Roemmermann Gregor, Bohe Olivia, Heimann Laura, Wirth Franziska, Drumm Franziska, Biberthaler Peter, Moog Philipp, Schwenk Christina, Muehlhaupt Nadja, Wan Li, Hanschen Marc
Department of Trauma Surgery, Klinikum Rechts der Isar, TUM University Hospital, School of Medicine, Technical University of Munich, 81675 Munich, Germany.
Experimental Trauma Surgery, Klinikum Rechts der Isar, TUM University Hospital, School of Medicine, Technical University of Munich, 81675 Munich, Germany.
Curr Issues Mol Biol. 2025 Jul 2;47(7):510. doi: 10.3390/cimb47070510.
Platelets are attributed an increasing role in the post-traumatic immune response. The exact mechanisms, particularly the link between immune response and hemostasis, have not been conclusively established. This study aimed to investigate the activity marker CD63 on platelets after polytrauma and its significance for hemostasis. A non-interventional, prospective clinical study was conducted, in which the blood of 20 polytraumatized patients was analyzed at nine time points within 10 days following trauma. Peripheral blood platelets were analyzed using flow cytometry to determine CD63 expression and rotational thromboelastometry (ROTEM) for hemostatic platelet function. Additionally, the clinical parameters of age, gender, and injury severity were correlated to the experimental outcomes. During the observation period, an increase in platelet count and CD63 expression was observed. Simultaneously, a hemostasiological dysfunction with reduced platelet maximum clot firmness (MCF) was observed. The factors of age, gender, and injury severity showed no significant influence on immunological activation or coagulation function. These results suggest that polytrauma induces a platelet response and CD63 activation while simultaneously impairing hemostasis. This reveals a novel perspective on post-traumatic coagulation disorders, indicating that immunologically active platelets may lose their ability to contribute effectively to blood clotting. Consequently, these findings emphasize the critical role of platelet immunology in hemostatic regulation.
血小板在创伤后免疫反应中的作用日益受到关注。确切机制，尤其是免疫反应与止血之间的联系，尚未完全明确。本研究旨在探讨多发伤后血小板上的活性标志物CD63及其对止血的意义。进行了一项非干预性前瞻性临床研究，对20例多发伤患者在创伤后10天内的9个时间点采集血液进行分析。采用流式细胞术分析外周血血小板以确定CD63表达，并采用旋转血栓弹力图（ROTEM）评估血小板的止血功能。此外，将年龄、性别和损伤严重程度等临床参数与实验结果进行相关性分析。在观察期内，观察到血小板计数和CD63表达增加。同时，观察到止血功能障碍，血小板最大血凝块硬度（MCF）降低。年龄、性别和损伤严重程度等因素对免疫激活或凝血功能无显著影响。这些结果表明，多发伤可诱导血小板反应和CD63激活，同时损害止血功能。这揭示了创伤后凝血障碍的新观点，表明具有免疫活性的血小板可能失去有效促进血液凝固的能力。因此，这些发现强调了血小板免疫学在止血调节中的关键作用。
