Effects of Endotoxemia on Thrombopoiesis in Men
Effects of Endotoxemia on Thrombopoiesis in Men
复制标题
内毒素血症对男性血小板生成的影响
作者：
P. Stohlawetz;C. Folman;A. von dem Borne;T. Pernerstorfer;H. Eichler;S. Panzer;B. Jilma
摘要背景。发热性疾病通常与血小板周转增加和血小板输注无效相关，尽管几种致热细胞因子可促进血小板生成。本研究旨在描述实验性人内毒素血症对血小板更新和血小板生成的影响。方法.将内毒素（4 ng/kg）注入30名健康男性体内，以研究全身性人类炎症中血小板生成的调节。检测血小板计数、血小板生成素（TPO）、糖杯蛋白（glycocalicin）和网织血小板（RP）水平，以评价急性内毒素血症对血小板生成的影响。10例受试者接受阿司匹林1000 mg口服预处理。评估阿司匹林对血小板周转的可能影响，10名受试者接受扑热息痛以控制退热效果。结果在LPS静脉注射后1小时，血小板计数下降约15%（p <0.001），24小时开始恢复，并在LPS静脉注射后7天超过基线值8%（CI：5-12; p <0.001）。网织血小板计数从1.62%（CI：1.24-2.0）增加至6 h时的最大值2.39%（CI：1.81-2.98; p = 0.003）。TPO水平从基线值10 A.U/ml（CI：8.8-11.2）增加到24 h时的15.5 A.U/ml（CI：13.6-17.3）（p <0.001），而血浆糖帽蛋白没有变化（p >0.05）。在6小时，循环血小板-中性粒细胞聚集体的数量增加超过100%（p <0.001）。阿司匹林和扑热息痛均不影响任何测量参数的变化。结论低度内毒素血症诱导血小板计数迅速下降，随后是网织血小板和TPO水平的早期增加，但不是糖钙蛋白水平。最后，外周血小板计数在LPS输注后几天增加。
Summary Background. Febrile conditions are often associated with increased platelet turnover and refractoriness to platelet transfusions, although several pyrogenic cytokines enhance thrombopoiesis. This study aimed to characterize the effects of experimental human endotoxemia on platelet turnover and thrombopoiesis. Methods. Endotoxin (4 ng/kg) was infused into 30 healthy men to study the regulation of thrombopoiesis in systemic human inflammation. Platelet counts, plasma thrombopoietin (TPO) and glycocalicin levels, and reticulated platelets (RP) were measured to evaluate the effect of acute endotoxemia on thrombopoiesis. Ten subjects received pretreatment with 1000 mg aspirin po. to evaluate possible effects of aspirin on platelet turnover, and ten subjects received paracetamol to control for effects of anti-pyresis. Results. Platelet counts dropped by about 15% (p <0.001) one hour after LPS infusion, began to recover at 24 h, and exceeded baseline values by 8% (CI: 5-12; p <0.001) at 7 days after LPS iv. Reticulated platelet counts increased from 1.62% (CI: 1.24-2.0) to a maximum of 2.39% (CI: 1.81-2.98; p = 0.003) at 6 h. TPO levels increased from baseline values of 10 A.U/ml (CI: 8.8-11.2) to 15.5 A.U/ml (CI: 13.6-17.3) at 24 h (p <0.001), whereas plasma glycocalicin was not changed (p >0.05). The number of circulating platelet-neutrophil aggregates increased more than 100% at 6 h (p <0.001). Neither aspirin nor paracetamol affected changes in any of the parameters measured. Conclusion. Low grade endotoxemia induces a rapid fall of platelet counts, which is followed by an early increase in reticulated platelets and TPO levels but not of glycocalicin levels. Finally peripheral platelet counts increase several days after LPS infusion.
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