Cellular origin and procoagulant properties of microparticles in meningococcal sepsis
Cellular origin and procoagulant properties of microparticles in meningococcal sepsis
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DOI：
10.1182/blood.v95.3.930.003k46_930_935
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发表时间：
2000-02-01
期刊：
影响因子：
20.3
通讯作者：
Sturk, A
中科院分区：
文献类型：
--
作者：
Nieuwland, R;Berckmans, RJ;Sturk, A
脑膜炎球菌败血症患者通常患有弥散性血管内凝血（DIC），本研究的目的是解决这些患者是否具有导致DIC发展的循环微粒数量增加。通过流式细胞术分析5名幸存者、2名非幸存者和5名健康志愿者的血浆样品中微粒的存在，通过血浆凝血酶原片段F1+2的酶联免疫吸附试验定量体内持续凝血激活，并通过凝血酶生成试验估计微粒在体外的促凝血特性。入院时，与对照组相比，所有患者的血小板或粒细胞微粒数量均增加（分别为P = 0.004和P = 0.008）。患者的F1+2水平升高（P = .004），并且他们的微粒比对照组在体外更强烈地支持凝血酶生成（P = .003）。来自具有最暴发性疾病过程和严重DIC的患者的血浆含有表达CD 14和组织因子的微粒，并且这些微粒在体外表现出极端的凝血酶生成。我们得出结论，脑膜炎球菌败血症患者具有促凝血的循环微粒的数量升高。这些研究结果可能表明一种新的治疗方法，以打击过度凝血激活的临床条件。(C)2000年，美国血液学会。
Patients with meningococcal sepsis generally suffer from disseminated intravascular coagulation (DIC), The aim of this study was to address whether these patients have elevated numbers of circulating microparticles that contribute to the development of DIC. Plasma samples from 5 survivors, 2 nonsurvivors, and 5 healthy volunteers were analyzed for the presence of microparticles by flow cytometry, Ongoing coagulation activation in vivo was quantified by enzyme-linked immunosorbent assay of plasma prothrombin fragment F1+2, and procoagulant properties of microparticles in vitro were estimated by thrombin-generation assay. On admission, ail patients had increased numbers of micro particles originating from platelets or granulocytes when compared with controls (P = .004 and P = .008, respectively). Patients had elevated levels of F1+2 (P = .004), and their microparticles supported thrombin generation more strongly in vitro (P = .003) than those of controls. Plasma from the patient with the most fulminant disease course and severe DIC contained microparticles that expressed both CD14 and tissue factor, and these microparticles demonstrated extreme thrombin generation in vitro, We conclude that patients with meningococcal sepsis have elevated numbers of circulating microparticles that are procoagulant. These findings may suggest a novel therapeutic approach to combat clinical conditions with excessive coagulation activation.(C) 2000 by The American Society of Hematology.