Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum der Charité (DHZC), Berlin, Germany; Division of Pediatric Cardiology, Graz Medical University, Graz, Austria.
Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora CO, USA.
Semin Perinatol. 2023 Mar;47(2):151719. doi: 10.1016/j.semperi.2023.151719. Epub 2023 Mar 1.
Platelet plug formation is critically involved in murine ductus arteriosus closure and thrombocytopenia in preterm infants seems to negatively affect spontaneous and pharmacologically induced ductal closure. Furthermore, platelet dysfunction may contribute to ductal patency, especially in extremely immature infants. Neonatal platelets likely have multifaceted roles during ductal closure, such as secretion of several signaling molecules and facilitation of specific cell-cell interactions. The only available randomized-controlled trial on platelet transfusions in preterm infants with patent ductus arteriosus demonstrated that a liberal transfusion regimen did not promote ductal closure, but was associated with an increased rate of intraventricular hemorrhage. Herein, we discuss the available mechanistic evidence on the role of platelets in ductus arteriosus closure and their potential clinical implications in preterm infants. We further briefly outline future research directions aimed at a better understanding of platelet-endothelial interactions in neonatal health and disease.
血小板栓形成在鼠动脉导管闭合中起着关键作用，早产儿的血小板减少似乎会对自发性和药物诱导的导管闭合产生负面影响。此外，血小板功能障碍可能会导致导管持续开放，尤其是在极不成熟的婴儿中。在动脉导管闭合过程中，新生儿血小板可能具有多种作用，例如分泌几种信号分子和促进特定细胞-细胞相互作用。唯一一项关于血小板输注治疗早产儿动脉导管未闭的随机对照试验表明，宽松的输血方案并不能促进导管闭合，但与脑室内出血的发生率增加有关。在此，我们讨论了血小板在动脉导管闭合中的作用及其在早产儿中的潜在临床意义的现有机制证据。我们还简要概述了未来的研究方向，旨在更好地了解新生儿健康和疾病中血小板-内皮相互作用。
