Taylor M L, Ilton M K, Misso N L, Watkins D N, Hung J, Thompson P J
Department of Medicine, University of Western Australia, Queen Elizabeth II Medical Centre, Perth, Australia.
Br J Clin Pharmacol. 1998 Aug;46(2):139-45. doi: 10.1046/j.1365-2125.1998.00766.x.
Aspirin has proven clinical efficacy in limiting the thrombotic complications of atherosclerotic vascular disease but its mechanism of action remains unclear. Recent evidence suggests the anti-platelet action of aspirin may be partly mediated by neutrophil derived nitric oxide (NO). The aim of the study was to determine the effects of aspirin on thrombin-induced platelet expression of the alpha-granule membrane protein, P-selectin, and the platelet surface glycoprotein required for aggregation, GPIIb-IIIa, and to assess whether this was enhanced by the presence of neutrophils.
Platelet P-selectin and GPIIb-IIIa receptor expression were assessed by flow cytometric analysis of washed platelets stimulated with thrombin (0.025 iu ml(-1), sub aggregatory concentration) alone or after pre-incubation with aspirin (0.05, 0.1, 0.5, 1.0 mg m1(-1) either in the presence or absence of neutrophils (100 platelets per neutrophil). NO release was determined by assay of nitrite in the supernatants from parallel samples.
In preliminary aggregation studies, aspirin at all concentrations inhibited arachidonic acid but not thrombin-induced platelet aggregation. Similarly, aspirin at all concentrations failed to inhibit thrombin-induced platelet P-selectin or GPIIb-IIIa expression and this was not influenced by the presence of neutrophils. A reduction in P-selectin and GPIIb-IIIa receptor density on non-activated platelets co-incubated with unstimulated neutrophils was associated with NO release from neutrophils, but this was not enhanced by the addition of aspirin.
These results confirm that thrombin-induced platelet alpha-granule release, with consequent P-selectin expression, and platelet GPIIb-IIIa expression, are not affected by aspirin inhibition of cyclo-oxygenase and suggest that the anti-thrombotic efficacy of aspirin in vivo may partly depend on other mechanisms. This study did not demonstrate an effect of neutrophils or neutrophil derived NO on aspirin inhibition of platelet adhesion receptor expression.
阿司匹林在限制动脉粥样硬化性血管疾病的血栓形成并发症方面已被证明具有临床疗效,但其作用机制仍不清楚。最近的证据表明,阿司匹林的抗血小板作用可能部分由中性粒细胞衍生的一氧化氮(NO)介导。本研究的目的是确定阿司匹林对凝血酶诱导的血小板α-颗粒膜蛋白P-选择素和聚集所需的血小板表面糖蛋白GPIIb-IIIa表达的影响,并评估中性粒细胞的存在是否会增强这种影响。
通过流式细胞术分析洗涤后的血小板,评估血小板P-选择素和GPIIb-IIIa受体的表达。血小板分别用凝血酶(0.025 iu ml(-1),亚聚集浓度)单独刺激,或在有或无中性粒细胞(每中性粒细胞100个血小板)存在的情况下,预先与阿司匹林(0.05、0.1、0.5、1.0 mg m1(-1))孵育后刺激。通过检测平行样品上清液中的亚硝酸盐来测定NO释放。
在初步的聚集研究中,所有浓度的阿司匹林均抑制花生四烯酸诱导的血小板聚集,但不抑制凝血酶诱导的血小板聚集。同样,所有浓度的阿司匹林均未能抑制凝血酶诱导的血小板P-选择素或GPIIb-IIIa表达,且这不受中性粒细胞存在的影响。与未刺激的中性粒细胞共同孵育的未活化血小板上P-选择素和GPIIb-IIIa受体密度的降低与中性粒细胞释放NO有关,但添加阿司匹林并未增强这种作用。
这些结果证实,凝血酶诱导的血小板α-颗粒释放以及随之而来的P-选择素表达和血小板GPIIb-IIIa表达不受阿司匹林对环氧化酶的抑制作用影响,提示阿司匹林在体内抗血栓形成的疗效可能部分取决于其他机制。本研究未证明中性粒细胞或中性粒细胞衍生的NO对阿司匹林抑制血小板黏附受体表达有影响。