糖尿病和癌症患者血小板过度活跃和功能障碍

B. Badlou
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摘要

然而,在进展中的慢性糖尿病和癌症患者中,整个凝血级联功能是不正常的。2型糖尿病(DT2)患者的血小板(PLTs)参与血栓形成和止血(T&H),与健康个体相比,血小板(PLTs)粘附在血管内皮上,更自愿地聚集,微血管和大血管循环异常也是如此。然而[1-4],我们已经知道循环plt对于T&H、炎症[3]、生长因子输送、再生;了解它们的功能是了解糖尿病和癌症相关疾病中血管疾病病理生理的基础[2-5]。然而,血小板在血栓炎症消退中的重要作用尚未得到充分认识[3]。最近,我们的研究小组发现,人类血小板的聚集功能/反应性受到晚期糖化血红蛋白的影响[2]。最近的研究也提供了强有力的证据,证明糖尿病并发症与血小板反应性增加之间存在关联[2,4,5],尽管一些代谢异常被报道为这种反应性和功能障碍的主要原因,但其明确的机制尚未完全揭示。完整的健康血管内皮在平滑肌的正常收缩功能及其与plt的正常相互作用中起着关键作用。目前尚不清楚的是,高血糖在糖尿病和癌症相关疾病患者的功能性和器质性微血管缺陷以及PLTs(高)活性中的作用[4]。纤维蛋白原和纤溶酶原激活物抑制剂1水平的升高有利于血栓形成和血栓形成后的溶解缺陷[1]。胰岛素抵抗是DT2的一致发现,微血管和大血管循环异常也是如此。这些并发症与血小板和神经血管单位功能障碍有关[1-4]。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Platelet Hyperactivity and Dysfunction in Diabetes and Cancer
However, the entire coagulation cascade is dysfunctional, in progressed chronic diabetes and cancer patients. Platelets (PLTs) in type 2 diabetic (DT2) involved in Thrombosis and Haemostasis (T&H) of individuals adhere to vascular endothelium and aggregate more voluntarily than those in healthy individuals, as are abnormalities in the microvascular and macrovascular circulations. However [1-4] it is already known that the circulating PLTs are essential for T&H, inflammation [3] growth factors delivery, regeneration; and knowledge of their function is fundamental to understanding the pathophysiology of vascular disease in diabetes and cancer-related diseases [2-5]. Though, PLTs significant role as participants in the resolution of thromboinflammation is underappreciated [3]. Recently our group has shown that human PLTs’ aggregating function/reactivity affected by advanced glycated hemoglobin [2]. Recent studies have also provided strong evidence for an association between diabetes complications and an increase in PLTs’ reactivity [2,4,5] Though some metabolic abnormalities have been reported as the major causes of this reactivity and malfunction, which the defined mechanism has not been fully revealed. Intact healthy vascular endothelium play pivotal role in the normal functioning of smooth muscle contractility as well as its normal interaction with PLTs. What is not clear is the role of hyperglycemia in the functional and organic microvascular deficiencies and PLTs (hyper-) activity in individuals with diabetes and cancer-related diseases [4] Increased levels of fibrinogen and plasminogen activator inhibitor 1 favor both thrombosis and defective dissolution of clots once formed [1]. Insulin resistance is a uniform finding in DT2, as are abnormalities in the microvascular and macrovascular circulations. These complications are associated with dysfunction of platelets and the neurovascular unit [1-4].
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