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1.
Medicine (Baltimore) ; 99(27): e20888, 2020 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-32629679

RESUMEN

This study aims to identify prognostic value of neutrophil-to-lymphocyte ratio (NLR) in early miscarriages. A total of 260 pregnant women with vaginal spotting were recruited from the Department of Obstetrics and Gynecology of the Kyung Hee Medical Center from January 1, 2011, and December 31, 2018. Venous samples were obtained from the women for measurements of platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and NLR. All the patients were in < 14 gestational weeks of their pregnancy. Eighty-four patients were excluded because of incomplete data, loss of follow-up, and serious medical diseases. We enrolled 176 women for analysis and divided them into two groups. Group 1 included 104 women with threatened abortion; and group 2, 72 women with missed abortion. A significant difference in NLR was found between the groups (p = 0.001; P < .01). The multivariate analysis also revealed that NLR was the only prognostic factor of early miscarriage (odd ratio [OR], 0.732; 95% confidence interval [CI], 0.612-0.881, P = .001). The area under the Receiver-operating characteristic of NLR for distinguishing between the missed and threatened abortion groups was 0.792, and the best cutoff value was 5.72 (P < .05).


Asunto(s)
Aborto Espontáneo/sangre , Linfocitos/metabolismo , Neutrófilos/metabolismo , Adulto , Plaquetas/metabolismo , Femenino , Humanos , Monocitos/metabolismo , Embarazo , Pronóstico , Estudios Retrospectivos
2.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(7): 696-700, 2020 Jul.
Artículo en Chino | MEDLINE | ID: mdl-32669163

RESUMEN

OBJECTIVE: To study the reference ranges of platelet and related parameters within 24 hours after birth in preterm infants with different gestational ages. METHODS: According to the inclusion and exclusion criteria, a retrospective analysis was performed for the chart review data of 1 070 preterm infants with a gestational age of 23-36+6 weeks who were admitted to the neonatal intensive care unit from January to December in 2018. The reference ranges of platelet parameters were calculated for the preterm infants within 24 hours after birth. RESULTS: There were no significant differences in platelet count (PLT) and plateletcrit (PCT) among the preterm infants with different gestational ages (P>0.05). The late preterm infants (34-36+6 weeks; n=667) had significantly lower mean platelet volume (MPV) and platelet distribution width (PDW) than the extremely preterm infants (23-27+6 weeks; n=36) and the early preterm infants (28-33+6 weeks; n=367) (P<0.05). There were no significant differences in these platelet parameters between the preterm infants with different sexes (P>0.05). The reference ranges of platelet parameters in preterm infants were calculated based on gestational age. The reference ranges of PLT and PCT were (92-376)×109/L and 0.1%-0.394% respectively, for the preterm infants with a gestational age of 23-36+6 weeks. The reference ranges of MPV and PDW were 9.208-12.172 fl and 8.390%-16.407% respectively, for the preterm infants with a gestational age of 23-36+6 weeks; the reference ranges of MPV and PDW were 9.19-11.95 fl and 9.046%-15.116% respectively, for the preterm infants with a gestational age of 34-36+6 weeks. CONCLUSIONS: The MPV and PDW of preterm infants with different gestational age are different within 24 hours after birth, and it is more helpful for clinical practice to formulate the reference range of MPV and PDW according to gestational age.


Asunto(s)
Edad Gestacional , Volúmen Plaquetario Medio , Plaquetas , Humanos , Recién Nacido , Valores de Referencia , Estudios Retrospectivos
4.
Blood Adv ; 4(13): 2967-2978, 2020 07 14.
Artículo en Inglés | MEDLINE | ID: mdl-32609845

RESUMEN

Thrombocytopenia is a common complication of influenza virus infection, and its severity predicts the clinical outcome of critically ill patients. The underlying cause(s) remain incompletely understood. In this study, in patients with an influenza A/H1N1 virus infection, viral load and platelet count correlated inversely during the acute infection phase. We confirmed this finding in a ferret model of influenza virus infection. In these animals, platelet count decreased with the degree of virus pathogenicity varying from 0% in animals infected with the influenza A/H3N2 virus, to 22% in those with the pandemic influenza A/H1N1 virus, up to 62% in animals with a highly pathogenic A/H5N1 virus infection. This thrombocytopenia is associated with virus-containing platelets that circulate in the blood. Uptake of influenza virus particles by platelets requires binding to sialoglycans and results in the removal of sialic acids by the virus neuraminidase, a trigger for hepatic clearance of platelets. We propose the clearance of influenza virus by platelets as a paradigm. These insights clarify the pathophysiology of influenza virus infection and show how severe respiratory infections, including COVID-19, may propagate thrombocytopenia and/or thromboembolic complications.


Asunto(s)
Plaquetas/virología , Virus de la Influenza A/patogenicidad , Gripe Humana/complicaciones , Ácido N-Acetilneuramínico/metabolismo , Polisacáridos/metabolismo , Trombocitopenia/etiología , Animales , Plaquetas/metabolismo , Plaquetas/patología , Modelos Animales de Enfermedad , Hurones , Interacciones Huésped-Patógeno , Humanos , Subtipo H1N1 del Virus de la Influenza A/patogenicidad , Subtipo H1N1 del Virus de la Influenza A/fisiología , Subtipo H3N2 del Virus de la Influenza A/patogenicidad , Subtipo H3N2 del Virus de la Influenza A/fisiología , Subtipo H5N1 del Virus de la Influenza A/patogenicidad , Subtipo H5N1 del Virus de la Influenza A/fisiología , Virus de la Influenza A/fisiología , Gripe Humana/metabolismo , Gripe Humana/patología , Gripe Humana/virología , Infecciones por Orthomyxoviridae/complicaciones , Infecciones por Orthomyxoviridae/metabolismo , Infecciones por Orthomyxoviridae/patología , Infecciones por Orthomyxoviridae/virología , Trombocitopenia/metabolismo , Trombocitopenia/patología , Trombocitopenia/virología , Internalización del Virus
5.
Rinsho Ketsueki ; 61(6): 628-633, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-32624536

RESUMEN

Since induced pluripotent stem (iPS) cell-derived blood products can be produced from any individual, they are expected to complement current transfusion products. However, a main problem is how to produce 10 U platelet preparations. Therefore, we established an immortalized megakaryocyte cell line (imMKCL) from iPS cells. We also found that turbulent flow was an essential physical factor for platelet generation in vivo. This knowledge enabled us to obtain 100 billion functional platelets from imMKCL using an 8 L bioreactor. We propose that the enhanced platelet production in the bioreactor occurs due to the turbulent flow that promoted the release of stress-induced cytokines.


Asunto(s)
Plaquetas , Reactores Biológicos , Células Madre Pluripotentes Inducidas , Megacariocitos , Trombopoyesis
6.
Rev Esp Patol ; 53(3): 182-187, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32650969
7.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(3): 388-392, 2020 Jun 30.
Artículo en Chino | MEDLINE | ID: mdl-32616137

RESUMEN

Platelets are non-nuclear blood cells that are widely involved in physiological and pathological processes.Their main role is to participate in hemostasis and thrombosis.Toll-like receptors(TLRs)are innate immune receptors.Platelets express multiple TLRs and can promote thrombosis by recognizing ligand-induced platelet activation and aggregation.This article reviews the relationship between platelets/TLR and thrombosis and the roles of TLRs in the development of thrombotic diseases.


Asunto(s)
Plaquetas , Trombosis , Hemostasis , Humanos , Activación Plaquetaria , Receptores Toll-Like
9.
Cardiovasc Ther ; 2020: 2342837, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32547635

RESUMEN

Cardiovascular diseases (CVD) represent one of the biggest causes of death globally, and their prevalence, aetiology, and outcome are related to genetic, metabolic, and environmental factors, among which sex- and age-dependent differences may play a key role. Among CVD risk factors, platelet hyperactivity deserves particular mention, as it is involved in the pathophysiology of main cardiovascular events (including stroke, myocardial infarction, and peripheral vascular injury) and is closely related to sex/age differences. Several determinants (e.g., hormonal status and traditional cardiovascular risk factors), together with platelet-related factors (e.g., plasma membrane composition, receptor signaling, and platelet-derived microparticles) can elucidate sex-related disparity in platelet functionality and CVD onset and outcome, especially in relation to efficacy of current primary and secondary interventional strategies. Here, we examined the state of the art concerning sex differences in platelet biology and their relationship with specific cardiovascular events and responses to common antiplatelet therapies. Moreover, as healthy nutrition is widely recognized to play a key role in CVD, we also focused our attention on specific dietary components (especially polyunsaturated fatty acids and flavonoids) and patterns (such as Mediterranean diet), which also emerged to impact platelet functions in a sex-dependent manner. These results highlight that full understanding of gender-related differences will be useful for designing personalized strategies, in order to prevent and/or treat platelet-mediated vascular damage.


Asunto(s)
Plaquetas/efectos de los fármacos , Enfermedades Cardiovasculares/dietoterapia , Enfermedades Cardiovasculares/tratamiento farmacológico , Dieta Saludable , Dieta Mediterránea , Disparidades en el Estado de Salud , Inhibidores de Agregación Plaquetaria/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Plaquetas/metabolismo , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Valor Nutritivo , Prevención Primaria , Factores de Riesgo , Conducta de Reducción del Riesgo , Prevención Secundaria , Factores Sexuales , Resultado del Tratamiento , Adulto Joven
10.
Medicine (Baltimore) ; 99(22): e20346, 2020 May 29.
Artículo en Inglés | MEDLINE | ID: mdl-32481414

RESUMEN

The immune system plays a fundamental role in the response to neoadjuvant chemotherapy (NAC) of locally advanced breast cancer (LABC) patients. Patients with pathological complete response (pCR) after NAC have a higher survival rate. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are peripheral blood indicators of inflammatory response. This investigates the correlation between NLR, PLR, LMR, and other clinicopathological features of breast cancer patients before receiving NAC and pCR.Data of LABC patients who underwent NAC between 2009 and 2018 were retrospectively reviewed. Each patient's peripheral complete blood count was recorded before starting NAC. The cut-off values for neutrophils, lymphocytes, monocytes, and platelets in the peripheral blood and NLR, PLR, and LMR were determined by receiver operating characteristic curve analyses.The records of 131 patients were analyzed and divided into two groups, pCR (+ve) and pCR (-ve), and their clinicopathological features and laboratory findings were compared. pCR was achieved in 23.6% of patients. The cut-off values of neutrophils, lymphocytes, monocytes, and platelets at the time of diagnosis and NLR, PLR, and LMR were, respectively, 4150 µL, 2000 µL, 635 µL, 271 × 10 µL, 1.95, 119, and 3.35. The pCR rate was higher in patients with low neutrophil count, low NLR, and high lymphocyte count (P = .002, <.001, and .040, respectively).As per the findings of multivariate logistic regression analysis, the independent predictive factors of pCR were clinical tumor size T1 and T2, grade 3, ER negativity, and low NLR (P = .015, .001, .020, .022, and .001, respectively).While NLR was found to be an independent predictive factor of pCR in LABC patients receiving NAC, a similar result was not observed for PLR and LMR. NLR can be a useful biomarker for predicting the response of patients receiving NAC.


Asunto(s)
Neoplasias de la Mama/sangre , Neoplasias de la Mama/patología , Mediadores de Inflamación/sangre , Adulto , Anciano , Biomarcadores de Tumor , Plaquetas/metabolismo , Quimioterapia Adyuvante , Femenino , Humanos , Mediadores de Inflamación/metabolismo , Linfocitos/metabolismo , Persona de Mediana Edad , Monocitos/metabolismo , Neutrófilos/metabolismo , Estudios Retrospectivos , Análisis de Supervivencia
12.
PLoS One ; 15(4): e0232018, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32352972

RESUMEN

INTRODUCTION: In many African countries, laboratory reference values are not established for the local healthy adult population. In Mozambique, reference values are known for young adults (18-24yo) but not yet established for a wider age range. Our study aimed to establish hematological, biochemical and immunological reference values for vaccine trials in Mozambican healthy adults with high-risk for HIV acquisition. METHODS: A longitudinal cohort and site development study in Mozambique between November 2013 and 2014 enrolled 505 participants between 18 to 35 years old. Samples from these healthy participants, were analyzed to determine reference values. All volunteers included in the analysis were clinically healthy and human immunodeficiency virus (HIV), hepatitis B and C virus, and syphilis negative. Median and reference ranges were calculated for the hematological, biochemical and immunological parameters. Ranges were compared with other African countries, the USA and the US National Institute of Health (NIH) Division of AIDS (DAIDS) toxicity tables. RESULTS: A total of 505 participant samples were analyzed. Of these, 419 participants were HIV, hepatitis B and C virus and syphilis negative including 203 (48.5%) females and 216 (51.5%) males, with a mean age of 21 years. In the hematological parameters, we found significant differences between sex for erythrocytes, hemoglobin, hematocrit, MCV, MCH and MCHC as well as white blood cells, neutrophils and platelets: males had higher values than females. There were also significant differences in CD4+T cell values, 803 cells/µL in men versus 926 cells/µL in women. In biochemical parameters, men presented higher values than women for the metabolic, enzymatic and renal parameters: total and direct bilirubin, ALT and creatinine. CONCLUSION: This study has established reference values for healthy adults with high-risk for HIV acquisition in Mozambique. These data are helpful in the context of future clinical research and patient care and treatment for the general adult population in the Mozambique and underline the importance of region-specific clinical reference ranges.


Asunto(s)
Células Sanguíneas/química , Infecciones por VIH/prevención & control , Pruebas Hematológicas/normas , Adulto , Plaquetas/química , Estudios de Cohortes , Femenino , Infecciones por VIH/sangre , Hematócrito/normas , Hemoglobinas/análisis , Humanos , Recuento de Leucocitos/normas , Leucocitos/química , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Mozambique/epidemiología , Valores de Referencia , Factores de Riesgo
13.
Medicine (Baltimore) ; 99(20): e20307, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32443379

RESUMEN

INTRODUCTION: Uncertainty remains regarding the impact of enteric-coated (EC) aspirin as it relates to the reduction of cardiovascular risk. We hypothesize that EC formulation based on a previous report may blunt aspirin response as evidenced by reduced Thromboxane A2 (TXA 2) levels in diabetic patients. Thus, it was imperative to ascertain and validate the effect of the EC formulation of Aspirin on the Thromboxane B2 (TXB2) level. METHODS/DESIGN: An open-label consecutive randomized interventional controlled trial. Patients with newly diagnosed ischemic stroke who are just about to start Aspirin were assessed for eligibility and inclusion in our trial. Consecutive patients (admitted to the stroke unit of Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar) will be randomized to receive either EC aspirin or plain Aspirin. They will be required to continue taking them throughout the study (3 days). Demographics and laboratory records of the study participants will be abstracted from online records. Further study variables will be obtained manually in designated case record forms (CRF). The primary outcomes are the incidence of aspirin non-responders (level of residual serum TXB2 associated with elevated thrombotic risk (<99.0% inhibition or TXB2 >3.1 ng/mL) within 72 h after three daily aspirin doses). Whereas secondary outcomes are the incidence of GIT bleeding of various preparations of Aspirin. The study was approved by MRC and IRB of Hamad Medical Corporation (MRC number: 01-18-156). DISCUSSION: This trial will determine potential differences in the efficacy of EC Aspirin and plain Aspirin on the Thromboxane B2 level. Additionally, it will ascertain the tolerability and safety of both formulations of Aspirin in patients with newly diagnosed ischemic stroke. These results will either support the current notion of no difference between the two formulations. However, if a difference is found, this will invite for future trials exploring clinical outcomes occurrence between various formulations. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov NCT04330872 registered on April 2, 2020.


Asunto(s)
Aspirina/uso terapéutico , Isquemia Encefálica/tratamiento farmacológico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Accidente Cerebrovascular/tratamiento farmacológico , Adolescente , Adulto , Anciano , Aspirina/administración & dosificación , Aspirina/efectos adversos , Plaquetas/efectos de los fármacos , Femenino , Hemorragia Gastrointestinal/inducido químicamente , Humanos , Masculino , Persona de Mediana Edad , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/efectos adversos , Método Simple Ciego , Factores Socioeconómicos , Comprimidos Recubiertos , Tromboxano B2/sangre , Adulto Joven
14.
Rev Assoc Med Bras (1992) ; 66(2): 133-138, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32428146

RESUMEN

OBJECTIVE: Periodontitis may stimulate infectious and immune response and cause the development of atherogenesis, coronary heart disease, and myocardial infarction. The aim of this study was to compare the plateletcrit (PCT) and mean platelet volume (MPV) levels derived from complete blood count (CBC) tests in patients suffering from stage 3 periodontitis with those of healthy individuals without periodontal disease. METHODS: The study included 57 patients (28 females and 29 males) with Stage 3 Periodontitis and 57 volunteering individuals (31 females and 26 males) who were periodontally healthy. The age of study participants ranged from 18 to 50 years. Their periodontal condition was investigated with probing depth (PD), clinical attachment level, bleeding on probing, and plaque index. Leukocyte (WBC) and erythrocyte count (RBC), hemoglobin (Hb) and hematocrit (HCT) levels, mean corpuscular volume (MCV) and red cell distribution width (RDW), thrombocyte count, mean platelet volume (MPV), plateletcrit (PCT ), and neutrophil and lymphocyte counts were evaluated based on the CBC test results of the study participants. RESULTS: PCT, WBC, Neutrophil, and MPV values were found to be significantly higher in the periodontitis group (p<0.05). There were no significant differences in RBC counts, Hb, HCT, MCV, RDW, and platelet and lymphocyte counts between the two study groups (p>0.05). CONCLUSIONS: PCT and MPV levels may be a more useful marker to determine an increased thrombotic state and inflammatory response in periodontal diseases.


Asunto(s)
Plaquetas/citología , Volúmen Plaquetario Medio , Periodontitis/sangre , Adolescente , Adulto , Recuento de Células Sanguíneas , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice Periodontal , Valores de Referencia , Estadísticas no Paramétricas , Adulto Joven
15.
Rev Assoc Med Bras (1992) ; 66(2): 160-165, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32428150

RESUMEN

OBJECTIVE: Coronary collateral development (CCD) predicts the severity of coronary heart disease. Hemogram parameters, such as mean platelet volume (MPV), eosinophil, red cell distribution width, and platelet distribution width (PDW), are supposed novel inflammatory markers. We aimed to compare hemogram parameter values in patients presenting with non-ST-elevation myocardial infarction (NSTEMI) with adequate or inadequate CCD. METHODS: A total of 177 patients with NSTEMI undergoing coronary arteriography were enrolled and divided into two groups based on the development of CCD: one group with adequate CCD (n=88) and the other with impaired CCD (n=89). RESULTS: Baseline demographics and clinical risk factors were similar between the groups. Hemogram parameters were not significantly different between the two groups. However, compared to the inadequate CCD group, the median PDW was significantly higher in the adequate CCD group, 17.6 (1.4) vs. 17.8 (1.6) p=0.004. In a multivariate analysis, PDW (p=0.001, 95% CI for OR: 0.489(0,319-0,750) was found to be significantly different in the adequate CCD group compared to the inadequate CCD group. Pearson's correlation analysis revealed that PDW was significantly correlated with the Rentrop score (r=0.26, p<0.001). CONCLUSIONS: We suggest that since PDW is an index that is inexpensive and easy to assess, it could serve as a marker of CCD in patients with NSTEMI.


Asunto(s)
Circulación Colateral/fisiología , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/fisiopatología , Circulación Coronaria/fisiología , Infarto del Miocardio sin Elevación del ST/sangre , Infarto del Miocardio sin Elevación del ST/fisiopatología , Anciano , Anciano de 80 o más Años , Recuento de Células Sanguíneas , Plaquetas , Angiografía Coronaria , Femenino , Humanos , Modelos Logísticos , Masculino , Volúmen Plaquetario Medio , Persona de Mediana Edad , Análisis Multivariante , Valores de Referencia , Estudios Retrospectivos , Factores de Riesgo , Estadísticas no Paramétricas
16.
Arterioscler Thromb Vasc Biol ; 40(6): 1441-1453, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32375545

RESUMEN

Megakaryocyte-derived platelets and endothelial cells store their hemostatic cargo in α- and δ-granules and Weibel-Palade bodies, respectively. These storage granules belong to the lysosome-related organelles (LROs), a heterogeneous group of organelles that are rapidly released following agonist-induced triggering of intracellular signaling pathways. Following vascular injury, endothelial Weibel-Palade bodies release their content into the vascular lumen and promote the formation of long VWF (von Willebrand factor) strings that form an adhesive platform for platelets. Binding to VWF strings as well as exposed subendothelial collagen activates platelets resulting in the release of α- and δ-granules, which are crucial events in formation of a primary hemostatic plug. Biogenesis and secretion of these LROs are pivotal for the maintenance of proper hemostasis. Several bleeding disorders have been linked to abnormal generation of LROs in megakaryocytes and endothelial cells. Recent reviews have emphasized common pathways in the biogenesis and biological properties of LROs, focusing mainly on melanosomes. Despite many similarities, LROs in platelet and endothelial cells clearly possess distinct properties that allow them to provide a highly coordinated and synergistic contribution to primary hemostasis by sequentially releasing hemostatic cargo. In this brief review, we discuss in depth the known regulators of α- and δ-granules in megakaryocytes/platelets and Weibel-Palade bodies in endothelial cells, starting from transcription factors that have been associated with granule formation to protein complexes that promote granule maturation. In addition, we provide a detailed view on the interplay between platelet and endothelial LROs in controlling hemostasis as well as their dysfunction in LRO related bleeding disorders.


Asunto(s)
Plaquetas/ultraestructura , Gránulos Citoplasmáticos/fisiología , Células Endoteliales/ultraestructura , Hemostasis/fisiología , Lisosomas/fisiología , Trastornos de la Coagulación Sanguínea/genética , Trastornos de la Coagulación Sanguínea/fisiopatología , Colágeno/fisiología , Gránulos Citoplasmáticos/ultraestructura , Humanos , Lisosomas/ultraestructura , Cuerpos de Weibel-Palade/fisiología , Cuerpos de Weibel-Palade/ultraestructura , Factor de von Willebrand/metabolismo
17.
Platelets ; 31(5): 627-632, 2020 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-32397915

RESUMEN

Coronavirus disease 2019 (COVID-19) is a new infectious disease that currently lacks standardized and established laboratory markers to evaluate its severity. In COVID-19 patients, the number of platelets (PLTs) and dynamic changes of PLT-related parameters are currently a concern. The present paper discusses the potential link between PLT parameters and COVID-19. Several studies have identified a link between severe COVID-19 patients and specific coagulation index, in particular, high D-dimer level, prolonged prothrombin time, and low PLT count. These alterations reflect the hypercoagulable state present in severe COVID-19 patients, which could promote microthrombosis in the lungs, as well as in other organs. Further information and more advanced hematological parameters related to PLTs are needed to better estimate this link, also considering COVID-19 patients at different disease stages and stratified in different cohorts based on preexisting co-morbidity, age, and gender. Increasing the understanding of PLT functions in COVID-19 will undoubtedly improve our knowledge on disease pathogenesis, clinical management, and therapeutic options, but could also lead to the development of more precise therapeutic strategies for COVID-19 patients.


Asunto(s)
Betacoronavirus , Plaquetas/fisiología , Infecciones por Coronavirus/sangre , Pandemias , Neumonía Viral/sangre , Trombofilia/etiología , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Biomarcadores/sangre , Plaquetas/ultraestructura , Moléculas de Adhesión Celular/metabolismo , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/patología , Citocinas/metabolismo , Coagulación Intravascular Diseminada/etiología , Interacciones Farmacológicas , Células Endoteliales/patología , Endotelio Vascular/patología , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Humanos , Inflamación , Pulmón/patología , Peptidil-Dipeptidasa A/fisiología , Recuento de Plaquetas , Pruebas de Función Plaquetaria , Neumonía Viral/complicaciones , Neumonía Viral/patología , Tiempo de Protrombina , Receptores Virales/fisiología , Síndrome de Dificultad Respiratoria del Adulto/etiología , Síndrome de Dificultad Respiratoria del Adulto/prevención & control , Síndrome Respiratorio Agudo Grave/sangre , Síndrome Respiratorio Agudo Grave/patología , Trombofilia/sangre , Trombofilia/tratamiento farmacológico , Trombosis de la Vena/epidemiología , Trombosis de la Vena/etiología , Trombosis de la Vena/patología , Trombosis de la Vena/prevención & control
18.
Clin Chim Acta ; 508: 98-102, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32405079

RESUMEN

BACKGROUND: Novel coronavirus infectious disease (COVID-19) has been spreading worldwide, and tracking laboratory indexes during the diagnosis and treatment of patients with severe COVID-19 can provide a reference for patients in other countries and regions. METHODS: We closely tracked the epidemiological history, diagnosis and treatment process, as well as dynamic changes in routine blood indicators, of a severe COVID-19 patient who was hospitalized for 26 days. RESULTS: Our study found that the patient's condition worsened in the first week after admission, white blood cells (WBCs), neutrophils, lymphocytes, monocytes, eosinophils, red blood cells (RBCs), hemoglobin, neutrophil lymphocyte ratio (NLR), platelets (PLT) and platelet lymphocyte ratio (PLR) decreased. On the 7th day of admission, the levels of these cells decreased to their lowest values, though the red blood cell distribution width (RDW) and C-reactive protein (CRP) level remained at high values. From 8 to 14 days of admission, the patient's condition improved, hypoxemia was corrected, and mechanical ventilation was discontinued. The number of WBCs, neutrophils, monocytes, eosinophils and lymphocytes increased gradually, and the erythrocyte parameters stopped declining and stabilized in a certain range; CRP decreased rapidly. On the 20th day of admission, the nucleic acid test was negative, WBC, neutrophil, CRP, NLR and PLR decreased gradually, and monocyte, lymphocyte, and eosinophil counts increased. Although RBCs and hemoglobin (Hb) levels continued to decrease, RDW gradually increased, indicating the recovery of hematopoiesis. In addition, it should be noted that monocytes and eosinophils were at extremely low levels within 10 days after admission; the recovery time of eosinophils was approximately 12 days after admission, which was earlier than other parameters, which might be of great value in judging the progress of the disease. CONCLUSIONS: Dynamic changes in routine blood parameters might be helpful for the prognosis of COVID-19 patients and evaluation of the treatment effect.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/sangre , Neumonía Viral/diagnóstico , Antibacterianos/uso terapéutico , Betacoronavirus/efectos de los fármacos , Biomarcadores/sangre , Plaquetas/efectos de los fármacos , Plaquetas/patología , Plaquetas/virología , Proteína C-Reactiva/metabolismo , Recuento de Células , Convalecencia , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/terapia , Eritrocitos/efectos de los fármacos , Eritrocitos/patología , Eritrocitos/virología , Femenino , Humanos , Persona de Mediana Edad , Monocitos/efectos de los fármacos , Monocitos/patología , Monocitos/virología , Neutrófilos/efectos de los fármacos , Neutrófilos/patología , Neutrófilos/virología , Oseltamivir/uso terapéutico , Pandemias , Neumonía Viral/fisiopatología , Neumonía Viral/terapia , Pronóstico , Respiración Artificial , Índice de Severidad de la Enfermedad
19.
PLoS Pathog ; 16(5): e1008544, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32407390

RESUMEN

Beyond their canonical roles in hemostasis and thrombosis, platelets function in the innate immune response by interacting directly with pathogens and by regulating the recruitment and activation of immune effector cells. Thrombocytopenia often coincides with neutropenia in patients with hematologic malignancies and in allogeneic hematopoietic cell transplant recipients, patient groups at high risk for invasive fungal infections. While neutropenia is well established as a major clinical risk factor for invasive fungal infections, the role of platelets in host defense against human fungal pathogens remains understudied. Here, we examined the role of platelets in murine Aspergillus fumigatus infection using two complementary approaches to induce thrombocytopenia without concurrent neutropenia. Thrombocytopenic mice were highly susceptible to A. fumigatus challenge and rapidly succumbed to infection. Although platelets regulated early conidial phagocytosis by neutrophils in a spleen tyrosine kinase (Syk)-dependent manner, platelet-regulated conidial phagocytosis was dispensable for host survival. Instead, our data indicated that platelets primarily function to maintain hemostasis and lung integrity in response to exposed fungal antigens, since thrombocytopenic mice exhibited severe hemorrhage into the airways in response to fungal challenge in the absence of overt angioinvasion. Challenge with swollen, heat-killed, conidia was lethal in thrombocytopenic hosts and could be reversed by platelet transfusion, consistent with the model that fungus-induced inflammation in platelet-depleted mice was sufficient to induce lethal hemorrhage. These data provide new insights into the role of platelets in the anti-Aspergillus host response and expand their role to host defense against filamentous molds.


Asunto(s)
Aspergillus fumigatus/inmunología , Plaquetas/inmunología , Trasplante de Células Madre Hematopoyéticas , Neutropenia/inmunología , Aspergilosis Pulmonar/inmunología , Quimera por Trasplante/inmunología , Aloinjertos , Animales , Ratones , Neutropenia/microbiología , Neutropenia/patología , Aspergilosis Pulmonar/patología , Quimera por Trasplante/microbiología
20.
PLoS One ; 15(5): e0227932, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32469873

RESUMEN

BACKGROUND AND OBJECTIVE: For many pathological states, microparticles are supposed to be one of the causes of hypercoagulation. Although there are some indirect data about microparticles participation in coagulation activation and propagation, the integral hemostasis test Thrombodynamics allows to measure micropaticles participation in these two coagulation phases directly. Demonstrates microparticles participation in coagulation activation by influence on the appearance of coagulation centres in the plasma volume and the rate of clot growth from the surface with immobilized tissue factor.Methods: Microparticles were obtained from platelets and erythrocytes by stimulation with thrombin receptor-activating peptide (SFLLRN) and calcium ionophore (A23187), respectively, from monocytes, endothelial HUVEC culture and monocytic THP cell culture by stimulation with lipopolysaccharides. Microparticles were counted by flow cytometry and titrated in microparticle-depleted normal plasma in the Thrombodynamics test. RESULTS: Monocyte microparticles induced the appearance of clotting centres through the TF pathway at concentrations approximately 100-fold lower than platelet and erythrocyte microparticles, which activated plasma by the contact pathway. For endothelial microparticles, both activation pathways were essential, and their activity was intermediate. Monocyte microparticles induced plasma clotting by the appearance of hundreds of clots with an extremely slow growth rate, while erythrocyte microparticles induced the appearance of a few clots with a growth rate similar to that from surface covered with high-density tissue factor. Patterns of clotting induced by platelet and endothelial microparticles were intermediate. Platelet, erythrocyte and endothelial microparticles impacts on the rate of clot growth from the surface with tissue factor did not differ significantly within the 0-200·103/ul range of microparticles concentrations. However, at concentrations greater than 500·103/ul, erythrocyte microparticles increased the stationary clot growth rate to significantly higher levels than do platelet microparticles or artificial phospholipid vesicles consisting of phosphatidylcholine and phosphatidylserine. CONCLUSION: Microparticles of different origins demonstrated qualitatively different characteristics related to coagulation activation and propagation.


Asunto(s)
Coagulación Sanguínea/efectos de los fármacos , Micropartículas Derivadas de Células/efectos de los fármacos , Trombina/metabolismo , Trombosis/sangre , Plaquetas/efectos de los fármacos , Calcimicina/farmacología , Calcio/metabolismo , Micropartículas Derivadas de Células/metabolismo , Células Endoteliales/efectos de los fármacos , Eritrocitos/efectos de los fármacos , Citometría de Flujo , Células Endoteliales de la Vena Umbilical Humana , Humanos , Monocitos/efectos de los fármacos , Fragmentos de Péptidos/farmacología , Trombosis/tratamiento farmacológico , Trombosis/patología
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