Kinlough-Rathbone R L, Perry D W, Rand M L, Packham M A
Department of Pathology, McMaster University, Hamilton, Ontario, Canada.
Thromb Haemost. 1997 Apr;77(4):741-7.
Effects of plasmin on platelets, that influence subsequent responses to aggregating agents, are relevant to attempts to prevent rethrombosis following administration of fibrinolytic agents. We describe plasmin-induced inhibition of platelet responses to thrombin, but potentiation of responses to other aggregating agents. Washed human platelets were labeled with 14C-serotonin, treated for 30 min at 37 degrees C with 0, 0.1 or 0.2 CU/ml of plasmin, followed by aprotinin, washed and resuspended in a Tyrode-albumin solution with apyrase. Incubation with 0.2 CU/ml of plasmin almost completely inhibited thrombin-induced (0.1 U/ml) aggregation, release of 14C-serotonin, and increase in cytosolic [Ca2+]. In contrast, with plasmin-pretreated platelets, aggregation and release of 14C-serotonin were strongly potentiated in response to low concentrations of the thrombin receptor-activating peptide SFLLRN, ADP, platelet-activating factor, collagen, arachidonic acid, the thromboxane mimetic U46619, and the calcium ionophores A23187 and ionomycin. Aspirin or RGDS partially inhibited potentiation. Plasmin-pretreated platelets resuspended in plasma anticoagulated with FPRCH2Cl (PPACK) also showed enhanced responses to aggregating agents other than thrombin. The contrasting effects on responses to thrombin and SFLLRN are noteworthy. Plasmin cleaves GPIIb/IIIa so that it becomes a competent fibrinogen receptor, and binding of 125I-fibrinogen during ADP-induced aggregation was greatly potentiated within 10 s. Potentiation of aggregation by other agonists may be due to increased binding of released fibrinogen. Thus, platelets freed from a thrombus may have increased responsiveness to low concentrations of aggregating agents other than thrombin. These results provide further support for the use of inhibitors of platelet reactions in conjunction with administration of fibrinolytic agents.
纤溶酶对血小板的影响会影响后续对聚集剂的反应,这与试图预防纤维蛋白溶解剂给药后的再血栓形成相关。我们描述了纤溶酶诱导的对血小板对凝血酶反应的抑制,但对其他聚集剂反应的增强作用。用14C-5-羟色胺标记洗涤过的人血小板,在37℃下用0、0.1或0.2 CU/ml的纤溶酶处理30分钟,随后加入抑肽酶,洗涤并重悬于含抑腺苷三磷酸双磷酸酶的台氏液-白蛋白溶液中。用0.2 CU/ml的纤溶酶孵育几乎完全抑制了凝血酶诱导的(0.1 U/ml)聚集、14C-5-羟色胺的释放以及胞质[Ca2+]的增加。相反,对于经纤溶酶预处理的血小板,低浓度的凝血酶受体激活肽SFLLRN、ADP、血小板激活因子、胶原、花生四烯酸、血栓素类似物U46619以及钙离子载体A23187和离子霉素会强烈增强其14C-5-羟色胺的聚集和释放。阿司匹林或RGDS部分抑制了这种增强作用。重悬于用FPRCH2Cl(PPACK)抗凝的血浆中的经纤溶酶预处理的血小板对除凝血酶外的其他聚集剂也表现出增强的反应。对凝血酶和SFLLRN反应的对比效应值得注意。纤溶酶切割糖蛋白IIb/IIIa,使其成为有活性的纤维蛋白原受体,并且在ADP诱导的聚集过程中,125I-纤维蛋白原的结合在10秒内大大增强。其他激动剂对聚集的增强作用可能是由于释放的纤维蛋白原结合增加。因此,从血栓中游离出来的血小板对除凝血酶外的低浓度聚集剂可能具有增强的反应性。这些结果为联合使用血小板反应抑制剂和纤维蛋白溶解剂提供了进一步的支持。