Platelet in progression of atherosclerosis: a potential target in diabetic patients.
Platelet in progression of atherosclerosis: a potential target in diabetic patients.
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DOI：
10.2174/1573399054022758
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发表时间：
2005-05
影响因子：
3.3
通讯作者：
H. Koyama;Y. Nishizawà
中科院分区：
文献类型：
--
作者：
H. Koyama;Y. Nishizawà
糖尿病患者报告的血小板功能改变似乎与糖尿病血管并发症的发病机制有关。然而，直到最近，血小板在自发性动脉粥样硬化进展中的作用仍然值得怀疑。损伤反应假说的原始版本，其中在裸露的内皮上沉积的血小板在动脉粥样硬化的自发发展中起关键作用，在过去的三十年中已经被显着修改;动脉粥样硬化形成现在被认为是一个慢性炎症过程，其中单核细胞和T细胞发挥核心作用。然而，最近已经积累的证据表明，活化的血小板有助于载脂蛋白E缺陷小鼠动脉粥样硬化的进展。活化的血小板与白细胞聚集，释放促炎细胞因子、趋化因子和生长调节分子，导致内皮活化、白细胞募集和平滑肌细胞功能改变。事实上，已经表明，在冠状动脉疾病患者的循环中发现了活化的血小板及其与白细胞的聚集体。我们最近在大规模的人体研究中发现，糖尿病患者的循环P-选择素阳性血小板高于非糖尿病受试者，与颈动脉粥样硬化显著正相关。本综述将重点介绍糖尿病患者血小板功能的改变及其在动脉粥样硬化进展中的意义。
Altered platelet function reported in diabetic patients appears to be involved in the pathogenesis of diabetic vascular complications. However until recently, the role of platelets in progression of spontaneous atherosclerosis remained questionable. The original version of the response to injury hypothesis, where deposited platelets at denuded endothelium play key roles in the spontaneous development of atherosclerosis, has been modified dramatically over the past three decades; atherogenesis is now considered a chronic inflammatory process in which monocytes and T cells play central roles. Recently however, evidence has been accumulated that activated platelet contributes to progression of atherosclerosis in apo E-deficient mice. Activated platelets aggregate with leukocytes, release proinflammatory cytokines, chemokines and growth regulatory molecules, resulting in endothelial activation, leukocyte recruitment and altered smooth muscle cell function. Indeed, it has been shown that activated platelets, and their aggregates with leukocytes are found in the circulation of patients with coronary artery diseases. We have recently shown that circulating P-selectin positive platelets, which are higher in diabetic patients than non-diabetic subjects, are significantly and positively associated with carotid atherosclerosis in the large-scale human studies. This review will focus on altered platelet function in diabetic patients, and its implications in the progression of atherosclerosis.