Corash L
Department of Laboratory Medicine, University of California School of Medicine, San Francisco 94143.
Blood Cells. 1989;15(1):81-107.
The origins and biologic significance of platelet heterogeneity in general, and platelet volume heterogeneity in particular, have been controversial scientific issues during the past decade. Although it has generally been held that specific megakaryocyte properties, especially ploidy level, are important determinants of platelet volume, the precise relationship between megakaryocyte properties and platelet properties is not well defined. The physiologic processes that specifically determine the relationship between megakaryocyte ploidy and platelet volume are unclear, and understanding of these processes has been further complicated due to the multiplicity of experimental and clinical models used to study the problem. Although it is generally true that increases in megakaryocyte ploidy are associated with increases in megakaryocyte volume, it is not well established that platelet volume is also increased during normal or abnormal thrombopoiesis as a direct result of a change in the ploidy level. Reexamination of earlier studies and some recent investigations suggest that changes in platelet volume and megakaryocyte ploidy are in fact dissociated in response to experimental thrombocytopenia. Critical review of the literature concerning the relationship between megakaryocyte ploidy and platelet volume reveals a limited number of conclusions that are well substantiated and emphasizes the relative lack of understanding about the events governing the complex process of platelet production and platelet heterogeneity.
在过去十年中,血小板异质性的起源及其生物学意义,尤其是血小板体积异质性,一直是备受争议的科学问题。尽管人们普遍认为特定的巨核细胞特性,尤其是倍性水平,是血小板体积的重要决定因素,但巨核细胞特性与血小板特性之间的确切关系尚未明确界定。具体决定巨核细胞倍性与血小板体积之间关系的生理过程尚不清楚,而且由于用于研究该问题的实验和临床模型多种多样,对这些过程的理解变得更加复杂。虽然一般来说,巨核细胞倍性增加与巨核细胞体积增加相关,但在正常或异常血小板生成过程中,血小板体积是否会因倍性水平的变化而直接增加,这一点尚未得到充分证实。对早期研究和一些近期调查的重新审视表明,在实验性血小板减少症的情况下,血小板体积变化与巨核细胞倍性实际上是分离的。对有关巨核细胞倍性与血小板体积关系的文献进行批判性综述后发现,只有少数结论得到了充分证实,这凸显了我们对血小板生成复杂过程及血小板异质性相关事件的了解相对不足。