Résumé
Abstract Purpose: To investigate the correlation of inhaled nitric oxide (NO) on plasma levels of cardiac troponin I (cTnI) and von Willebrand factor (vWF), glycoprotein (GP) IIb/IIIa, granule membrane protein 140 (GMP-140) in rabbits with acute massive pulmonary embolism (PE). Methods: Thirty apanese white rabbits were divided into 3 groups, thrombus were injected in model group (n = 10), NO were inhalated for 24 h after massive PE in NO group (n = 10), saline were injected in control group (n = 10). The concentrations of vWF, GP IIb/IIIa, GMP-140 and cTnI were tested at 4, 8, 12, 16, 20, and 24 h, Correlation analyses were conducted between cTnI and vWF, GP IIb/IIIa, and GMP-140 by Pearson's correlation. Results: The concentration of cTnI and vWF, GP IIb/IIIa, and GMP-140 was increased in the model group, compared to control group. In the inhaled group, the concentrations of cTnI, vWF, GP IIb/IIIa, and GMP-140 were reduced compared to model group. There was a positive correlation between cTnI and vWF, GP IIb/IIIa, and GMP-140. Conclusion: Inhaled nitric oxide can lead to a decrease in levels of cardiac troponin I, von Willebrand factor, glycoprotein, and granule membrane protein 140, after an established myocardial damage, provoked by acute massive pulmonary embolism.
Sujets)
Animaux , Lapins , Embolie pulmonaire/sang , Facteur de von Willebrand/analyse , Complexe glycoprotéique IIb-IIIa de la membrane plaquettaire/analyse , Complexe glycoprotéique IIb-IIIa de la membrane plaquettaire/effets des médicaments et des substances chimiques , Sélectine P/sang , Troponine I/sang , Monoxyde d'azote/administration et posologie , Embolie pulmonaire/anatomopathologie , Embolie pulmonaire/traitement médicamenteux , Valeurs de référence , Facteurs temps , Administration par inhalation , Facteur de von Willebrand/effets des médicaments et des substances chimiques , Reproductibilité des résultats , Résultat thérapeutique , Sélectine P/effets des médicaments et des substances chimiques , Troponine I/effets des médicaments et des substances chimiques , Modèles animaux de maladie humaine , Microtomographie aux rayons X , Ventricules cardiaques/anatomopathologie , Myocarde/anatomopathologieRésumé
BACKGROUND: A recent study has shown that triple anti-platelet therapy (cilostazol+clopidogrel+aspirin) resulted in a significantly lower restenosis rate after coronary stenting than did conventional therapy (clopidogrel+aspirin). However, the anti-platelet effects of cilostazol, when combined with clopidogrel and aspirin, have not been evaluated. METHODS: Low dose cilostazol (50 mg/BID) was given to 47 patients who had already been taking clopidogrel (75 mg/day) and aspirin (100 mg/day) for more than 1 month subsequent to coronary stenting due to AMI and unstable angina. Markers of platelet activation, P-selectin and activated GPIIb/IIIa on platelets, were measured at baseline and 2 weeks after cilostazol treatment. We empirically divided patients into tertiles (low, n=16; moderate, n=14; high group, n=17), according to the baseline P-selectin expression. We then performed a comparative assessment of the anti-platelet effects of cilostazol at baseline and after 2 weeks of cilosatzol administration. RESULTS: P-selectin was significantly decreased after 2 weeks of cilostazol treatment in total patients (n=47, 3.2 +/- 2.4% to 2.0 +/- 1.9%, p=0.03). This inhibition of P-selectin expression was mainly achieved in the moderate and high P-selectin groups (low group; 1.4 +/- 0.5 to 1.9 +/- 1.3%, p> 0.05, moderate group; 2.5 +/- 0.3 to 1.3 +/- 0.3%, p 0.05). Underlying disease, cardiovascular risk factors, concomitant medication including statin, and hsCRP were not related to the degree of P-selectin expression. CONCLUSION: Our data demonstrated that cilostazol treatment in addition to conventional anti-platelet therapy provides more effective suppression of platelet P-selectin expression in patients with relatively high platelet activity.
Sujets)
Femelle , Humains , Mâle , Adulte d'âge moyen , Acide acétylsalicylique/usage thérapeutique , Relation dose-effet des médicaments , Association de médicaments , Ischémie myocardique/chirurgie , Sélectine P/sang , Antiagrégants plaquettaires/usage thérapeutique , Complexe glycoprotéique IIb-IIIa de la membrane plaquettaire/analyse , Endoprothèses , Tétrazoles/usage thérapeutique , Thrombose/sang , Ticlopidine/analogues et dérivésRésumé
El objetivo de este trabajo fue el estudio de receptores de membrana plaquetaria en el Síndrome Urémico Hemolítico. Se estudiaron 20 niños de 17,3 ñ 5,2 meses de edad con diagnóstico clínico y de laboratorio de dicha enfermedad. En muestras obtenidas a los 15 días, al mes y a los dos meses del comienzo de la enfermedad se aislaron las plaquetas de los pacientes y también de controles normales de una población etaria comparable. Se solubilizaron las glicoproteínas (GP) de membranas y se procedió al análisis de las mismas por Western-blot. Se utilizaron anticuerpos monoclonales específicos. Se observaron niveles bajos de GPIb y GPlIbIIIa en la primera muestra. La GPIb, luego, aumentó rápidamente normalizándose al mes de evolución. En cambio, el complejo GPlIbIIIa, si bien aumentó ligeramente en la tercera muestra, se mantuvo francamente disminuido (5-25 por ciento). La GPlIb presentó niveles bajos no alcanzando la normalidad dentro del período estudiado, mientras que la GPIIIa mantuvo un nivel estable cercano al límite inferior normal (25-50 por ciento). De los resultados obtenidos se puede concluir que la síntesis de GP no estaría alterada ya que la GPIb se normaliza rápidamente; la integrina GPlIbIIIa es el principal receptor afectado. Esta alteración puede deberse a algún bloqueo por anticuerpos inespecíficos o por péptidos de secuencia RGD o bien a una alteración estructural de la GPlIb por proteólisis inespecífica