Intensive Care Unit, Department of Translational Medicine and for Romagna, Azienda Ospedaliera Universitaria di Ferrara, University of Ferrara, 44121 Ferrara, Italy.
Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, 44124 Cona, Italy.
Cells. 2022 Jan 26;11(3):424. doi: 10.3390/cells11030424.
Beyond their role in hemostasis, platelets have emerged as key contributors in the immune response; accordingly, the occurrence of thrombocytopenia during sepsis/septic shock is a well-known risk factor of mortality and a marker of disease severity. Recently, some studies elucidated that the response of platelets to infections goes beyond a simple fall in platelets count; indeed, sepsis-induced thrombocytopenia can be associated with-or even anticipated by-several changes, including an altered morphological pattern, receptor expression and aggregation. Of note, alterations in platelet function and morphology can occur even with a normal platelet count and can modify, depending on the nature of the pathogen, the pattern of host response and the severity of the infection. The purpose of this review is to give an overview on the pathophysiological interaction between platelets and pathogens, as well as the clinical consequences of platelet dysregulation. Furthermore, we try to clarify how understanding the nature of platelet dysregulation may help to optimize the therapeutic approach.
除了在止血中的作用外，血小板已成为免疫反应的关键贡献者；因此，脓毒症/感染性休克期间血小板减少是死亡率的一个众所周知的危险因素，也是疾病严重程度的一个标志物。最近，一些研究阐明了血小板对感染的反应不仅仅是血小板计数简单下降；事实上，脓毒症引起的血小板减少症可能与几种变化相关联，甚至可以预测这些变化，包括形态模式、受体表达和聚集的改变。值得注意的是，即使血小板计数正常，血小板功能和形态的改变也可能发生，并且根据病原体的性质、宿主反应的模式和感染的严重程度而改变。本综述的目的是概述血小板与病原体之间的病理生理相互作用，以及血小板调节异常的临床后果。此外，我们试图阐明如何理解血小板调节异常的性质可能有助于优化治疗方法。
