Neumeister P, Hiller E, Gawaz M, Holler E, Kolb H J, Sill H, Pihusch R, Mempel W, Wittmann G, Salat C
Division of Haematology, Department of Internal Medicine, Karl-Franzens-University Graz, Auenbruggerpl. 38, A-8036 Graz, Austria.
Eur J Med Res. 1998 Oct 14;3(10):465-9.
Thrombotic complications are observed in patients undergoing bone marrow transplantation despite thrombocytopenia and impaired coagulation due to liver function disturbances. Endothelial cell damage which is involved in the pathogenesis of major transplant related complications like graft-versus-host disease, veno-occlusive disease, sepsis or microangiopathy may be a contributing factor. Little is known about platelet function in bone marrow transplant recipients. In order to study functional alterations in circulating platelets we investigated unstimulated and ADP-stimulated platelets of 10 bone marrow transplant recipients ex vivo by flow cytometry in a pilot study using a panel of monoclonal antibodies to characterize changes in membrane glycoproteins. Samples were collected before and during conditioning and at three timepoints after engraftment. 10 healthy volunteers served as controls. Platelets of bone marrow transplant recipients showed partly a significant, higher expression of surface bound fibrinogen, activated fibrinogen receptor, and glycoprotein Ib as compared to controls. P-selectin, a marker of platelet degranulation was significantly elevated after ADP-induced stimulation at all timepoints compared to controls. Only marginal differences were found for GP IIb/IIIa surface expression. The data point to an increased platelet activation state in bone marrow transplant recipients which might contribute to the thrombotic phenomena observed in these patients.
尽管骨髓移植患者存在血小板减少以及因肝功能紊乱导致的凝血功能受损，但仍会观察到血栓形成并发症。内皮细胞损伤参与了移植物抗宿主病、静脉闭塞性疾病、败血症或微血管病等主要移植相关并发症的发病机制，可能是一个促成因素。关于骨髓移植受者的血小板功能知之甚少。为了研究循环血小板的功能改变，我们在一项初步研究中，通过流式细胞术，使用一组单克隆抗体来表征膜糖蛋白的变化，对10名骨髓移植受者未受刺激和ADP刺激的血小板进行了体外研究。在预处理前、预处理期间以及植入后的三个时间点采集样本。10名健康志愿者作为对照。与对照组相比，骨髓移植受者的血小板部分显示出表面结合纤维蛋白原、活化纤维蛋白原受体和糖蛋白Ib的表达显著更高。与对照组相比，在所有时间点，ADP诱导刺激后，作为血小板脱颗粒标志物的P选择素显著升高。在GP IIb/IIIa表面表达方面仅发现微小差异。数据表明骨髓移植受者的血小板活化状态增加，这可能是导致这些患者出现血栓形成现象的原因。
