The Role of Platelet Activation in the Acute Aortic Dissection-related Systemic Inflammatory Responses_West China Medical Journal

Authors：

 HeQian ¹ , GuJun ² , QinChaoyi ² , CaoYu ¹ , ZhangHongwei ² , XiaoZhenghua ² , XuFei ³ , ZhangEryong ² ,  HuJia ²

1. Department of Emergency;West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Cardiovascular Surgery;West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Anesthesia, Chengdu Women and Children's Central Hospital, Chengdu, Sichuan 610091, P. R. China;

Corresponding author：

HuJia, Email: humanjia@msn.com

Keywords：

Aortic dissection; Platelet activation; Systemic inflammatory responses; Tumor necrosis factior-α; Interleukin-6

DOI：

10.7507/1002-0179.201600271

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Objective To explore whether platelet activation is associated with systemic inflammatory responses. Methods We conducted a cross-sectional study to enroll all aortic dissection (AD) patients (AD group) from January 1, 2015 to June 30, 2015 in the Emergency Department. According to the characteristics of AD patients, we matched hypertension (hypertension group) and health participants (health group) with AD patients at a proportion of 1:1:1. Blood samples were collected on admission for blood routine test [mean platelet volume (MPV)/platelet (PLT)] and inflammatory cytokines [tumor necrosis factor (TNF)-α and interleukin (IL)-6] analysis. We compared all parameters among the three groups and performed bivariate correlation analyses. Results Expressions of TNF-α and IL-6 in the AD group [(20.9±4.5), (168.8±75.1) pg/mL] were significantly higher than those in the hypertension group [(4.3±1.9), (8.4±2.9) pg/mL] and healthy group [(5.4±1.6), (8.7±3.8) pg/mL] (P＜0.05). MPV/PLT in the AD group was significantly higher than that in the hypertension group and healthy group (0.106±0.035 vs 0.049±0.010, P＜0.05; 0.106±0.035 vs 0.054±0.019, P＜0.05). There were positive correlations between MPV/PLT and TNF-α (r=0.516, P=0.002), and between MPV/PLT and IL-6 (r=0.633, P＜0.001) in the AD group. Conclusion In summary, our study shows that platelets of AD patients can be activated, and the degree of activation is associated with systemic inflammatory responses.

Citation： HeQian, GuJun, QinChaoyi, CaoYu, ZhangHongwei, XiaoZhenghua, XuFei, ZhangEryong, HuJia. The Role of Platelet Activation in the Acute Aortic Dissection-related Systemic Inflammatory Responses. West China Medical Journal, 2016, 31(6): 1004-1007. doi: 10.7507/1002-0179.201600271 Copy

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2.	Hagan PG, Nienaber CA, Isselbacher EM, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease[J]. JAMA, 2000, 283(7): 897-903.
3.	Luo F, Zhou XL, Li JJ, et al. Inflammatory response is associated with aortic dissection[J]. Ageing Res Rev, 2009, 8(1): 31-35.
4.	Sbarouni E, Georgiadou P, Analitis A, et al. Significant changes in platelet count, volume and size in acute aortic dissection[J]. Int J Cardiol, 2013, 168(4): 4349-4350.
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9.	Azab B, Torbey E, Singh J, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction[J]. Platelets, 2011, 22(8): 557-566.
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11.	Hasegawa Y, Ishikawa S, Ohtaki A, et al. Impaired lung oxygenation in acute aortic dissection[J]. J Cardiovasc Surg (Torino), 1999, 40(2): 191-195.
12.	Huang B, Tian L, Fan X, et al. Low admission platelet counts predicts increased risk of in-hospital mortality in patients with type A acute aortic dissection[J]. Int J Cardiol, 2014, 172(3): e484-e486.
13.	Brewer DB. Max Schultze (1865), G. Bizzozero (1882) and the discovery of the platelet[J]. Br J Haematol, 2006, 133(3): 251-258.
14.	Lindemann S, Tolley ND, Dixon DA, et al. Activated platelets mediate inflammatory signaling by regulated interleukin 1beta synthesis[J]. J Cell Biol, 2001, 154(3): 485-490.
15.	Dinarello CA. The IL-1 family and inflammatory diseases[J]. Clin Exp Rheumatol, 2004, 20(5 Suppl 27): S1-S13.
16.	李明, 法宪恩, 杨景学, 等. 急性主动脉夹层患者血浆细胞因子及内毒素水平测定[J]. 郑州大学学报: 医学版, 2014(1): 80-82.
17.	Gu J, Hu J, Qian H, et al. Intestinal barrier dysfunction: a novel therapeutic target for inflammatory response in acute Stanford type a aortic dissection[J]. J Cardiovasc Pharmacol Ther, 2016, 21(1): 64-69.
18.	肖正华, 古君, 胡佳, 等. 基于炎症反应变化程度的主动脉夹层病程分期的初步探讨[J]. 中国胸心血管外科临床杂志, 2014, 21(6): 721-724.

1. Sheikh AS, Ali K, Mazhar S. Acute aortic syndrome[J]. Circulation, 2013, 128(10): 1122-1127.
2. Hagan PG, Nienaber CA, Isselbacher EM, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease[J]. JAMA, 2000, 283(7): 897-903.
3. Luo F, Zhou XL, Li JJ, et al. Inflammatory response is associated with aortic dissection[J]. Ageing Res Rev, 2009, 8(1): 31-35.
4. Sbarouni E, Georgiadou P, Analitis A, et al. Significant changes in platelet count, volume and size in acute aortic dissection[J]. Int J Cardiol, 2013, 168(4): 4349-4350.
5. Booher AM, Isselbacher EM, Nienaber CA, et al. The IRAD classification system for characterizing survival after aortic dissection[J]. Am J Med, 2013, 126(8): 730.e19-730.e24.
6. 中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中国医学前沿杂志: 电子版, 2011, 3(5): 42-93.
7. 张桂珍, 范启修, 包承鑫. 血小板收缩蛋白与血小板激活[J]. 国际输血及血液学杂志, 1985(2): 79-83.
8. De Marco L, Girolami A, Zimmerman TS, et al. Interaction of purified typeⅡB von Willebrand factor with the platelet membrane glycoprotein Ib induces fibrinogen binding to the glycoproteinⅡb/Ⅲa complex and initiates aggregation[J]. Proc Natl Acad Sci USA, 1985, 82(21): 7424-7428.
9. Azab B, Torbey E, Singh J, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction[J]. Platelets, 2011, 22(8): 557-566.
10. Semple JW, Italiano J, Freedman J. Platelets and the immune continuum[J]. Nat Rev Immunol, 2011, 11(4): 264-274.
11. Hasegawa Y, Ishikawa S, Ohtaki A, et al. Impaired lung oxygenation in acute aortic dissection[J]. J Cardiovasc Surg (Torino), 1999, 40(2): 191-195.
12. Huang B, Tian L, Fan X, et al. Low admission platelet counts predicts increased risk of in-hospital mortality in patients with type A acute aortic dissection[J]. Int J Cardiol, 2014, 172(3): e484-e486.
13. Brewer DB. Max Schultze (1865), G. Bizzozero (1882) and the discovery of the platelet[J]. Br J Haematol, 2006, 133(3): 251-258.
14. Lindemann S, Tolley ND, Dixon DA, et al. Activated platelets mediate inflammatory signaling by regulated interleukin 1beta synthesis[J]. J Cell Biol, 2001, 154(3): 485-490.
15. Dinarello CA. The IL-1 family and inflammatory diseases[J]. Clin Exp Rheumatol, 2004, 20(5 Suppl 27): S1-S13.
16. 李明, 法宪恩, 杨景学, 等. 急性主动脉夹层患者血浆细胞因子及内毒素水平测定[J]. 郑州大学学报: 医学版, 2014(1): 80-82.
17. Gu J, Hu J, Qian H, et al. Intestinal barrier dysfunction: a novel therapeutic target for inflammatory response in acute Stanford type a aortic dissection[J]. J Cardiovasc Pharmacol Ther, 2016, 21(1): 64-69.
18. 肖正华, 古君, 胡佳, 等. 基于炎症反应变化程度的主动脉夹层病程分期的初步探讨[J]. 中国胸心血管外科临床杂志, 2014, 21(6): 721-724.

West China Medical Journal

The Role of Platelet Activation in the Acute Aortic Dissection-related Systemic Inflammatory Responses

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