Artificial cerebrospinal fluid restores aspirin-inhibited physiological hemostasis through recovery of platelet aggregation function
Artificial cerebrospinal fluid restores aspirin-inhibited physiological hemostasis through recovery of platelet aggregation function
复制标题
人工脑脊液通过恢复血小板聚集功能恢复阿司匹林抑制的生理止血
DOI：
10.1007/s00701-022-05471-9
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
T Yamamoto
中科院分区：
文献类型：
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作者：
R Suzuki;Y Kozuma;C Inoue;K Tanabe;I Noboruo;H Arao;T Kawaguchi;N Shimizu;T Yamamoto
背景最佳止血提供了神经外科手术中的安全性和可靠性，从而改善了手术结果。以前，人工脑脊液（aCSF）及其组分碳酸氢钠被发现通过放大血小板聚集促进生理性止血。本研究旨在验证是否aCSF放大血小板依赖性止血的存在下，antiplatelet agents.MethodsWe制备富血小板血浆（PRP）或洗涤血小板使用阿司匹林（乙酰水杨酸，（阿萨））或生理盐水（NS）。我们评价了用市售aCSF溶液或NS处理的样本的聚集扩增、整合素αIIbβ3活化、磷脂酰丝氨酸（PS）暴露、P-选择素（CD 62 P）表达和微粒（MP）形成。我们通过测量ASA或NS注射的C57 BL/6 N小鼠的尾部出血时间来评估aCSF对阿萨存在下体内止血的影响。结果与NS相比，aCSF通过恢复血小板活化（包括PS暴露、MP释放、CD 62 P表达和整合素αIIbβ3活化）来增强ASA抑制的血小板聚集。当使用洗涤的血小板时，aCSF几乎完全抵消阿萨对血小板聚集的抑制。与NS相比，用aCSF处理显著缩短了ASA注射小鼠的截肢尾部的延长出血时间。碳酸氢钠也直接放大ASA抑制的血小板aggregation.ConclusionsaCSF和碳酸氢钠促进生理止血通过恢复抑制血小板聚集，即使在阿萨的存在。在术野中使用aCSF可能有利于促进血小板功能受损患者的止血，并有助于改善神经外科手术的结局。
BackgroundOptimal hemostasis provides safety and reliability during neurosurgery which improves surgical outcomes. Previously, artificial cerebrospinal fluid (aCSF) and its component sodium bicarbonate were found to facilitate physiological hemostasis by amplifying platelet aggregation. This study aimed to verify whether aCSF amplifies platelet-dependent hemostasis in the presence of antiplatelet agents.MethodsWe prepared platelet-rich plasma (PRP) or washed platelets using aspirin (acetylsalicylic acid, (ASA)) or normal saline (NS). We evaluated samples treated with a commercially available aCSF solution or NS for amplification of aggregation, activation of integrin αIIbβ3, phosphatidylserine (PS) exposure, P-selectin (CD62P) expression, and formation of microparticles (MPs). We assessed the effect of aCSF on in vivo hemostasis in the presence of ASA by measuring the tail bleeding time in ASA-or NS-injected C57BL/6 N mice.ResultsCompared with NS, aCSF amplified ASA-inhibited platelet aggregation by recovering platelet activation including PS exposure, MP release, CD62P expression, and integrin αIIbβ3 activation. When using washed platelets, aCSF almost completely counteracted the inhibition of platelet aggregation by ASA. Prolonged bleeding time from the amputated tail of ASA-injected mice was significantly shortened by the treatment with aCSF compared to NS. Sodium bicarbonate also directly amplified ASA-inhibited platelet aggregation.ConclusionsaCSF and sodium bicarbonate facilitate physiological hemostasis through the recovery of inhibited platelet aggregation even in the presence of ASA. The utilization of aCSF in the operative field may be advantageous for facilitating hemostasis in patients with impaired platelet function and contribute to improving outcomes of neurosurgery.