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循环和血小板衍生的微颗粒在人血液中增强动脉粥样硬化斑块上的血栓形成。

Circulating and platelet-derived microparticles in human blood enhance thrombosis on atherosclerotic plaques.

机构信息

Cardiovascular Research Center, CSIC-ICCC, Barcelona, Spain.

出版信息

Thromb Haemost. 2012 Dec;108(6):1208-19. doi: 10.1160/TH12-07-0486. Epub 2012 Nov 8.

Abstract

Plaque rupture followed by thrombosis is the underlying cause of the majority of acute coronary syndromes. Circulating microparticles (cMPs), membrane blebs released into blood by activated cells, have been associated to vascular diseases. Specifically, high levels of platelet-derived microparticles (pMPs) have been found in patients with coronary disease. However, it is unknown whether microparticles have a contributing role to the development of damaged vessel wall-induced arterial thrombi. The aim of this proof of concept study was to investigate whether an increased number of cMPs and pMPs could functionally contribute to blood thrombogenicity on areas of arterial damage. Microparticles were isolated from blood of healthy volunteers and were characterised by flow cytometry. Effects of microparticles on platelet deposition were assessed under controlled flow conditions exposing damaged arterial wall in the Badimon perfusion chamber and collagen type-I in the flat perfusion chamber to human blood. Platelet deposition on damaged arteries was significantly increased in cMP- and pMP-enriched bloods (p<0.05). pMPs also induced increase in platelet (p<0.05) and fibrin (p<0.05) deposition on human atherosclerotic arteries and in platelet adhesion to purified collagen surfaces. pMP-enriched blood induced a dose-dependent shortening of epinephrine/collagen closure time evaluated by PFA-100 (p<0.001), increased low-dose ADP-induced platelet aggregation by LTA (p<0.05), and decreased clotting time by thromboelastography (p<0.01). In conclusion, an increased content of cMPs and pMPs, even in normal blood conditions, enhance platelet deposition and thrombus formation. This study shows for the first time that, beyond biomarkers of cell activation, blood microparticles have functional effects on cardiovascular atherothrombotic disease.

摘要

斑块破裂后继发血栓形成是大多数急性冠脉综合征的根本原因。循环中的微粒(cMPs),即激活细胞释放到血液中的膜泡,与血管疾病有关。具体而言,在冠心病患者中发现血小板衍生的微粒(pMPs)水平升高。然而,尚不清楚微粒是否对受损血管壁诱导的动脉血栓形成的发展有促进作用。本概念验证研究的目的是研究在动脉损伤部位,cMPs 和 pMPs 的数量增加是否能对血液的血栓形成功能有促进作用。从健康志愿者的血液中分离微粒,并通过流式细胞术进行表征。在 Badimon 灌注室中暴露受损动脉壁和在平板灌注室中暴露胶原蛋白 I 下,控制血流条件下评估微粒对血小板沉积的影响。在 cMP 和 pMP 富集的血液中,血小板在受损动脉上的沉积明显增加(p<0.05)。pMPs 还诱导血小板(p<0.05)和纤维蛋白(p<0.05)在人动脉粥样硬化动脉上的沉积增加,以及血小板在纯化胶原蛋白表面的黏附。pMP 富集的血液通过 PFA-100 评估诱导肾上腺素/胶原蛋白闭合时间呈剂量依赖性缩短(p<0.001),通过 LTA 增加低剂量 ADP 诱导的血小板聚集(p<0.05),并通过血栓弹性图降低凝血时间(p<0.01)。总之,即使在正常血液条件下,cMPs 和 pMPs 的含量增加也会增强血小板沉积和血栓形成。本研究首次表明,除了细胞激活的生物标志物外,血液微粒对心血管动脉血栓形成疾病具有功能作用。

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