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Increased platelet binding to circulating monocytes in acute coronary syndromes.

AbstractBACKGROUND:
Present therapies for acute coronary syndromes aim toward limiting platelet-platelet adhesion and aggregation processes. However, platelet-leukocyte interactions may contribute importantly to disease progression in the arterial wall. Recent studies suggest that prevention of platelet-leukocyte binding via P-selectin glycoprotein ligand-1 (PSGL-1) may be beneficial in animal models of vascular injury.
METHODS AND RESULTS:
P-selectin-PSGL-1 interactions were found to account for most platelet-monocyte binding observed in peripheral blood samples from healthy donors. However, a significant component of observed adhesion was calcium independent, involving neither PSGL-1 nor P-selectin. Platelet-monocyte interactions were examined in 52 patients admitted within 14 hours of symptom onset, with acute coronary syndromes defined as unstable angina (n=12) and acute myocardial infarction (n=13) or noncardiac chest pain (n=27). When compared with patients with noncardiac chest pain, significantly elevated levels of platelet-monocyte binding were found in patients with acute myocardial infarction (70.1+/-15.4% versus 45.4+/-23.3%; P<0.01) and unstable angina (67.4+/-12.9% versus 45.4+/-23.3%; P>0.01). Calcium-independent platelet-monocyte binding was significantly elevated in myocardial infarction patients alone (14.7+/-7.7% versus 6.1+/-5.96%; P<0.001).
CONCLUSIONS:
There is evidence for a significant P-selectin-independent molecular component to the platelet-monocyte conjugation observed in peripheral blood. Patients with myocardial infarction and unstable angina demonstrate increased total binding of platelets to monocytes. Additionally, calcium-independent adhesion was significantly elevated in patients with evidence of myocardial infarction. These findings demonstrate that novel cation-independent adhesion mechanisms may mediate platelet-monocyte binding, representing a new therapeutic target after vascular injury associated with myocardial infarction.
AuthorsJaydeep Sarma, Caterina A Laan, Shirjel Alam, Ashwani Jha, Keith A A Fox, Ian Dransfield
JournalCirculation (Circulation) Vol. 105 Issue 18 Pg. 2166-71 (May 07 2002) ISSN: 1524-4539 [Electronic] United States
PMID11994250 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Membrane Glycoproteins
  • P-Selectin
  • P-selectin ligand protein
  • Calcium
Topics
  • Adult
  • Angina, Unstable (blood)
  • Blood Platelets (cytology, physiology)
  • Calcium (physiology)
  • Cell Adhesion
  • Chest Pain (blood, diagnosis)
  • Female
  • Humans
  • Leukocytes (physiology)
  • Male
  • Membrane Glycoproteins (physiology)
  • Middle Aged
  • Monocytes (cytology, physiology)
  • Myocardial Infarction (blood)
  • P-Selectin (physiology)
  • Syndrome

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