Kissova Jarmila, Ovesna Petra, Bulikova Alena, Zavřelova Jiřina, Penka Miroslav
aDepartment of Haematology, University Hospital Brno bMedical Faculty cInstitute of Biostatistics and Analyses, Masaryk University Brno, Brno, Czech Republic.
Blood Coagul Fibrinolysis. 2015 Jun;26(4):448-53. doi: 10.1097/MBC.0000000000000293.
Microparticles are small membrane fragments with dimension between 0.1 and 1 μm, which are released during cell activation or apoptosis, exposing the phospholipid phosphatidylserine and membrane antigens typical for cellular origin. Philadelphia-negative myeloproliferative neoplasms (MPNs) are characterized by an increased risk of thrombosis. Data from literature suggest an association between thrombosis and the procoagulant activity of microparticles. Association between the procoagulant activity of microparticles and the incidence of thrombosis was assesed in a group of 126 patients with Philadelphia-negative MPNs. Measurement of microparticles procoagulant activity was performed using a functional assay, namely the Zymuphen MP-activity (Hyphen Biomed, Neuville-sur-oise, France). A total of 539 samples were analysed within this group of patients, regardless of patients' state of health. A significantly higher circulating microparticles procoagulant activity was found in MPN patients as compared with the control group (P < 0.001). A pathological level of procoagulant activity was observed more frequently in patients with polycythaemia vera (88%, P = 0.002) than groups of patients with essential thrombocythaemia (73.2%) and primary myelofibrosis (68.3%); the same result was confirmed in patients with a history of venous thrombosis in comparison with patients without thrombosis (84.7 vs. 73.2%, P = 0.029). Patients without cytoreductive treatment had a higher activity of microparticles (P = 0.010). Furthermore, presence of JAK2 V617F mutation was associated with an increased procoagulant activity (P = 0.007), as well as the higher JAK2 V617F allele burden (P = 0.001). Further prospective clinical studies will be necessary to evaluate the clinical relevance of microparticles in the prediction hypercoagulable state in these patients.
微粒是尺寸在0.1至1μm之间的小膜碎片，其在细胞活化或凋亡过程中释放，暴露磷脂酰丝氨酸和细胞来源典型的膜抗原。费城阴性骨髓增殖性肿瘤（MPN）的特征是血栓形成风险增加。文献数据表明血栓形成与微粒的促凝活性之间存在关联。在一组126例费城阴性MPN患者中评估了微粒促凝活性与血栓形成发生率之间的关联。使用功能测定法，即Zymuphen MP活性（Hyphen Biomed，法国努瓦西勒塞克）测量微粒的促凝活性。在该组患者中，共分析了539个样本，无论患者的健康状况如何。与对照组相比，MPN患者中循环微粒促凝活性明显更高（P<0.001）。真性红细胞增多症患者（88%，P=0.002）比原发性血小板增多症患者组（73.2%）和原发性骨髓纤维化患者组（68.3%）更频繁地观察到促凝活性的病理水平；与无血栓形成的患者相比，有静脉血栓形成病史的患者也得到了相同的结果（84.7%对73.2%，P=0.029）。未接受细胞减灭治疗的患者微粒活性更高（P=0.010）。此外，JAK2 V617F突变的存在与促凝活性增加相关（P=0.007），以及更高的JAK2 V617F等位基因负担（P=0.001）。有必要进行进一步的前瞻性临床研究，以评估微粒在预测这些患者高凝状态中的临床相关性。
