Windeløv N A, Ostrowski S R, Johansson P I, Wanscher M, Larsen C F, Sørensen A M, Rasmussen L S
Department of Anaesthesia, Centre of Head and Orthopaedics, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark,
Inflamm Res. 2015 Apr;64(3-4):235-41. doi: 10.1007/s00011-015-0802-4. Epub 2015 Feb 20.
To elucidate whether platelets differentiate cytokine release following trauma, we prospectively measured three major platelet-derived cytokines in 213 trauma patients on hospital arrival.
We measured plasma levels of the anti-inflammatory β-thromboglobulins (βTGs), transforming growth factor-β1 (TGFβ1) and the pro-inflammatory platelet factor 4 (PF4) cytokines. We also measured soluble glycoprotein VI (sGPVI), procoagulant platelet microparticles (PMPs) and white blood cell (WBC) counts, and evaluated in vitro platelet function in primary and secondary haemostasis by aggregometry and thromboelastometry, respectively. We evaluated associations of each cytokine by multivariate regression including injury severity score (ISS), WBC counts, sGPVI and platelet counts as explanatory variables.
Severely injured patients (ISS > 15) had higher levels of βTGs and TGFβ1 (both p < 0.01) but lower levels of PF4 (p = 0.02). GPVI and PMPs levels correlated with TGFβ1 and PF4 whereas we found no significant association between cytokine levels and measures of haemostasis. By multivariate regression, a high WBC count was associated with high levels of TGFβ1 (p = 0.01) and βTGs (p < 0.01) but with low levels of PF4 (p = 0.03).
Severely injured patients had higher levels of βTGs and TGFβ1 but lower levels of the PF4; a high WBC count predicted this anti-inflammatory profile of platelet cytokines.
为了阐明创伤后血小板是否会分化释放细胞因子，我们前瞻性地测定了213例创伤患者入院时三种主要的血小板衍生细胞因子。
我们测定了抗炎性β-血小板球蛋白（βTGs）、转化生长因子-β1（TGFβ1）和促炎性血小板因子4（PF4）细胞因子的血浆水平。我们还测定了可溶性糖蛋白VI（sGPVI）、促凝血血小板微粒（PMPs）和白细胞（WBC）计数，并分别通过凝集测定法和血栓弹力测定法评估了初级和次级止血过程中的体外血小板功能。我们通过多变量回归评估了每种细胞因子的相关性，将损伤严重程度评分（ISS）、WBC计数、sGPVI和血小板计数作为解释变量。
重伤患者（ISS>15）的βTGs和TGFβ1水平较高（均p<0.01），但PF4水平较低（p = 0.02）。GPVI和PMPs水平与TGFβ1和PF4相关，而我们发现细胞因子水平与止血指标之间无显著关联。通过多变量回归分析，高WBC计数与高水平的TGFβ1（p = 0.01）和βTGs（p<0.01）相关，但与低水平的PF4（p = 0.03）相关。
重伤患者的βTGs和TGFβ1水平较高，但PF4水平较低；高WBC计数预示了血小板细胞因子的这种抗炎特征。
