Changes in platelet membrane glycoproteins and platelet-leukocyte interaction during hemodialysis.
Platelet aggregation and interaction with other vascular cells play a key role in hemostatic events during hemodialysis. We studied seven patients with end-stage renal failure on long-term hemodialysis treatment. Flow-cytometric techniques and platelet-specific monoclonal antibodies were used to measure the platelet surface expression of glycoproteins-fibrinogen receptor on glycoprotein IIb-IIIa (GP IIb-IIIa; CD41) and alpha-granule membrane protein (GMP-140; CD62). In addition, adhesion of platelets or platelet microparticles with leukocytes was evaluated by appearance of the platelet-specific antigen (GP IIb-IIIa) on leukocytes. Blood samples were taken before the start of dialysis and 15, 60, and 240 min thereafter. There was a significant increase in fibrinogen receptor activation on circulating platelets after 15 min of dialysis treatment (P < 0.001) and enhanced degranulation of GMP-140 (P < 0.05). In parallel, the interaction of platelets with neutrophils and monocytes also increased with the duration of dialysis and was maximal after 15 min (P < 0.001). We conclude that the platelet fibrinogen receptor on GP IIb-IIIa in circulating platelets is activated during hemodialysis and is associated with increased adhesion of platelets or platelet microparticles with circulating leukocytes. Thus, the phenomenon described here of platelet-leukocyte interaction could be pathophysiologically important for the development of dialysis-associated leukopenia.
Gawaz
M
M
I. Medizinische Klinik, Klinikum Rechts der Isar, Technische Universität München, Germany.
Bogner
C
C
D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000166:cytology*; D015815:Cell Adhesion Molecules / Q000097:blood; D002450:Cell Communication / Q000502:physiology; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D007962:Leukocytes / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D019007:P-Selectin; D010980:Platelet Membrane Glycoproteins / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects*
D015815:Cell Adhesion Molecules; D019007:P-Selectin; D010980:Platelet Membrane Glycoproteins