Elevation of Endothelial Microparticles, Platelets, and Leukocyte Activation in Patients With Venous Thromboembolism

医学 血小板 川地31 血小板活化 单核细胞 整合素αM 流式细胞术 P-选择素 内皮 免疫学 内皮细胞活化 内科学 内分泌学 免疫组织化学
作者
Julio A. Chirinos,Gustavo A. Heresi,Hermes Velásquez,Wenche Jy,Joaquín J. Jiménez,Eugene Ahn,Lawrence L. Horstman,Andres O. Soriano,Juan P. Zambrano,Yeon S. Ahn
出处
期刊:Journal of the American College of Cardiology [Elsevier BV]
卷期号:45 (9): 1467-1471 被引量:286
标识
DOI:10.1016/j.jacc.2004.12.075
摘要

The purpose of this research was to determine the levels of platelet, leukocyte, and endothelial activation and markers of cellular interactions in patients with venous thromboembolism (VTE).The details of interactions between endothelium, platelets, and leukocytes in VTE are not well understood.We studied 25 patients with VTE and compared 25 healthy controls. We used flow cytometry to measure: 1) endothelial microparticles (EMP) identified by CD31+/CD42b- (EMP(31)) or E-selectin (EMP(62E)); 2) platelet microparticles (CD31+/CD42b+); 3) surface expression of P-selectin in platelets and CD11b in leukocytes; 4) EMP-monocyte conjugates (percentage of monocytes positive for E-selectin); and 5) platelet-leukocyte conjugates (PLC) expressed as percentage of leukocytes positive for CD41.Patients with VTE had marked elevations of EMP(31) (2,193 vs. 383 counts/microl; p = 0.003), EMP(62E) (368 vs. 223 counts/microl; p = 0.001), and EMP-monocyte conjugates (3.3% vs. 2.5%; p = 0.002), as well as increased activation of platelets (35.2 vs. 5.0 fluorescence intensity units for P-selectin; p < 0.0001) and leukocytes (13.9 vs. 7.7 U for CD11b; p = 0.004). Also elevated in VTE were PLC (61.7% vs. 39.6%; p = 0.01). Expression of CD11b in leukocytes strongly correlated with PLC (r = 0.74; p < 0.0001).Marked activation of endothelium, platelets, and leukocytes occurs in VTE, and VTE, or the accompanying inflammatory process, involves the release of EMP and formation of EMP-monocyte conjugates and PLC. These findings support prior studies suggesting that release of EMP and their binding to monocytes are key events in thrombogenesis. Our findings also support the concept that the formation of PLC regulates leukocyte activation and participates in linking thrombosis with inflammation.
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