No indications for platelet activation in acute clinical myocardial or renal ischemia/reperfusion injury

American Journal of Translational Research

Robert JM Klautz¹  Eric P van der Veer²  Kirsten A Kortekaas³  Mark Roest⁴  Marlies EJ Reinders⁵  Dorottya K de Vries⁶ 

[1] Current address: Department of Biochemistry, Cardiovascular Research Institute, Maastricht University, Maastricht, The Netherlands;Department of Cardiology, OLVG Oost, Amsterdam, The Netherlands;Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands;Department of Clinical Chemistry and Hematology, University Medical Center Utrecht, Utrecht, The Netherlands;Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands;Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands

关键词: Ischemia;    reperfusion;    inflammation;    platelets;   

DOI  :  

学科分类：医学（综合）

来源: e-Century Publishing Corporation

【 摘 要 】

The pathophysiology of ischemia/reperfusion (I/R) injury is complex and poorly understood. Animal studies imply platelet activation as an initiator of the inflammatory response upon reperfusion. However, it remains unclear whether and how these results translate to clinical I/R. This study evaluates putative platelet activation in the context of two forms of clinical I/R (heart valve surgery with aortic-cross clamping, n = 39 and kidney transplantation, n = 34). The technique of sequential selective arteriovenous (AV) measurements over the reperfused organs was applied to exclude the influence of systemic changes occurring during surgery while simultaneously maximizing sensitivity. Platelet activation and degranulation was evaluated by assessing the expression levels of established markers, i.e. RANTES (Regulated on Activation, Normal T Cell Expressed and Secreted), β-thromboglobulin (β-TG), platelet-derived growth factor (PDGF)-BB and CXCL8 (known as interleukin-8), and by employing an in-vitro assay that specifically tests for platelet excitability. Moreover, a histological analysis was performed by means of CD41 staining. Results show stable RANTES, β-TG, PDGF-BB and CXCL8 AV-concentrations within the first half hour over the reperfused organs, suggesting that myocardial and renal I/R are not associated with platelet activation. Results from the platelet excitability assay were in line with these findings and indicated reduced and stable platelet excitability following renal and myocardial reperfusion, respectively. Histological analysis yield evidence of platelet marginalization in the reperfused organs. In conclusion, results from this study do not support a role for platelet activation in early phases of clinical I/R injury.

【 授权许可】

CC BY-NC