Shin Hyun-Jung, Koo Bon-Wook, Kim Ji-Na, Park Ji-In, Na Hyo-Seok
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Medicina (Kaunas). 2025 Apr 8;61(4):682. doi: 10.3390/medicina61040682.
: Serotonin modulates platelet aggregation and secretion, but its role in hemostasis remains controversial. This study hypothesized that the 5-HT receptor antagonist palonosetron may inhibit platelet function and aimed to evaluate its effects on blood coagulation using thromboelastography (TEG). : Blood samples from 11 healthy volunteers were treated with palonosetron at concentrations of 25, 250, and 2500 ng/mL. Untreated samples served as controls. Coagulation parameters were assessed using global hemostasis (citrated kaolin, citrated rapid TEG, citrated kaolin with heparinase, and citrated functional fibrinogen) and PlateletMapping (adenosine diphosphate [ADP], arachidonic acid, and others) assays. : In the global hemostasis assay, maximum amplitude values, reflecting clot strength, decreased with increasing palonosetron concentrations in all tests, including citrated kaolin ( = 0.031), citrated rapid TEG ( = 0.001), citrated kaolin with heparinase ( = 0.033), and citrated functional fibrinogen ( = 0.011). The PlateletMapping assay showed significant reductions in ADP-induced platelet aggregation ( = 0.001), with the largest inhibition observed at 2500 ng/mL ( = 0.007). Despite these changes, all values remained within normal reference ranges. : Palonosetron induces hypocoagulable trends in vitro by inhibiting platelet function and fibrinogen-mediated clot strength. However, these changes are unlikely to result in clinically significant hemostatic impairment when used within therapeutic doses. Further research is warranted to confirm these findings and explore their clinical relevance.
血清素调节血小板聚集和分泌，但其在止血中的作用仍存在争议。本研究假设5-羟色胺受体拮抗剂帕洛诺司琼可能抑制血小板功能，并旨在使用血栓弹力图（TEG）评估其对血液凝固的影响。：从11名健康志愿者采集的血样用浓度为25、250和2500 ng/mL的帕洛诺司琼处理。未处理的样本作为对照。使用整体止血（枸橼酸化高岭土、枸橼酸化快速TEG、含肝素酶的枸橼酸化高岭土和枸橼酸化功能性纤维蛋白原）和血小板功能检测（二磷酸腺苷[ADP]、花生四烯酸等）试验评估凝血参数。：在整体止血试验中，反映血凝块强度的最大振幅值在所有试验中均随帕洛诺司琼浓度增加而降低，包括枸橼酸化高岭土（P = 0.031）、枸橼酸化快速TEG（P = 0.001）、含肝素酶的枸橼酸化高岭土（P = 0.033）和枸橼酸化功能性纤维蛋白原（P = 0.011）。血小板功能检测显示ADP诱导的血小板聚集显著降低（P = 0.001），在2500 ng/mL时抑制作用最大（P = 0.007）。尽管有这些变化，但所有值仍在正常参考范围内。：帕洛诺司琼通过抑制血小板功能和纤维蛋白原介导的血凝块强度在体外诱导低凝趋势。然而，当在治疗剂量内使用时，这些变化不太可能导致临床上显著的止血功能损害。有必要进一步研究以证实这些发现并探索其临床相关性。
