Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard-Karls-Universität Tübingen , Tübingen , Germany.
Platelets. 2013;24(7):560-5. doi: 10.3109/09537104.2012.746455. Epub 2012 Dec 5.
Platelet collagen receptor glycoprotein VI (pGPVI) is elevated in patients with acute coronary syndrome (ACS) and ischemic stroke. Recently, we developed a novel bead-based sandwich immunoassay to determine soluble GPVI (sGPVI), which has been validated in ACS patients. This study aimed to evaluate the plasma levels of sGPVI and pGPVI expression in patients with suspected stroke. We consecutively evaluated 176 patients, who were admitted to the stroke unit. Surface expression of pGPVI was determined by flow cytometry, sGPVI concentrations were determined using our sandwich immunoassay. Unlike patients with TIA, patients with stroke showed significantly decreased plasma levels of sGPVI compared to patients with non-ischemic (NI) events (TIA: mean [µg/L] ± standard deviation): 6.1 ± 2.1 vs. NI: 8 ± 4; p = 0.192; stroke: 5.9 ± 2.3 vs. NI; p = 0.013), whereas for pGPVI, patients with TIA and ischemic stroke revealed a significantly increased platelet surface expression compared to NI patients (TIA: mean fluorescence intensity [MFI] ± standard deviation): 20.9 ± 5.4 vs. NI: 17.6 ± 5.2; p = 0.021; stroke: 20.3 ± 6.2 vs. NI; p = 0.016). Using logistic regression analysis, both sGPVI (p = 0.002) and pGPVI (p = 0.012) are independently associated with ischemic stroke compared to other laboratory markers. To predict the individual risk for ischemic stroke using the plasma levels of sGPVI, receiver operating characteristic (ROC) analysis determined an optimal cutoff value of sGPVI at 6.5 µg/l, thus, patients with decreased plasma levels (<6.5 µg/l) have a 1.5-fold adjusted odds ratio (95%confidence interval, 1.4-2.7). Lower plasma levels of sGPVI are associated with the slightly elevated risk of stroke and may be a promising novel biomarker.
血小板胶原受体糖蛋白 VI（pGPVI）在急性冠脉综合征（ACS）和缺血性脑卒中患者中升高。最近，我们开发了一种新的基于珠子的夹心免疫分析法来测定可溶性 GPVI（sGPVI），并已在 ACS 患者中得到验证。本研究旨在评估疑似脑卒中患者的血浆 sGPVI 和 pGPVI 表达水平。我们连续评估了 176 名入住卒中单元的患者。通过流式细胞术测定 pGPVI 的表面表达，使用我们的夹心免疫分析法测定 sGPVI 浓度。与 TIA 患者不同，脑卒中患者的 sGPVI 血浆水平明显低于非缺血性（NI）事件患者（TIA：平均值[µg/L] ± 标准差：6.1 ± 2.1 vs. NI：8 ± 4；p = 0.192；脑卒中：5.9 ± 2.3 vs. NI；p = 0.013），而对于 pGPVI，TIA 和缺血性脑卒中患者的血小板表面表达明显高于 NI 患者（TIA：平均荧光强度[MFI] ± 标准差：20.9 ± 5.4 vs. NI：17.6 ± 5.2；p = 0.021；脑卒中：20.3 ± 6.2 vs. NI；p = 0.016）。通过逻辑回归分析，与其他实验室标志物相比，sGPVI（p = 0.002）和 pGPVI（p = 0.012）均与缺血性脑卒中独立相关。为了使用 sGPVI 的血浆水平预测缺血性脑卒中的个体风险，ROC 分析确定 sGPVI 的最佳截断值为 6.5μg/L，因此，血浆水平降低的患者（<6.5μg/L）的调整优势比为 1.5（95%置信区间，1.4-2.7）。sGPVI 血浆水平降低与脑卒中风险略有升高相关，可能是一种有前途的新型生物标志物。
