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Good Platelets Gone Bad: The Effects of Trauma Patient Plasma on Healthy Platelet Aggregation. | LitMetric

AI Article Synopsis

  • The study investigates how plasma from injured patients affects the behavior of healthy platelets, focusing on trauma-induced coagulopathy (TIC) and how different conditions (shock vs. no shock) influence platelet aggregation.
  • Healthy platelets were treated with plasma from patients categorized by injury severity and presence of shock, and platelet aggregation was assessed after stimulation.
  • Results showed that plasma from shocked patients impaired platelet aggregation, while plasma from severely injured patients without shock enhanced aggregation, suggesting that injury-related factors influence platelet function differently based on the presence of shock.

Article Abstract

Background: Altered postinjury platelet behavior is recognized in the pathophysiology of trauma-induced coagulopathy (TIC), but the mechanisms remain largely undefined. Studies suggest that soluble factors released by injury may inhibit signaling pathways and induce structural changes in circulating platelets. Given this, we sought to examine the impact of treating healthy platelets with plasma from injured patients. We hypothesized that healthy platelets treated ex-vivo with plasma from injured patients with shock would impair platelet aggregation, while treatment with plasma from injured patients with significant injury burden, but without shock, would enhance platelet aggregation.

Methods: Plasma samples were isolated from injured patients (pretransfusion) and healthy donors at a Level I trauma center and stored at -80°C. Plasma samples from four separate patients in each of the following stratified clinical groups were used: mild injury/no shock (injury severity score [ISS] 2-15, base excess [BE]>-6), mild injury/with shock (ISS 2-15, BE≤-6), severe injury/no shock (ISS>25, BE>-6), severe injury/with shock (ISS>25, BE≤-6), minimal injury (ISS 0/1, BE>-6), and healthy. Platelets were isolated from three healthy adult males and were treated with plasma for 30 min. Aggregation was stimulated with a thrombin receptor agonist and measured via multiple-electrode platelet aggregometry. Data were normalized to HEPES Tyrode's (HT) buffer-only treated platelets. Associations of plasma treatment groups with platelet aggregation measures were tested with Mann-Whitney U tests.

Results: Platelets treated with plasma from patients with shock (regardless of degree of injury) had significantly impaired thrombin-stimulated aggregation compared with platelets treated with plasma from patients without shock (P = 0.002). Conversely, platelets treated with plasma from patients with severe injury, but without shock, had amplified thrombin-stimulated aggregation (P = 0.030).

Conclusion: Shock-mediated soluble factors impair platelet aggregation, and tissue injury-mediated soluble factors amplify platelet aggregation. Future characterization of these soluble factors will support development of novel treatments of TIC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8547718PMC
http://dx.doi.org/10.1097/SHK.0000000000001622DOI Listing

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