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振动声学血小板激活:一种血栓形成的附加机制及其在打鼾和阻塞性睡眠呼吸暂停中的适用性

Vibro-Acoustic Platelet Activation: An Additive Mechanism of Prothrombosis with Applicability to Snoring and Obstructive Sleep Apnea.

作者信息

Palomares Daniel E, Tran Phat L, Jerman Catherine, Momayez Moe, Deymier Pierre, Sheriff Jawaad, Bluestein Danny, Parthasarathy Sairam, Slepian Marvin J

机构信息

Department of Biomedical Engineering, University of Arizona, Tucson, AZ 85724, USA.

Arizona Center for Accelerated Biomedical Innovation, University of Arizona, Tucson, AZ 85724, USA.

出版信息

Bioengineering (Basel). 2023 Dec 12;10(12):1414. doi: 10.3390/bioengineering10121414.


DOI:10.3390/bioengineering10121414
PMID:38136005
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10741028/
Abstract

Obstructive sleep apnea (OSA) and loud snoring are conditions with increased cardiovascular risk and notably an association with stroke. Central in stroke are thrombosis and thromboembolism, all related to and initiaing with platelet activation. Platelet activation in OSA has been felt to be driven by biochemical and inflammatory means, including intermittent catecholamine exposure and transient hypoxia. We hypothesized that snore-associated acoustic vibration (SAAV) is an activator of platelets that synergizes with catecholamines and hypoxia to further amplify platelet activation. Gel-filtered human platelets were exposed to snoring utilizing a designed vibro-acoustic exposure device, varying the time and intensity of exposure and frequency content. Platelet activation was assessed via thrombin generation using the Platelet Activity State assay and scanning electron microscopy. Comparative activation induced by epinephrine and hypoxia were assessed individually as well as additively with SAAV, as well as the inhibitory effect of aspirin. We demonstrate that snore-associated acoustic vibration is an independent activator of platelets, which is dependent upon the dose of exposure, i.e., intensity x time. In snoring, acoustic vibrations associated with low-frequency sound content (200 Hz) are more activating than those associated with high frequencies (900 Hz) (53.05% vs. 22.08%, = 0.001). Furthermore, SAAV is additive to both catecholamines and hypoxia-mediated activation, inducing synergistic activation. Finally, aspirin, a known inhibitor of platelet activation, has no significant effect in limiting SAAV platelet activation. Snore-associated acoustic vibration is a mechanical means of platelet activation, which may drive prothrombosis and thrombotic risk clinically observed in loud snoring and OSA.

摘要

阻塞性睡眠呼吸暂停(OSA)和大声打鼾是心血管风险增加的病症,尤其与中风有关。中风的核心是血栓形成和血栓栓塞,所有这些都与血小板活化相关并由其引发。OSA中的血小板活化被认为是由生化和炎症方式驱动的,包括间歇性儿茶酚胺暴露和短暂性缺氧。我们假设与打鼾相关的声学振动(SAAV)是血小板的一种激活剂,它与儿茶酚胺和缺氧协同作用,进一步放大血小板活化。利用设计的振动声学暴露装置,将凝胶过滤的人血小板暴露于打鼾环境中,改变暴露时间、强度和频率成分。通过使用血小板活性状态测定法和扫描电子显微镜观察凝血酶生成来评估血小板活化。分别评估肾上腺素和缺氧诱导的比较性活化以及与SAAV的叠加性活化,以及阿司匹林的抑制作用。我们证明,与打鼾相关的声学振动是血小板的一种独立激活剂,它取决于暴露剂量,即强度×时间。在打鼾过程中,与低频声音成分(200Hz)相关的声学振动比与高频(900Hz)相关的振动更具激活作用(53.05%对22.08%,P = 0.001)。此外,SAAV与儿茶酚胺和缺氧介导的活化具有叠加性,可诱导协同活化。最后,阿司匹林是一种已知的血小板活化抑制剂,在限制SAAV诱导的血小板活化方面没有显著作用。与打鼾相关的声学振动是血小板活化的一种机械方式,这可能在大声打鼾和OSA中临床上观察到的促血栓形成和血栓形成风险中发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/188a/10741028/232c304028af/bioengineering-10-01414-g010.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/188a/10741028/232c304028af/bioengineering-10-01414-g010.jpg

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The Use of Aspirin Increases the Risk of Major Adverse Cardiac and Cerebrovascular Events in Hypertensive Patients with Obstructive Sleep Apnea for the Primary Prevention of Cardiovascular Disease: A Real-World Cohort Study.

J Clin Med. 2022-11-29

[2]
Acoustic characterization of cavitation intensity: A review.

Ultrason Sonochem. 2022-1

[3]
A Pilot Study Of Aspirin Resistance In Obstructive Sleep Apnea Patients.

Clin Invest Med. 2021-10-3

[4]
Snoring Sound Characteristics are Associated with Common Carotid Artery Profiles in Patients with Obstructive Sleep Apnea.

Nat Sci Sleep. 2021-7-24

[5]
Aspirin and left ventricular assist devices: rationale and design for the international randomized, placebo-controlled, non-inferiority ARIES HM3 trial.

Eur J Heart Fail. 2021-7

[6]
Contemporary Clinical Use of Aspirin: Mechanisms of Action, Current Concepts, Unresolved Questions, and Future Perspectives.

Semin Thromb Hemost. 2021-10

[7]
Shear-mediated platelet activation in the free flow II: Evolving mechanobiological mechanisms reveal an identifiable signature of activation and a bi-directional platelet dyscrasia with thrombotic and bleeding features.

J Biomech. 2021-6-23

[8]
Snoring Is Associated With Increased Risk of Stroke: A Cumulative Meta-Analysis.

Front Neurol. 2021-4-1

[9]
Platelet Activation via Shear Stress Exposure Induces a Differing Pattern of Biomarkers of Activation versus Biochemical Agonists.

Thromb Haemost. 2020-5-5

[10]
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