McConnell L A, Leid R W
Am J Pathol. 1983 Mar;110(3):290-6.
The arachidonic acid pathway plays an important role in many inflammatory reactions. Current evidence suggests that platelets can play a central part in host inflammation. Since microfilariae are mobilized into the bloodstream following diethylcarbamazine (DEC) treatment, we have studied the effects of Onchocerca cervicalis cuticle preparations on equine platelet aggregation. The authors have found that O cervicalis cuticular preparations can induce platelet aggregation in vitro. Furthermore, this activity was abrogated by treatment with collagenase and not hyaluronidase, elastase, or alpha-chymotrypsin. When this evidence is viewed collectively with the evidence for in vivo parasite cuticular damage following DEC treatment, it becomes entirely plausible that the cuticular damage may indeed reveal a platelet-reactive surface, thus permitting platelet-parasite binding to occur. This binding would result in platelet aggregation and the generation and release of platelet-derived arachidonate metabolites. These metabolites may play a very critical role in the development of the described pathologic sequelae observed following DEC treatment. Field studies using cyclooxygenase and lipoxygenase inhibitors might therefore be very efficacious in decreasing the frequency of side effects due to DEC or other potentially effective drug regimens.
花生四烯酸途径在许多炎症反应中起重要作用。目前的证据表明,血小板在宿主炎症中可发挥核心作用。由于乙胺嗪(DEC)治疗后微丝蚴会进入血液循环,我们研究了马颈盘尾丝虫角质层制剂对马血小板聚集的影响。作者发现,马颈盘尾丝虫角质层制剂可在体外诱导血小板聚集。此外,用胶原酶处理可消除这种活性,而透明质酸酶、弹性蛋白酶或α-糜蛋白酶处理则不能。当将这一证据与DEC治疗后体内寄生虫角质层损伤的证据综合起来看时,角质层损伤确实可能暴露出血小板反应性表面,从而使血小板与寄生虫结合发生,这一点就完全说得通了。这种结合会导致血小板聚集以及血小板衍生的花生四烯酸代谢产物的生成和释放。这些代谢产物可能在DEC治疗后所观察到的所述病理后遗症的发展中起非常关键的作用。因此,使用环氧化酶和脂氧合酶抑制剂的现场研究可能在降低DEC或其他潜在有效药物方案引起的副作用发生率方面非常有效。