Long-acting PGE2 and Lisinopril Mitigate H-ARS.

Thrombocytopenia is a major complication in hematopoietic-acute radiation syndrome (H-ARS) that increases the risk of mortality from uncontrolled hemorrhage. There is a great demand for new therapies to improve survival and mitigate bleeding in H-ARS. Thrombopoiesis requires interactions between megakaryocytes (MKs) and endothelial cells. 16, 16-dimethyl prostaglandin E2 (dmPGE2), a longer-acting analogue of PGE2, promotes hematopoietic recovery after total-body irradiation (TBI), and various angiotensin-converting enzyme (ACE) inhibitors mitigate endothelial injury after radiation exposure. Here, we tested a combination therapy of dmPGE2 and lisinopril to mitigate thrombocytopenia in murine models of H-ARS following TBI. After 7.75 Gy TBI, dmPGE2 and lisinopril each increased survival relative to vehicle controls. Importantly, combined dmPGE2 and lisinopril therapy enhanced survival greater than either individual agent. Studies performed after 4 Gy TBI revealed reduced numbers of marrow MKs and circulating platelets. In addition, sublethal TBI induced abnormalities both in MK maturation and in in vitro and in vivo platelet function. dmPGE2, alone and in combination with lisinopril, improved recovery of marrow MKs and peripheral platelets. Finally, sublethal TBI transiently reduced the number of marrow Lin-CD45-CD31+Sca-1- sinusoidal endothelial cells, while combined dmPGE2 and lisinopril treatment, but not single-agent treatment, accelerated their recovery. Taken together, these data support the concept that combined dmPGE2 and lisinopril therapy improves thrombocytopenia and survival by promoting recovery of the MK lineage, as well as the MK niche, in the setting of H-ARS.

Effects of nitrite and far-red light on coagulation.

Nitric oxide, NO, has been explored as a therapeutic agent to treat thrombosis. In particular, NO has potential in treating mechanical device-associated thrombosis due to its ability to reduce platelet activation and due to the central role of platelet activation and adhesion in device thrombosis. Nitrite is a unique NO donor that reduces platelet activation in that it's activity requires the presence of red blood cells whereas NO activity of other NO donors is blunted by red blood cells. Interestingly, we have previously shown that red blood cell mediated inhibition of platelet activation by adenosine diphosophate (ADP) is dramatically enhanced by illumination with far-red light that is likely due to photolysis of red cell surface bound NO congeners. We now report the effects of nitrite, far-red light, and their combination on several measure of blood coagulation using a variety of agonists. We employed turbidity assays in platelet rich plasma, platelet activation using flow cytometry analysis of a fluorescently labeled antibody to the activated platelet fibrinogen binding site, multiplate impedance-based platelet aggregometry, and assessment of platelet adhesion to collagen coated flow-through microslides. In all cases, the combination of far-red light and nitrite treatment decreased measures of coagulation, but in some cases mono-treatment with nitrite or light alone had no effect. Perhaps most relevant to device thrombosis, we observed that platelet adhesions was inhibited by the combination of nitrite and light treatment while nitrite alone and far-red light alone trended to decrease adhesion, but the results were mixed. These results support the potential of combined far-red light and nitrite treatment for preventing thrombosis in extra-corporeal or shallow-tissue depth devices where the far-red light can penetrate. Such a combined treatment could be advantageous due to the localized treatment afforded by far-red light illumination with minimal systemic effects. Given the role of thrombosis in COVID 19, application to treatment of patients infected with SARS Cov-2 might also be considered.

Low-level light therapy reduces platelet destruction during extracorporeal circulation.

Extracorporeal circulation causes many deleterious effects on blood cells. Low-level light therapy (LLLT) in the red/near-infrared spectral range is known for its cytoprotective properties but its use during cardiopulmonary bypass (CPB) has not yet been studied. We aimed to assess whether LLLT protects platelets during CPB. 24 pigs were connected to 1-hour-CPB and observed for the next 23 hours. In 12 animals, blood circulating through the oxygenator was treated with LLLT. Platelet count and function were monitored throughout the experiment. The decrease in platelet count was greater in the control group, especially during CPB and after 24 hours. In LLLT group CD62P expression remained quite stable up to the 12th hour of the experiment, whereas in the control group it continuously decreased till the end of observation. Platelets in the control group were more prone to aggregation in the postoperative period than at the beginning of the experiment, whereas platelets in the LLLT group aggregated similarly or less intense. Limitation of platelet loss, pattern of aggregation and CD62P expression suggest that LLLT may stabilize platelet function during CPB and diminish the negative effects associated with the interaction of cells with an artificial surface.

[Hemoaggregation dynamics in human-operator during percutaneous laser blood irradiation].

The experiment with essentially healthy male subjects no older than 50 involved functional load testing and irradiation by a low-energy helium-neon laser according to the standard therapeutic regimen (0.2 ml/V/ 30 min/10 sessions). Biomedical evaluation of hemoaggregation was made by 30 parameters of a multifunctional diagnostic system characterizing three blood aggregation levels: rheological (biophysical), coagulolytic (biochemical) and system (mathematical). The investigation resulted in delineation of a single-vector hypodynamic transformation of biophysical and biochemical modules, i.e. decrease in the rheological and coagulative potential mediated by a moderate platelets disaggregation (24.6%) and hyperactivation of plasmin proferments in euglobulin fraction (126.76 %). Added sessions of percutaneous laser irradiation of blood were shown to induce a medium imbalance of biophysical and biochemical hemoaggregation. At the same time, low-energy laser did not modulate significantly the general functional state of human operator as the rheological and coagulative protective potential of organism remained reasonably high (88.89 and 87.5 %, respectively).

[Platelet aggregatory properties in patients with chronic pancreatitis and possibilities of correcting their impairments].

The purpose of the investigation was to study the impact of low-intensity laser therapy (LILT) on platelet aggregatory properties in patients with chronic pancreatitis (CP) on an exacerbation. A total of 105 patients aged 36 to 77 years who were divided into a study group (n = 60) and a control one (n = 45) were examined. Thirty persons who formed a healthy group were additionally examined. In the study group patients, drug therapy was supplemented by LILT via various methods. The control group received only drug therapy. The investigation revealed that patients with CP on an exacerbation showed diverse changes in platelet aggregatory properties towards hyperaggregation. LILT was ascertained to have a normalizing effect on platelet aggregatory properties in the study group patients.

[Influence of laser radiation of the whole blood in vitro on adhesion and aggregation of blood platelets].

The authors revealed dependence of reaction blood plates to photoeffect on the dose and rate of blood movement at laser radiation of donor blood in vitro. The red light decreases adhesion and aggregation of blood plates both at high and low rate of shift. Infrared laser radiation is effective only at high rate of shift leading to increase of adhesion and decrease of aggregation of blood plates. Blue laser is effective in small doses only and at low rate of sift it leads to decrease of adhesion and at high rate it provokes increase of adhesion. Blue laser do not have a significant influence on aggregation of blood plates. These results make possible to suppose ambiguity of biological response of venous and arterial blood to radiation.

[The influence of low-intensive laser therapy on the aggregation properties of thrombocytes in patients with peptic ulcer].

The purpose of the study was to evaluate the influence of low-intensive laser therapy (LILT) on the aggregation properties of thrombocytes in patients with exacerbation of peptic ulcer (PU). The subjects, 111 patients aged 18 to 63, were divided into two groups: the main group (n = 81), and the control group (n = 30). In addition there were 15 healthy people who also underwent examination. Patients in the main group received complex treatment with untiulcer drugs and different methods of laser therapy: intravenous laser irradiation of blood, cutaneous irradiation, and a combination of both. The control group was treated with drugs only. The study found various changes in the aggregation properties of thrombocytes in patients with PU exacerbation, which consisted mostly in hyperaggregation. LILT had a normalizing effect on the aggregation properties of thrombocytes in patients of the main group.

Effect of trans-resveratrol on the thrombogenicity and atherogenicity in apolipoprotein E-deficient and low-density lipoprotein receptor-deficient mice.

Resveratrol is one of the major polyphenolics in red wine that has been shown to exert the preventive effects against cardiovascular diseases. The effect of trans-resveratrol (t-RES) administered as an ingredient of the diet on the atherothrombotic tendency was assessed in genetically hypercholesterolemic mice after laser-induced damage on endothelium. Mice lacking both apolipoprotein E and low-density lipoprotein receptor (apoE-/-/LDLR-/-) were fed with a high-fat diet with or without t-RES (9.6 and 96 mg/kg diet) for 8 weeks. The atherosclerotic tendency was morphometrically analyzed in their aortae. The thrombotic tendency was determined by inducing thrombus by the irradiation of a helium-neon laser on carotid arteries of these mice with injection of Evans blue. Atherosclerotic area and thrombus size were evaluated by image analyzing in a computer system. Even though the plasma concentrations of lipids (total cholesterol and triacylglycerol) did not change in the control and t-RES groups, a significant decrease (approximately 30%) in the formation of atheroma was observed in the aortae of the t-RES group. The size of laser-induced thrombus that mostly consisted of platelet aggregates was significantly reduced (approximately 25%) in the t-RES group compared with that in the control group. Thus, t-RES orally administrated with a high-fat diet in apoE-/-/LDLR-/- mice significantly suppressed atherosclerosis in their aortae and reduced the laser-induced thrombosis in their carotid arteries.

Influence of garlic compared to aspirin on induced photothrombosis in mouse pial microvessels, in vivo.

Effect of garlic on photochemically-induced platelet aggregation in pial microvessels of the mouse, in vivo, was compared to that of acetyl salicylic acid (ASA). Three trials were carried out, in which garlic at doses of 12.5, 25, 50 and 100 mg/kg and ASA doses of 25, 50 and 100 mg/kg were used. Each trial included treatment groups of male mice, approximately 30 g, and a control group. Animals were anesthetized (urethane, 1-2 mg/g, i.p.), the trachea was intubated and a craniotomy was performed. Induction of platelet aggregation was made by activation of circulating sodium fluorescein (0.1 ml of 5% solution/25 g, i.v.) with an intense mercury light. Garlic, ASA and vehicle solutions were injected, i.p., 60 min prior to the photochemical insult. The time for the first platelet aggregate to appear in pial arterioles was significantly delayed (P < 0.001) only by the 100 mg/kg garlic dose and by all ASA doses. The effect of this garlic dose on first aggregate was comparable to that of the 25 and 50 mg/kg ASA doses. Only the ASA doses delayed (P < 0.05) the appearance of first aggregate in venules. Arteriolar and venular diameter changes were not different among groups of all trials. Data of this study documented that garlic was capable of delaying platelet aggregation in mouse pial arterioles, in vivo.

Neuromuscular and microvascular changes associated with chronic administration of an extract of Teucrium stocksianum in mice.

This work examines the effect on the weights of vital body organs, on blood biochemical variables, on neuromuscular coordination and on cerebral microcirculation of aqueous extracts of Teucrium stocksianum, given to mice in drinking water at concentrations of 2 and 4% for 56 days. The treatment caused progressive impairment of neuromuscular coordination, as evidenced by the time spent on the rota-rod. After photochemical challenge, the time for first observable platelet aggregation in arterioles was shorter than for the control group by 22 and 45% in the 2 and 4% T. stocksianum-treated groups, respectively. Platelet aggregation on the venular side was not affected by the treatment nor were microvascular diameters. Treatment with the plant extract produced no statistically significant effect on the plasma biochemical variables that are considered indices of liver and kidney function. Histologically, brains obtained from mice treated with T. stocksianum showed loss of cerebellar Purkinje cells. Although it is likely that the accelerated platelet aggregation might have contributed to an ischaemic effect which could, at least in part, have caused the cytotoxicological changes, this does not exclude the possibility of a direct cytotoxicological effect of the plant extract. Further pharmacological and toxicological investigations on Teucrium species seem warranted.

Effect of psoralen and ultraviolet A on platelet functioning: an in vitro and in vivo study.

We investigated possible alterations induced by psoralen and ultraviolet A radiation (PUVA) on platelet function both in vitro and in vivo. In vitro, using conventional aggregometry and adenosine diphosphate (ADP), collagen, ristocetin and arachidonic acid as aggregating agents, platelet aggregation was determined on platelet-rich plasma (PRP) from normal subjects at basal conditions and following the addition of increasing concentrations of 8-methoxypsoralen (8-MOP) with and without exposure to ultraviolet A (UVA) light (5 J/cm2) and compared with UVA light exposure alone. At basal conditions and following exposure to UVA light alone, no changes in the normal platelet aggregation patterns were observed. Exposure to UVA light of PRP containing 8-MOP also demonstrated no abnormality in the platelet aggregation patterns at 8-MOP concentrations of 200 ng/ml. However, abnormal platelet aggregation as a response to ADP and collagen was observed at higher concentrations of 8-MOP, which was augmented upon exposure to UVA light. In vivo, platelet aggregometry was performed on PRP from 4 patients submitted to PUVA treatment at basal conditions, 2.5 h after oral ingestion of 8-MOP (0.6-0.8 mg/kg) and after 4 PUVA sessions. No patient showed modification of the platelet aggregation profile after either 8-MOP ingestion or PUVA treatment. Our study shows that 8-MOP at high concentrations in vitro impairs platelet aggregation by ADP and collagen augmented by UVA light exposure, but PUVA therapy causes no detectable abnormality in platelet function in vivo.

Radiation-protective and platelet aggregation inhibitory effects of five traditional Chinese drugs and acetylsalicylic acid following high-dose gamma-irradiation.

High doses of 60Co radiation (4.0-8.0 Gy) in mice, rats and rabbits caused increases in rate of platelet aggregation during the first 5 days after irradiation. The inhibitory effects of the extracts of five Chinese drug plants and acetylsalicylic acid on rate of platelet aggregation were observed in both in vitro and in vivo tests, averaging 23-53% in vitro and 46-69% in vivo. Antiradiation tests on mice vs. 7.5-8.0 Gy of gamma-radiation, using the plant extracts and acetylsalicylic acid as protective agents, increased survival rates by 8-50% for the plant extracts and 35% for acetylsalicylic acid.

Irradiation of platelets with UV-B light exposes fibrinogen binding sites via an intracellular mechanism.

Previous studies have shown that ultraviolet irradiation (UVI) causes platelet aggregation. In the present study we exposed platelet suspensions to a relatively high dose of UV-B (8 J/cm2) under conditions comparable to those of UVI of platelet concentrates in order to obtain more insight into the UV-induced aggregation response and to evaluate the significance of this phenomenon for the clinical use of UV-irradiated platelet concentrates. This study provides evidence that UV-B induced aggregation is mediated by a Ca2(+)-dependent process of fibrinogen binding to an intact glycoprotein IIb-IIIa complex on platelet membranes. Although UV-induced platelet aggregation is independent of thromboxane A2 formation and ADP secretion, it requires metabolic energy, cytosolic Ca2+ and a low cyclic-AMP level. Thus, UV-B irradiation causes platelet aggregation by exposing fibrinogen binding sites via an intracellular mechanism. Since the amount of bound fibrinogen following UVI is relatively low (about 2,300 molecules platelet) and the binding remains reversible, its effect on platelet behaviour after transfusion may be minor.

UV light-induced changes in washed pig platelets.

The effect of ultraviolet radiation (UV-A, 360 nm) on the thrombin-induced aggregation of washed pig platelets as well as on the release of adenine nucleotides and proteins was studied. The level in platelets of adenine nucleotides, mainly ADP and ATP, decreased rapidly following the exposure of platelets to a high dose of UV-A (0.5 W/cm2, 30 min). Through thrombin-induced aggregation of irradiated platelets was inhibited, the release reaction occurred. The amount of the released adenine nucleotides and proteins was, however, dependent on the dose of UV light. These findings suggest that UV-A light can stimulate the platelet release reaction.

Platelet aggregation induced in mice by whole-body hyperthermia.

Whole-body hyperthermia ( WBH ) induced by 2450-MHz irradiation resulted in a decrease in platelet number in the circulating blood 3.5 hr after irradiation. Afterward, the treated mice developed thrombocytosis which peaked 3 days after WBH . This phenomenon was suppressed by administration of antiinflammatory drugs (methylprednisolone acetate and indomethacin) or aggregating inhibitors (heparin, pentoxifylline and dibutyryl cyclic AMP). These facts suggest that thrombocytosis occurring in treated mice arises to offset a deficiency of platelets induced by aggregations and adhesions. Further investigation of platelets in vitro indicated that the addition of plasma extract from mice treated with WBH to heated platelets induced a significant aggregation of platelets.

Platelet injury during phototherapy.

Phototherapy with blue fluorescent light is widely employed for treatment of neonatal hyperbilirubinemia. Functional, biochemical, and morphologic changes produced by blue fluorescent light in human platelets were identified and characterized. Platelet-rich plasma was exposed for up to 170 min to amounts of light equivalent to that used in phototherapy of neonatal hyperbilirubinemia. Within 110 min of light exposure, platelets were essentially no longer aggregable by ADP and connective tissue suspension and were depleted of ADP, ATP, and glycogen. Electron photomicrographs revealed these platelets to be swollen, depleted of glycogen granules and organelles, and to have ill-defined membranes. Platelet injury could be accelerated by adding a photosensitizing agent, hematoporphyrin, to platelet samples before exposure. In contrast, control platelets kept in the dark for 170 min or nonirradiated platelets resuspended in irradiated plasma maintained their integrity. The results indicate that platelets are damaged in vitro when exposed to amounts of blue light used in phototherapy.