[Interaction of epinephrine and ADP in regulation of platelet function in chronic cerebral ischemia ].

The purpose is devoted to test of hypothesis that patients with chronic cerebral ischemia (CCI) have decreased secretion of platelet ADP as the reason of platelet aggregation restriction in response to stimulation of adrenaline. Methods. We used platelet-rich plasma which was separated by centrifugation from peripheral blood of 55 patients with a diagnosis of CCI of stage 1-2. Platelets aggregation was studied on aggregometer Chrono - Log (USA). ADP and Epinephrine were used for platelet stimulation at effective concentration (EC50). Modulatory role of ADP subthreshold doses (0.5 mM) in platelet activation was analyzed with its addition to a suspension of platelets stimulated by agonists (EC50). Results. In 35 patients (group 1) with platelet hyperreactivity to ADP (EC50) response of platelets to Epinephrine was heterogeneous: in 17 cases (48.6%) there was high response (50%) and in 18 cases (51.4%) there was low platelet response to Epinephrine. 20 patients (group 2) had hyporesponsiveness of platelets upon stimulation by both agonists. It was established that the low initial response of platelets to Epinephrinе in vitro might be due to reduced secretion of ADP, i.e. limited adaptive response since administration of ADP subthreshold doses enhances adrenoreactivity of platelets. If pathochemical violations underlying the formation of platelet disadaptation are reversible, it is possible to recover the reaction of platelets to Epinephrine. Conclusion. In reducing the functional response of platelets to Epinephrinе key issue is establishing the reversibility of violations of platelets adaptive response of platelets.

[Molecular mechanisms of individual platelet reactivity in hematuria secondary to lithotripsy].

AIM: To investigate the mechanisms of individual platelet reactivity to ADP and adrenaline associated with the variability of hematuria after lithotripsy in patients with chronic obstructive pyelonephritis (COPN). MATERIALS AND METHODS: The study included 41 COPN patients admitted to the Department of Urology for lithotripsy (LT). The contact ultrasonic LT was performed using the Karl Storz Calcuson Ultrasonic Lithotripsy System. Postoperative hematuria was assessed by microscopic red blood cell count. Platelets were separated from the citrated peripheral blood by centrifugation. Platelet aggregation was measured by Chrono-log aggregometer using agonists (ADP, adrenaline) at a concentration of EC50 and EU10. RESULTS: There were three types of platelet functional response to ADP and adrenaline after LT (increased, unchanged and decreased aggregation), but the predominant type of individual response was increased platelet aggregation. Testing 24 hours after LT revealed 7 platelet phenotypes differing in functional activity of 2-adrenoceptor agonist and purine receptors (R2Y1 and R2Y12). Normal purine receptor activity was associated with the ability of platelets to respond to adrenaline by increasing the functional activity aimed at limiting hematuria. Reduced platelet response to ADP after LT reaching the level of hyporesponsiveness may be viewed as a predictor of severe hematuria after surgery. CONCLUSION: Individual platelet reactivity, manifested by the interaction of ADP and adrenaline agonist, determines the effectiveness of the increase in pro-aggregation capacity of platelets in developing postoperative hematuria.

[Age-related features of peripheral blood cell adaptive reaction in women with chronic obstructive pyelonephritis].

The aim of the study was to evaluate the adaptive changes of peripheral blood cells of recurrence inflammation in aged women with chronic obstructive pyelonephritis (COPN). An analysis of clinical and laboratory data was carried out on 50 women who were distributed into two age periods: under 55 years (the comparison group) and over 65 years. In women of 65+, during recurrence of COPN, the degree of leukocyte increase, neutrophils, monocytes and erythrocyte sedimentation rate (ESR) reached 90,1, 20,8, 71,4 and 31,6%, whereas lymphocyte count was less by 2,8 times in comparison with remission. In women under 55 years (in recurrence of COPN), degree of leukocyte increase was 87% (p<0,001), neutrophils--4, 8% (p<0,05), monocytes--in 2,04 times (p<0,001), ESR was less in 3,1 times (p<0,001) and lymphocyte count was less than 19,5% (p>0,05). The manifestation of neutrophilocytosis and lymphocytopenia might be due to age-related features of adaptive reaction in peripheral blood cells during the COPN recurrence.