Oda A, Miyakawa Y, Druker B J, Ozaki K, Yabusaki K, Shirasawa Y, Handa M, Kato T, Miyazaki H, Shimosaka A, Ikeda Y
Division of Hematology, Department of Internal Medicine, Keio University, Tokyo, Japan.
Blood. 1996 Jun 1;87(11):4664-70.
Recombinant thrombopoietin has been reported to stimulate megakaryocytopoiesis and thrombopoiesis and it may be quite useful to treat patients with low platelet counts after chemotherapy. As little is known regarding the possible activation of platelets by thrombopoietin, we examined the effects of thrombopoietin on platelet aggregation induced by shear stress and various agonists in native plasma. Using hirudin as an anticoagulant, thrombopoietin (1 to 100 ng/mL) enhanced platelet aggregation induced by 2 micromol/L adenosine-diphosphate (ADP) in a dose dependent fashion. The enhancement was not affected by treatment of platelets with 1 mmol/L aspirin plus SQ-29548 (a thromboxane antagonist, 1 micromol/L) but was inhibited by a soluble form of the thrombopoietin receptor, suggesting that the enhancement was mediated by the specific receptors and does not require thromboxane production. Epinephrine (1 micromol/L), which does not induce platelet aggregation in hirudin platelet rich plasma (PRP), did so in the presence of thrombopoietin (10 ng/mL). Thrombopoietin (10 ng/mL) also enhanced or primed platelet aggregation induced by collagen (0.5 micron.mL),. thrombin, serotonin, and vasopressin. Thrombopoietin does not induce any rise in cytosolic ionized calcium concentration nor activation of protein kinase C, as estimated by phosphorylation of preckstrin, indicating that the priming effects of thrombopoietin does not require those processes. The ADP- or thrombin-induced rise in cytosolic ionized calcium concentration was not enhanced by thrombopoietin (100 ng/mL). Further, shear (ca. 90 dyn/cm2)-induced platelet aggregation was also potentiated by thrombopoietin. The priming effect on epinephrine-induced platelet aggregation in hirudin PRP was unique to thrombopoietin, with no effects seen using interleukin-6 (IL-6), IL-11, IL-3, erythropoietin, granulocyte-colony stimulating factor, granulocyte macrophage-colony stimulating factor, or c-kit ligand. These data indicate that monitoring of platelet functions may be necessary in the clinical trials of thrombopoietin.
据报道,重组血小板生成素可刺激巨核细胞生成和血小板生成,对治疗化疗后血小板计数低的患者可能非常有用。由于关于血小板生成素可能激活血小板的情况知之甚少,我们研究了血小板生成素对天然血浆中剪切应力和各种激动剂诱导的血小板聚集的影响。使用水蛭素作为抗凝剂,血小板生成素(1至100 ng/mL)以剂量依赖的方式增强了2 μmol/L二磷酸腺苷(ADP)诱导的血小板聚集。用1 mmol/L阿司匹林加SQ-29548(一种血栓素拮抗剂,1 μmol/L)处理血小板对这种增强作用没有影响,但可被可溶性血小板生成素受体抑制,这表明这种增强作用是由特异性受体介导的,不需要血栓素的产生。肾上腺素(1 μmol/L)在水蛭素富血小板血浆(PRP)中不会诱导血小板聚集,但在有血小板生成素(10 ng/mL)存在时会诱导聚集。血小板生成素(10 ng/mL)还增强或引发了胶原蛋白(0.5 μg/mL)、凝血酶、血清素和血管加压素诱导的血小板聚集。据通过血小板-肌动蛋白磷酸化估计,血小板生成素不会引起胞质游离钙浓度升高,也不会激活蛋白激酶C,这表明血小板生成素的引发作用不需要这些过程。血小板生成素(100 ng/mL)不会增强ADP或凝血酶诱导的胞质游离钙浓度升高。此外,血小板生成素也增强了剪切力(约90 dyn/cm²)诱导的血小板聚集。血小板生成素对水蛭素PRP中肾上腺素诱导的血小板聚集的引发作用是其特有的,使用白细胞介素-6(IL-6)、IL-11、IL-3、促红细胞生成素、粒细胞集落刺激因子、粒细胞巨噬细胞集落刺激因子或c-kit配体未见效果。这些数据表明,在血小板生成素的临床试验中可能需要监测血小板功能。