIIa的缺失以及纤维蛋白原含量的降低。对G.t.中这些发现的分析得出了当代的概念,即血小板表面的GP IIb和IIIa作为血小板聚集的受体发挥作用。