Blood:获得性血小板GPVI受体功能障碍提示早期败血症!

2021-06-11 Nebula MedSci原创

在败血症发病早期就会出现血小板GPVI受体功能障碍,GPVI缺陷或可作为诊断早期败血症的指标

中心点:

败血症患者表现为获得性血小板功能缺陷、GPVI 受体反应性大量丧失

血小板GPVI功能障碍在疾病早期就已经很明显,并在患者康复后恢复

糖蛋白VI(GPVI)是胶原蛋白的血小板免疫受体酪氨酸激活模体 (ITAM) 受体,在炎症和败血症动物模型中对血管完整性起着重要作用。了解败血症患者的 ITAM受体信号缺陷(尤其是在疾病发作期间)可能会提高我们对其病理生理学的理解。

在本飞行研究中,通过流式细胞术、凝集测定法和免疫印迹连续综合分析了15位败血症患者进入重症监护室(ICU)当天、第5天至第7天和转出ICU当天的血小板。

败血症患者的血小板活性降低

分析结果显示,所有患者的血小板功能均显著降低。采用胶原相关多肽刺激了GPVI后,缺陷最为明显。15位患者中有14位在入ICU当天已出现GPVI功能障碍,远早于血小板计数的严重下降

与败血症患者的全血共培养可诱导健康供体的血小板出现GPVI缺陷

败血症患者的血小板不能转导GPVI介导的信号以触发Syk激酶或LAT的酪氨酸磷酸化。将健康供体的血小板与败血症患者的全血共培养,可诱导健康供体的血小板出现部分GPVI缺陷,但与败血症患者的血浆共培养则无此效应。GPVI刺激后的血小板聚集增多仅见于病情改善的患者中。

综上所述,由于GPVI信号减弱发生在败血症发病早期,该缺陷或可作为诊断早期败血症的指标,这需要在前瞻性研究中进一步证实。

原始出处:

Weiss Lukas J,Manukjan Georgi,Pflug Annerose et al. Acquired platelet GPVI receptor dysfunction in critically ill patients with sepsis.[J] .Blood, 2021, 137: 3105-3115. https://doi.org/10.1182/blood.2020009774

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    2021-08-28 wrj0121
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    2021-06-12 仁术2021

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