血小板浓缩物中的高碎片率会影响血小板的激活、促凝血和聚集能力。
High fragmentation in platelet concentrates impacts the activation, procoagulant, and aggregatory capacity of platelets.
作者信息
Tynngård Nahreen, Alshamari Aseel, Sandgren Per, Kenny Dermot, Vasilache Ana Maria, Abedi Mohammad R, Ramström Sofia
机构信息
Department of Clinical Chemistry and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Research and Development Unit in Region Östergötland and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
出版信息
Platelets. 2023 Dec;34(1):2159018. doi: 10.1080/09537104.2022.2159018.
Platelets are transfused to patients to prevent bleeding. Since both preparation and storage can impact the hemostatic functions of platelets, we studied platelet concentrates (PCs) with different initial composition in regard to platelet fragmentation and its impact on storage-induced changes in activation potential. Ten whole blood derived PCs were assessed over 7 storage days. Using flow cytometry, platelet (CD41+) subpopulations were characterized for activation potential using activation markers (PAC-1, P-selectin, and LAMP-1), phosphatidylserine (Annexin V), and mitochondrial integrity (DiIC(5)). Aggregation response, coagulation, and soluble activation markers (cytokines and sGPVI) were also measured. Of the CD41+ events, the PCs contained a median of 82% normal-sized platelets, 10% small platelets, and 8% fragments. The small platelets exhibited procoagulant hallmarks (increased P-selectin and Annexin V and reduced DiIC(5)). Normal-sized platelets responded to activation, whereas activation potential was decreased for small and abolished for fragments. Five PCs contained a high proportion of small platelets and fragments (median of 28% of CD41+ events), which was significantly higher than the other five PCs (median of 9%). A high proportion of small platelets and fragments was associated with procoagulant hallmarks and decreased activation potential, but, although diminished, they still retained some activation potential throughout 7 days storage.
给患者输注血小板以预防出血。由于制备和储存都会影响血小板的止血功能,我们研究了具有不同初始组成的血小板浓缩物(PCs)的血小板碎片化情况及其对储存诱导的激活潜能变化的影响。对10份全血来源的PCs进行了为期7天的储存评估。使用流式细胞术,利用激活标记物(PAC-1、P-选择素和LAMP-1)、磷脂酰丝氨酸(膜联蛋白V)和线粒体完整性(DiIC(5))对血小板(CD41+)亚群的激活潜能进行了表征。还测量了聚集反应、凝血和可溶性激活标记物(细胞因子和可溶性糖蛋白VI)。在CD41+事件中,PCs中正常大小血小板的中位数为82%,小血小板为10%,碎片为8%。小血小板表现出促凝特征(P-选择素和膜联蛋白V增加,DiIC(5)减少)。正常大小的血小板对激活有反应,而小血小板的激活潜能降低,碎片的激活潜能则消失。5份PCs中小血小板和碎片的比例较高(CD41+事件的中位数为28%),显著高于其他5份PCs(中位数为9%)。高比例的小血小板和碎片与促凝特征和激活潜能降低有关,但尽管有所减弱,它们在7天的储存期内仍保留了一些激活潜能。