Suzuki-Inoue Katsue
Department of Clinical and Laboratory Medicine, Faculty of Medicine, University of Yamanashi.
Rinsho Ketsueki. 2024;65(9):1106-1115. doi: 10.11406/rinketsu.65.1106.
Unlike for anticoagulants, no good monitoring methods exist for antiplatelet agents, and their monitoring is considered unnecessary. In the platelet aggregation test, which is the standard test for platelet function, aggregation is evaluated by adding a platelet activator to platelets in a cuvette. Therefore, it provides information on the maximum potential of platelets to induce aggregation, but not the actual in vivo degree of platelet activation. In vivo platelet activation markers are not widely used because they require a special blood collection method, although some tests are covered by insurance. My colleagues and I identified the platelet activation receptor C-type lectin-like receptor 2 (CLEC-2) and found that CLEC-2 is cleaved and released during platelet activation. We established a plasma-soluble CLEC-2 (sCLEC-2) assay system with the aim of using it as a marker of in vivo platelet activation. Elevation of sCLEC-2 has been reported in various thrombotic diseases. The multi-center prospective cohort study CLECSTRO is now underway to investigate the usefulness of sCLEC-2 for diagnosis, typing, and prognostic estimation in acute ischemic stroke.
与抗凝剂不同，抗血小板药物不存在良好的监测方法，并且其监测被认为没有必要。在血小板聚集试验（这是血小板功能的标准试验）中，通过向比色皿中的血小板添加血小板激活剂来评估聚集情况。因此，它提供的是关于血小板诱导聚集的最大潜能的信息，而非体内血小板实际的激活程度。体内血小板激活标志物未被广泛应用，因为它们需要特殊的采血方法，尽管有些检测在医保范围内。我和我的同事鉴定出了血小板激活受体C型凝集素样受体2（CLEC-2），并发现CLEC-2在血小板激活过程中会被裂解并释放。我们建立了一种血浆可溶性CLEC-2（sCLEC-2）检测系统，旨在将其用作体内血小板激活的标志物。在各种血栓性疾病中均有sCLEC-2升高的报道。多中心前瞻性队列研究CLECSTRO目前正在进行，以研究sCLEC-2在急性缺血性卒中的诊断、分型和预后评估中的实用性。
