Lages B, Dangelmaier C A, Holmsen H, Weiss H J
Department of Medicine, Columbia University College of Physicians and Surgeons, New York 10019.
J Clin Invest. 1988 Jun;81(6):1865-72. doi: 10.1172/JCI113532.
Storage pool-deficient (SPD) platelets, which have decreased amounts of dense-granule and/or alpha-granule constituents, contain normal amounts of lysosomal acid hydrolases, but in some cases exhibit impaired secretion of these enzymes. We examined this impaired secretion response in SPD patients with varying extents of granule deficiencies, and determined the effects of added dense-granule constituents. Acid hydrolase secretion was impaired in patients with severe dense-granule deficiencies, but not in patients with lesser dense-granule deficiencies, including those with alpha-granule deficiencies as well. When dense-granule constituents (ADP, ATP, serotonin, Ca+2, pyrophosphate) were added to gel-filtered platelets, ADP, but none of the other constituents, completely corrected the impairment of thrombin and A23187-induced secretion in SPD platelets. The concentration of ADP required to normalize thrombin-induced secretion varied markedly, from 0.01 to 10 microM, among the individual patients. Fixation of platelets with formaldehyde before centrifugation did not prevent the enhancement of secretion by ADP. Excess ATP, which acts as a specific antagonist of ADP-mediated responses, completely blocked this enhancement of secretion in SPD platelets by ADP, and partially inhibited acid hydrolase secretion induced by low, but not high, concentrations of thrombin in normal platelets as well. Treatment of normal platelets with acetylsalicylic acid in vivo, but not in vitro, produced an impairment of acid hydrolase secretion similar in extent to that in SPD platelets, but which could not be completely corrected by added ADP. One possible explanation of these results is that the impairment of acid hydrolase secretion may be secondary to the dense-granule deficiency in SPD platelets, and that secreted ADP may potentiate the lysosomal secretion response in normal platelets as well.
储存池缺陷(SPD)血小板的致密颗粒和/或α颗粒成分含量减少,溶酶体酸性水解酶含量正常,但在某些情况下这些酶的分泌受损。我们研究了颗粒缺陷程度不同的SPD患者中这种受损的分泌反应,并确定了添加致密颗粒成分的影响。严重致密颗粒缺陷的患者酸性水解酶分泌受损,但致密颗粒缺陷较轻的患者,包括同时存在α颗粒缺陷的患者,其酸性水解酶分泌未受损。当将致密颗粒成分(ADP、ATP、5-羟色胺、Ca+2、焦磷酸)添加到凝胶过滤血小板中时,只有ADP能完全纠正SPD血小板中凝血酶和A23187诱导的分泌受损,其他成分均无此作用。在个体患者中,使凝血酶诱导的分泌恢复正常所需的ADP浓度差异显著,从0.01到10微摩尔不等。离心前用甲醛固定血小板并不能阻止ADP增强分泌。ATP作为ADP介导反应的特异性拮抗剂,完全阻断了ADP对SPD血小板分泌的增强作用,并且在正常血小板中,ATP也部分抑制了低浓度而非高浓度凝血酶诱导的酸性水解酶分泌。体内而非体外给予乙酰水杨酸处理正常血小板,会导致酸性水解酶分泌受损,其程度与SPD血小板相似,但添加ADP不能完全纠正。这些结果的一种可能解释是,酸性水解酶分泌受损可能继发于SPD血小板中的致密颗粒缺陷,并且分泌的ADP可能也会增强正常血小板中的溶酶体分泌反应。