Wirestam Lina, Gullstrand Birgitta, Jern Andreas, Jönsen Andreas, Linge Petrus, Tydén Helena, Kahn Robin, Bengtsson Anders A
Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Section of Pediatrics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Front Med (Lausanne). 2021 Apr 20;8:638750. doi: 10.3389/fmed.2021.638750. eCollection 2021.
Platelets have recently emerged as important immune modulators in systemic lupus erythematosus (SLE), in addition to their role in thrombosis and cardiovascular disease. However, studies investigating mean platelet volume (MPV) in SLE are often scarce, conflicting and cross-sectional. In this study, MPV was measured in clinical routine throughout a defined time-period to quantify both individual MPV fluctuations and investigate if such variations are associated with disease activity and clinical phenotypes of SLE. Of our 212 patients, 34 patients had only one MPV value reported with the remaining 178 patients having between 2 and 19 visits with recorded MPV values. The intra-individual MPV variation was low, with a median variation of 0.7 fL. This was further supported by the finding that 84% of patients stayed within their reference interval category (i.e., small, normal or large) over time. In our cohort, no correlation between disease activity and MPV neither cross-sectionally nor longitudinally was found. Mean platelet volume values were significantly smaller in SLE patients (mean 10.5 fL) compared to controls (mean 10.8 fL), < 0.0001. Based on the reference interval, 2.4% ( = 5) of patients had large-sized platelets, 84.4% ( = 179) had normal-sized and 13.2% ( = 28) had small-sized. A larger proportion (85.7%) of patients with small-sized platelets met the anti-dsDNA criterion (ACR10b; = 0.003) compared to patients with normal and large (57.6%) sized platelets. In conclusion, the intra-individual MPV variation was of low magnitude and fluctuations in disease activity did not have any significant impact on MPV longitudinally. This lack of variability in MPV over time indicates that measuring MPV at any time-point is sufficient. Further studies are warranted to evaluate MPV as a possible biomarker in SLE, as well as to determine the underlying mechanisms influencing platelet size in SLE.
除了在血栓形成和心血管疾病中的作用外，血小板最近已成为系统性红斑狼疮（SLE）中重要的免疫调节因子。然而，关于SLE患者平均血小板体积（MPV）的研究往往较少、相互矛盾且多为横断面研究。在本研究中，在一个确定的时间段内于临床常规中测量MPV，以量化个体MPV波动情况，并研究此类变化是否与SLE的疾病活动和临床表型相关。在我们的212例患者中，34例患者仅报告了一个MPV值，其余178例患者有2至19次记录了MPV值的就诊。个体内MPV变异较低，中位数变异为0.7 fL。随着时间推移，84%的患者保持在其参考区间类别（即小、正常或大）内，这一发现进一步支持了上述结果。在我们的队列中，未发现疾病活动与MPV在横断面或纵向存在相关性。与对照组（平均10.8 fL）相比，SLE患者的平均血小板体积值显著更小（平均10.5 fL），<0.0001。根据参考区间，2.4%（=5）的患者血小板较大，84.4%（=179）的患者血小板正常，13.2%（=28）的患者血小板较小。与血小板正常和较大（57.6%）的患者相比，血小板较小的患者中有更大比例（85.7%）符合抗双链DNA标准（ACR10b；=0.003）。总之，个体内MPV变异程度较低，疾病活动的波动在纵向对MPV没有任何显著影响。MPV随时间缺乏变异性表明在任何时间点测量MPV都是足够 的。有必要进一步研究以评估MPV作为SLE中一种可能的生物标志物，以及确定影响SLE中血小板大小的潜在机制。
