A study of platelet function in patients with chronic immune thrombocytopenia treated with thrombopoietin receptor agonists

IF 3.7 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2024-11-08 DOI:10.1016/j.thromres.2024.109211

Christos Stafylidis , Sevastianos Chatzidavid , Panagiotis Diamantopoulos , Dimitra Vlachopoulou , Stavroula Syriopoulou , Panagiota Katsiampoura , Nefeli Giannakopoulou , Abraham Pouliakis , Ioanna Anastasopoulou , Olga Katsarou , Marina Mantzourani , Nora-Athina Viniou

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引用次数: 0

Abstract

Background

Thrombopoietin receptor agonists (TPO-RAs) are widely used in immune thrombocytopenia (ITP) and are associated with increased thrombotic risk. However, data regarding their impact on platelet function is scarce.

Methods

Platelet function was evaluated in chronic ITP patients enrolled over one year, using light transmission aggregometry and platelet-derived microparticle (PMP) levels measurement with flow cytometry. Aggregation responses to various concentrations of ADP, collagen, ristocetin, and PMP levels were compared between TPO-RA-treated patients, patients treated with other agents and healthy individuals.

Results

TPO-RA-treated patients (n = 24) displayed significantly reduced aggregation responses to 2.5 μM, 5 μM, and 10 μM of ADP and collagen compared to 15 healthy individuals (59.5 % vs. 87.6 %, p < .0001, 43.6 % vs. 79.9 %, p < .0001, 26.1 % vs. 75.2 %, p < .0001, 67.2 % vs. 86 %, p < .0001, respectively). Reduced responses to ADP and collagen were also recorded in patients treated with other agents (n = 16) compared to healthy controls but without difference between the two treatment groups. Aggregation response to ristocetin was normal in all three groups. None of the patients yielded enhanced platelet aggregation. In TPO-RA-treated patients, a strong positive correlation between platelet counts and aggregation response to ristocetin was observed (r_s = 0.65, p = .0005). PMP levels were significantly elevated in TPO-RA-treated patients compared to patients treated with other agents (49.5 vs 4.5 events/uL, p < .0001) and healthy controls (5 events/uL, p < .0001).

Conclusions

These results suggest that TPO-RAs may not enhance platelet aggregation responses, whereas impaired responses may be a disease feature. Furthermore, TPO-RAs may increase PMP levels and thus be implicated in the modulation of platelet function in ITP patients.

查看原文本刊更多论文

对接受血小板生成素受体激动剂治疗的慢性免疫性血小板减少症患者血小板功能的研究。

背景：促血小板生成素受体激动剂（TPO-RA）被广泛用于免疫性血小板减少症（ITP），与血栓风险增加有关。然而，有关其对血小板功能影响的数据却很少：方法：使用透光聚集测定法和流式细胞术测量血小板衍生微粒（PMP）水平，对入选一年以上的慢性 ITP 患者的血小板功能进行评估。比较了接受 TPO-RA 治疗的患者、接受其他药物治疗的患者和健康人对不同浓度 ADP、胶原蛋白、利斯托西汀和 PMP 水平的聚集反应：与 15 名健康人相比，TPO-RA 治疗患者（n = 24）对 2.5 μM、5 μM 和 10 μM ADP 和胶原蛋白的聚集反应明显降低（59.5% 对 87.6%，p s = 0.65，p = .0005）。与接受其他药物治疗的患者相比，接受 TPO-RA 治疗的患者的 PMP 水平明显升高（49.5 vs 4.5 events/uL，p 结论：TPO-RA 治疗患者的 PMP 水平明显升高：这些结果表明，TPO-RA 可能不会增强血小板聚集反应，而血小板聚集反应受损可能是一种疾病特征。此外，TPO-RAs 可能会增加 PMP 水平，从而参与调节 ITP 患者的血小板功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.