Chiva-Blanch Gemma, Suades Rosa, Padró Teresa, Vilahur Gemma, Peña Esther, Ybarra Juan, Pou Jose M, Badimon Lina
Institut Català de Ciències Cardiovasculars (ICCC), Barcelona, Spain.
Centro Médico Teknon, Barcelona, Spain.
Rev Esp Cardiol (Engl Ed). 2016 Jul;69(7):672-80. doi: 10.1016/j.rec.2015.12.033. Epub 2016 Apr 18.
Diabetes mellitus is associated with an enhanced risk for cardiovascular disease and its prevalence is increasing. Diabetes induces metabolic stress on blood and vascular cells, promoting platelet activation and vascular dysfunction. The level of vascular cell activation can be measured by the number and phenotype of microparticles found in the circulation. The aim of this study was to investigate the effect of a platelet-inhibitory dose of aspirin on the number and type of microparticles shed to the circulation.
Forty-three diabetic patients were enrolled in the study and received a daily dose of 100mg of aspirin for 10 days to cover the average platelet life-span in the circulation. Before and after the intervention period, circulating microparticles were characterized and quantified by flow cytometry.
Type 1 diabetic patients had about twice the number of tissue factor-positive circulating microparticles (derived both from platelets and monocytes) and endothelial-derived E-selectin positive microparticles than type 2 diabetic patients. Aspirin therapy significantly inhibited platelets since cyclooxygenase 1 derived thromboxane generation levels were reduced by 99%. Microparticles derived from erythrocytes, activated monocytes, and smooth muscle cells were significantly reduced after 10 days of aspirin administration.
These results indicate that: a) vascular and blood cells in type 1 diabetic patients are exposed to more sustained stress shown by their specific microparticle origin and levels; b) aspirin therapy inhibits vascular wall cell activation and microparticle shedding, and c) the effects of aspirin are similar in type 1 and 2 diabetes.
糖尿病与心血管疾病风险增加相关，且其患病率正在上升。糖尿病会给血液和血管细胞带来代谢应激，促进血小板活化和血管功能障碍。血管细胞的活化程度可通过循环中发现的微粒数量和表型来衡量。本研究的目的是调查血小板抑制剂量的阿司匹林对循环中微粒数量和类型的影响。
43名糖尿病患者参与了本研究，并接受每日100毫克阿司匹林的剂量，持续10天，以覆盖循环中血小板的平均寿命。在干预期前后，通过流式细胞术对循环中的微粒进行表征和定量。
1型糖尿病患者组织因子阳性循环微粒（源自血小板和单核细胞）以及内皮源性E选择素阳性微粒的数量约为2型糖尿病患者的两倍。阿司匹林治疗显著抑制了血小板，因为环氧化酶1衍生的血栓素生成水平降低了99%。阿司匹林给药10天后，源自红细胞、活化单核细胞和平滑肌细胞的微粒显著减少。
这些结果表明：a）1型糖尿病患者的血管和血细胞受到更持续的应激，这体现在其特定的微粒来源和水平上；b）阿司匹林治疗可抑制血管壁细胞活化和微粒脱落，且c）阿司匹林在1型和2型糖尿病中的作用相似。
