Platelets最新文献

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Enhanced platelet sensitization is accompanied by increased expression of the transporter MRP4 and elevated plasma S1P levels in mild COVID-19 convalescents. 在轻度 COVID-19 康复者中,伴随着转运体 MRP4 表达的增加和血浆 S1P 水平的升高,血小板致敏性增强。
IF 2.5 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-10-30 DOI: 10.1080/09537104.2024.2413713
Céline Tolksdorf, Andrea Seidel, Christian Baume, Eileen Moritz, Karen Saljé, Kathrin Lehmann, Karsten Becker, Ulrike Garscha, Thomas Thiele, Edzard Schwedhelm, Mirjam von Lucadou, Mladen V Tzvetkov, Stefan Engeli, Gabriele Jedlitschky, Bernhard H Rauch
{"title":"Enhanced platelet sensitization is accompanied by increased expression of the transporter MRP4 and elevated plasma S1P levels in mild COVID-19 convalescents.","authors":"Céline Tolksdorf, Andrea Seidel, Christian Baume, Eileen Moritz, Karen Saljé, Kathrin Lehmann, Karsten Becker, Ulrike Garscha, Thomas Thiele, Edzard Schwedhelm, Mirjam von Lucadou, Mladen V Tzvetkov, Stefan Engeli, Gabriele Jedlitschky, Bernhard H Rauch","doi":"10.1080/09537104.2024.2413713","DOIUrl":"https://doi.org/10.1080/09537104.2024.2413713","url":null,"abstract":"<p><p>Viral infections can lead to platelet activation and hemostatic complications. However, the extent to which platelet reactivity remains altered after convalescence, contributing to long-term health impairments as observed after COVID-19 is not yet fully understood. Therefore, we conducted a cohort study (DRKS00025217) to determine platelet function in individuals convalesced from mild COVID-19. Assays were performed <i>ex vivo</i> with blood from convalescents at 2-15 weeks and 6-10 months after convalescence, focusing on platelet aggregation, activation markers, and thrombin formation. In addition, two other potentially relevant factors for platelet function were examined: the immunomodulatory mediator sphingosine-1-phosphate (S1P) and the platelet expression of the transporter MRP4 (ABCC4). Our findings indicate that robust platelet functions, including platelet aggregation determined by light transmission aggregometry, and thrombin formation, were not altered in convalescents compared to matched control individuals. However, an elevation in subtle platelet activation markers, such as P-selectin surface expression and activation of glycoprotein IIb/IIIa, was observed 2-15 weeks after convalescence. This was accompanied by an increased expression of MRP4 in platelets and significantly elevated levels of S1P in platelet-poor plasma. Our findings suggest increased platelet sensitization and a pro-inflammatory state even after convalescence from mild COVID-19, pointing toward MRP4 and S1P as associated factors.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2413713"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Finding and following: a deep learning-based pipeline for tracking platelets during thrombus formation in vivo and ex vivo. 寻找和跟踪:基于深度学习的管道,用于在体内和体外血栓形成过程中跟踪血小板。
IF 3.3 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-05-09 DOI: 10.1080/09537104.2024.2344512
Abigail S McGovern, Pia Larsson, Volga Tarlac, Natasha Setiabakti, Leila Shabani Mashcool, Justin R Hamilton, Niklas Boknäs, Juan Nunez-Iglesias
{"title":"Finding and following: a deep learning-based pipeline for tracking platelets during thrombus formation <i>in vivo</i> and <i>ex vivo</i>.","authors":"Abigail S McGovern, Pia Larsson, Volga Tarlac, Natasha Setiabakti, Leila Shabani Mashcool, Justin R Hamilton, Niklas Boknäs, Juan Nunez-Iglesias","doi":"10.1080/09537104.2024.2344512","DOIUrl":"https://doi.org/10.1080/09537104.2024.2344512","url":null,"abstract":"<p><p>The last decade has seen increasing use of advanced imaging techniques in platelet research. However, there has been a lag in the development of image analysis methods, leaving much of the information trapped in images. Herein, we present a robust analytical pipeline for finding and following individual platelets over time in growing thrombi. Our pipeline covers four steps: detection, tracking, estimation of tracking accuracy, and quantification of platelet metrics. We detect platelets using a deep learning network for image segmentation, which we validated with proofreading by multiple experts. We then track platelets using a standard particle tracking algorithm and validate the tracks with custom image sampling - essential when following platelets within a dense thrombus. We show that our pipeline is more accurate than previously described methods. To demonstrate the utility of our analytical platform, we use it to show that <i>in vivo</i> thrombus formation is much faster than that <i>ex vivo</i>. Furthermore, platelets <i>in vivo</i> exhibit less passive movement in the direction of blood flow. Our tools are free and open source and written in the popular and user-friendly Python programming language. They empower researchers to accurately find and follow platelets in fluorescence microscopy experiments.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2344512"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Real-life clinical practice in Spain in the setting of new drug availability for ITP treatment. A Delphi-based Spanish expert panel consensus. 在新药上市的背景下西班牙治疗 ITP 的实际临床实践。基于德尔菲法的西班牙专家小组共识。
IF 3.3 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-05-14 DOI: 10.1080/09537104.2024.2336104
Tomás José González-López, Abelardo Bárez, Ángel Bernardo-Gutiérrez, Silvia Bernat, Fernando Fernández-Fuertes, José María Guinea de Castro, Reyes Jiménez-Bárcenas, Isidro Jarque
{"title":"Real-life clinical practice in Spain in the setting of new drug availability for ITP treatment. A Delphi-based Spanish expert panel consensus.","authors":"Tomás José González-López, Abelardo Bárez, Ángel Bernardo-Gutiérrez, Silvia Bernat, Fernando Fernández-Fuertes, José María Guinea de Castro, Reyes Jiménez-Bárcenas, Isidro Jarque","doi":"10.1080/09537104.2024.2336104","DOIUrl":"https://doi.org/10.1080/09537104.2024.2336104","url":null,"abstract":"<p><p>Immune thrombocytopenia (ITP) is a common autoimmune hematological disorder. Despite this, diagnosis is still challenging due to clinical heterogeneity and the lack of a specific diagnostic test. New findings in the pathology and the availability of new drugs have led to the development of different guidelines worldwide. In the present study, the Delphi methodology has been used to get a consensus on the management of adult patients with ITP in Spain and to help in decision-making. The Delphi questionnaire has been designed by a scientific ad hoc committee and has been divided into 13 topics, with a total of 127 items, covering the maximum possible scenarios for the management of ITP. As a result of the study, a total consensus of 81% has been reached. It is concluded that this Delphi consensus provides practical recommendations on topics related to diagnosis and management of ITP patients to help doctors to improve outcomes. Some aspects remain unclear, without consensus among the experts. Thus, more advances are needed to optimize ITP management.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2336104"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hemin regulates platelet clearance in hemolytic disease by binding to GPIbα. 血红蛋白通过与 GPIbα 结合调节溶血性疾病中的血小板清除。
IF 2.5 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-07-29 DOI: 10.1080/09537104.2024.2383642
Man Zhao, Dongxin Peng, Yuxuan Li, Minwei He, Yulong Zhang, Qianqian Zhou, Sujing Sun, Ping Ma, Liping Lv, Xiaohui Wang, Linsheng Zhan
{"title":"Hemin regulates platelet clearance in hemolytic disease by binding to GPIbα.","authors":"Man Zhao, Dongxin Peng, Yuxuan Li, Minwei He, Yulong Zhang, Qianqian Zhou, Sujing Sun, Ping Ma, Liping Lv, Xiaohui Wang, Linsheng Zhan","doi":"10.1080/09537104.2024.2383642","DOIUrl":"10.1080/09537104.2024.2383642","url":null,"abstract":"<p><p>Hemolysis is associated with thrombosis and vascular dysfunction, which are the pathological components of many diseases. Hemolytic products, including hemoglobin and hemin, activate platelets (PLT). Despite its activation, the effect of hemolysis on platelet clearance remains unclear, It is critical to maintain a normal platelet count and ensure that circulating platelets are functionally viable. In this study, we used hemin, a degradation product of hemoglobin, as a potent agonist to treat platelets and simulate changes in vivo in mice. Hemin treatment induced activation and morphological changes in platelets, including an increase in intracellular Ca<sup>2+</sup> levels, phosphatidylserine (PS) exposure, and cytoskeletal rearrangement. Fewer hemin-treated platelets were cleared by macrophages in the liver after transfusion than untreated platelets. Hemin bound to glycoprotein Ibα (GPIbα), the surface receptor in hemin-induced platelet activation and aggregation. Furthermore, hemin decreased GPIbα desialylation, as evidenced by reduced Ricinus communis agglutinin I (RCA- I) binding, which likely extended the lifetime of such platelets in vivo. These data provided new insight into the mechanisms of GPIbα-mediated platelet activation and clearance in hemolytic disease.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2383642"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Application of the Cellular Thermal Shift Assay (CETSA) to validate drug target engagement in platelets. 应用细胞热转移分析法 (CETSA) 验证血小板中的药物靶点参与。
IF 2.5 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-05-20 DOI: 10.1080/09537104.2024.2354833
Joanna-Marie Howes, Matthew T Harper
{"title":"Application of the Cellular Thermal Shift Assay (CETSA) to validate drug target engagement in platelets.","authors":"Joanna-Marie Howes, Matthew T Harper","doi":"10.1080/09537104.2024.2354833","DOIUrl":"10.1080/09537104.2024.2354833","url":null,"abstract":"<p><p>Small molecule drugs play a major role in the study of human platelets. Effective action of a drug requires it to bind to one or more targets within the platelet (target engagement). However, although <i>in vitro</i> assays with isolated proteins can be used to determine drug affinity to these targets, additional factors affect target engagement and its consequences in an intact platelet, including plasma membrane permeability, intracellular metabolism or compartmentalization, and level of target expression. Mechanistic interpretation of the effect of drugs on platelet activity requires comprehensive investigation of drug binding in the proper cellular context, i.e. in intact platelets. The Cellular Thermal Shift Assay (CETSA) is a valuable method to investigate target engagement within complex cellular environments. The assay is based on the principle that drug binding to a target protein increases that protein's thermal stability. In this technical report, we describe the application of CETSA to platelets. We highlight CETSA as a quick and informative technique for confirming the direct binding of drugs to platelet protein targets, providing a platform for understanding the mechanism of action of drugs in platelets, and which will be a valuable tool for investigating platelet signaling and function.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2354833"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141064598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Development of a super-hydrophilic anaerobic tube for the optimization of platelet-rich fibrin. 开发用于优化富血小板纤维蛋白的超亲水性厌氧管。
IF 3.3 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-02-22 DOI: 10.1080/09537104.2024.2316745
Yan Wei, Yihong Cheng, Hongjiang Wei, Yulan Wang, Xiaoxin Zhang, Richard J Miron, Yufeng Zhang, Shanglan Qing
{"title":"Development of a super-hydrophilic anaerobic tube for the optimization of platelet-rich fibrin.","authors":"Yan Wei, Yihong Cheng, Hongjiang Wei, Yulan Wang, Xiaoxin Zhang, Richard J Miron, Yufeng Zhang, Shanglan Qing","doi":"10.1080/09537104.2024.2316745","DOIUrl":"https://doi.org/10.1080/09537104.2024.2316745","url":null,"abstract":"<p><p>Horizontal platelet-rich fibrin (H-PRF) contains a variety of bioactive growth factors and cytokines that play a key role in the process of tissue healing and regeneration. The blood collection tubes used to produce Solid-PRF (plasmatrix (PM) tubes) have previously been shown to have a great impact on the morphology, strength and composition of the final H-PRF clot. Therefore, modification to PM tubes is an important step toward the future optimization of PRF. To this end, we innovatively modified the inner wall surface of the PM tubes with plasma and adjusted the gas environment inside the PM tubes to prepare super-hydrophilic anaerobic plasmatrix tubes (SHAP tubes). It was made anaerobic for the preparation of H-PRF with the aim of improving mechanical strength and bioactivity. The findings demonstrated that an anaerobic environment stimulated platelet activation within the PRF tubes. After compression, the prepared H-PRF membrane formed a fibrous cross-linked network with high fracture strength, ideal degradation characteristics, in addition to a significant increase in size. Thereafter, the H-PRF membranes prepared by the SHAP tubes significantly promoted collagen synthesis of gingival fibroblast and the mineralization of osteoblasts while maintaining excellent biocompatibility, and advantageous antibacterial properties. In conclusion, the newly modified PRF tubes had better platelet activation properties leading to better mechanical strength, a longer degradation period, and better regenerative properties in oral cell types including gingival fibroblast and alveolar osteoblasts. It also improves the success rate of H-PRF preparation in patients with coagulation dysfunction and expands the clinical application scenario.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2316745"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Translating proof-of-concept for platelet slip into improved antithrombotic therapeutic regimens. 将血小板滑移的概念验证转化为改进的抗血栓治疗方案。
IF 3.3 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-05-22 DOI: 10.1080/09537104.2024.2353582
Scott J Denardo, Pavlos P Vlachos, Brett A Meyers, Reza Babakhani-Galangashi, Lin Wang, Zejin Gao, James E Tcheng
{"title":"Translating proof-of-concept for platelet slip into improved antithrombotic therapeutic regimens.","authors":"Scott J Denardo, Pavlos P Vlachos, Brett A Meyers, Reza Babakhani-Galangashi, Lin Wang, Zejin Gao, James E Tcheng","doi":"10.1080/09537104.2024.2353582","DOIUrl":"10.1080/09537104.2024.2353582","url":null,"abstract":"<p><p>Platelets are central to thrombosis. Research at the intersection of biological and physical sciences provides proof-of-concept for shear rate-dependent platelet slip at vascular stenosis and near device surfaces. Platelet slip extends the observed biological \"slip-bonds\" to the boundary of functional gliding without contact. As a result, there is diminished engagement of the coagulation cascade by platelets at these surfaces. Comprehending platelet slip would more precisely direct antithrombotic regimens for different shear environments, including for percutaneous coronary intervention (PCI). In this brief report we promote translation of the proof-of-concept for platelet slip into improved antithrombotic regimens by: (1) reviewing new supporting basic biological science and clinical research for platelet slip; (2) hypothesizing the principal variables that affect platelet slip; (3) applying the consequent construct model in support of-and in some cases to challenge-relevant contemporary guidelines and their foundations (including for urgent, higher-risk PCI); and (4) suggesting future research pathways (both basic and clinical). Should future research demonstrate, explain and control platelet slip, then a paradigm shift for choosing and recommending antithrombotic regimens based on predicted shear rate should follow. Improved clinical outcomes with decreased complications accompanying this paradigm shift for higher-risk PCI would also result in substantive cost savings.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2353582"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Edi(torial) 2024: action plan for change and new initiatives. 2024 年教育:变革和新举措行动计划》。
IF 2.5 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-02-14 DOI: 10.1080/09537104.2024.2315713
Kirk A Taylor
{"title":"Edi(torial) 2024: action plan for change and new initiatives.","authors":"Kirk A Taylor","doi":"10.1080/09537104.2024.2315713","DOIUrl":"10.1080/09537104.2024.2315713","url":null,"abstract":"","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2315713"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139730373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of pre-delivery medication treatment on delivery outcome in patients with primary immune thrombocytopenia: a cohort study. 原发性免疫血小板减少症患者分娩前药物治疗对分娩结果的影响:一项队列研究。
IF 2.5 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-08-01 DOI: 10.1080/09537104.2024.2380366
Xue Xu, Mei-Ying Liang, Lin-Rui Zhao, Jian-Liu Wang, Xiao-Hui Zhang
{"title":"Impact of pre-delivery medication treatment on delivery outcome in patients with primary immune thrombocytopenia: a cohort study.","authors":"Xue Xu, Mei-Ying Liang, Lin-Rui Zhao, Jian-Liu Wang, Xiao-Hui Zhang","doi":"10.1080/09537104.2024.2380366","DOIUrl":"10.1080/09537104.2024.2380366","url":null,"abstract":"<p><strong>Background: </strong>Clinical research data showed a series of adverse events in the delivery period of primary immune thrombocytopenia (ITP) patients, including high cesarean section rate. Consensus report proposed that for patients with platelet count below 50 × 10<sup>9</sup>/L, prednisone or intravenous immunoglobulins (IVIg) can be given to raise the platelet count in third trimester in preparation for labor.</p><p><strong>Objectives: </strong>To evaluate the effect of low-dose prednisone or IVIg therapy on delivery outcomes in patients with ITP.</p><p><strong>Study design: </strong>This was a cohort study that included pregnant women with ITP from January 2017 to December 2022. Patients with platelet counts of (20-50) ×10<sup>9</sup>/L at the time of delivery (≥34 weeks) and who had not received any medication before were enrolled in the study. Patients were divided into the pre-delivery medication group (oral prednisone or IVIg) and untreated group according to their preferences. The differences in vaginal delivery rate, postpartum bleeding rate, and platelet transfusion volume between the two groups were compared using t-test, Wilcoxon rank-sum test, and χ2 test. Logistic regression analysis was used to identify the factors affecting vaginal delivery rate and postpartum bleeding rate, and multiple linear regression analysis was used to identify the factors affecting platelet transfusion volume.</p><p><strong>Results: </strong>During the study period, a total of 96 patients with ITP were enrolled, including 70 in the pre-delivery medication group and 26 in the untreated group. The platelet count of pre-delivery medication group was 54.8 ± 34.5 × 10<sup>9</sup>/L, which was significantly higher than that of untreated group 34.4 ± 9.0 × 10<sup>9</sup>/L (<i>p</i> = .004). The vaginal delivery rate of the medication group was higher than the untreated group [60.0% (42/70) vs. 30.8% (8/26), χ2 = 6.49, <i>p</i> = .013]. After adjusting for the proportion of multiparous women and gestational weeks, the results showed that medication therapy during the peripartum period was associated with vaginal delivery (OR = 4.937, 95% CI: 1.511-16.136, <i>p</i> = .008). The postpartum bleeding rates were 22.9% (16/70) and 26.9% (7/26) in the medication group and untreated group, respectively, with no significant difference between the two groups (χ2 = 0.17, <i>p</i> = .789), while the platelet transfusion volume was lower in the medication group than untreated group [(1.1 ± 1.0) vs. (1.6 ± 0.8) U].</p><p><strong>Conclusion: </strong>Pre-delivery medication therapy can increase vaginal delivery rate, reduce platelet transfusion volume, but does not decrease the incidence of postpartum hemorrhage.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2380366"},"PeriodicalIF":2.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between thrombocytopenia and prognosis in children with septic shock: a retrospective cohort study. 脓毒性休克患儿血小板减少与预后的关系:一项回顾性队列研究。
IF 3.3 3区 医学
Platelets Pub Date : 2024-12-01 Epub Date: 2024-06-11 DOI: 10.1080/09537104.2024.2363242
Ruichen Zhang, Haixin Huang, Siwei Lu, Jian Chen, Dandan Pi, Hongxing Dang, Chengjun Liu, Feng Xu, Yue-Qiang Fu
{"title":"Relationship between thrombocytopenia and prognosis in children with septic shock: a retrospective cohort study.","authors":"Ruichen Zhang, Haixin Huang, Siwei Lu, Jian Chen, Dandan Pi, Hongxing Dang, Chengjun Liu, Feng Xu, Yue-Qiang Fu","doi":"10.1080/09537104.2024.2363242","DOIUrl":"https://doi.org/10.1080/09537104.2024.2363242","url":null,"abstract":"<p><p>Septic shock is a life-threatening disease worldwide often associated with thrombocytopenia. Platelets play a crucial role in bridging the gap between immunity, coagulation, and endothelial cell activation, potentially influencing the course of the disease. However, there are few studies specifically evaluating the impact of thrombocytopenia on the prognosis of pediatric patients. Therefore, the study investigates effects of early thrombocytopenia in the prognosis of children with septic shock. Pediatric patients with septic shock from 2015 to 2022 were included monocentrically. Thrombocytopenia was defined as a platelet count of <100 × 10<sup>9</sup>/L during the first 24 hours of septic shock onset. The primary outcome was the 28-day mortality. Propensity score matching was used to pair patients with different platelet counts on admission but comparable disease severity. A total of 419 pediatric patients were included in the analysis. Patients with thrombocytopenia had higher 28-day mortality (55.5% vs. 38.7%, <i>p</i> = .005) compared to patients with no thrombocytopenia. Thrombocytopenia was associated with reduced 28-PICU free days (median value, 0 vs. 13 days, <i>p</i> = .003) and 28-ventilator-free (median value, 0 vs. 19 days, <i>p</i> = .001) days. Among thrombocytopenia patients, those with platelet count ≤50 × 10<sup>9</sup>/L had a higher 28-day mortality rate (63.6% vs. 45%, <i>p</i> = .02). Multiple logistic regression showed that elevated lactate (adjusted odds ratio (OR) = 1.11; 95% confidence interval (CI): 1.04-1.17; <i>P</i> <0.001) and white blood cell (WBC) count (OR = 0.97; 95% CI: 0.95-0.99; <i>p</i> = .003) were independent risk factors for the development of thrombocytopenia. Thrombocytopenia group had increased bleeding events, blood product transfusions, and development of organ failure. In Kaplan-Meier survival estimates, survival probabilities at 28 days were greater in patients without thrombocytopenia (<i>p</i> value from the log-rank test, <i>p</i> = .004). There were no significant differences in the type of pathogenic microorganisms and the site of infection between patients with and without thrombocytopenia. In conclusion, thrombocytopenia within 24 hours of shock onset is associated with an increased risk of 28-day mortality in pediatric patients with septic shock.</p>","PeriodicalId":20268,"journal":{"name":"Platelets","volume":"35 1","pages":"2363242"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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