Significance of platelet-derived microparticles and activated platelets in diabetic nephropathy.
We measured levels of platelet-derived microparticles (PMP), which have coagulative activity and are produced by platelet activation or physical stimulation, and CD62P/CD63-positive platelets in patients with diabetes mellitus to determine their clinical significance and effects on complications of diabetes including diabetic nephropathy. We also compared these levels before and after administration of the antiplatelet drug cilostazol. Plasma PMP and CD62P/CD63-positive platelet levels were significantly higher in patients with diabetes mellitus than normal controls. CD62P-positive platelet levels were significantly higher in patients with nephropathy than in patients without complications. After administration of cilostazol, PMP and CD62P/CD63-positive platelet levels were significantly decreased. The increases in platelet activity and its related procoagulant activity appear to account in part for the hypercoagulability observed in diabetes mellitus. Our findings suggest that activated platelets might play a role in the development of diabetic nephropathy. Furthermore, antiplatelet therapy with cilostazol for diabetic patients may be useful as antithrombin therapy including antiplatelet therapy, since it suppresses the production of intrinsic coagulants produced by platelet activation.
Omoto
S
S
Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Nomura
S
S
Shouzu
A
A
Hayakawa
T
T
Shimizu
H
H
Miyake
Y
Y
Yonemoto
T
T
Nishikawa
M
M
Fukuhara
S
S
Inada
M
M
D015703:Antigens, CD / Q000378:metabolism; D001777:Blood Coagulation / Q000187:drug effects / Q000502:physiology; D001792:Blood Platelets / Q000187:drug effects / Q000276:immunology / Q000502:physiology; D016022:Case-Control Studies; D000077407:Cilostazol; D003928:Diabetic Nephropathies / Q000097:blood* / Q000188:drug therapy; D003929:Diabetic Neuropathies / Q000097:blood / Q000188:drug therapy; D003930:Diabetic Retinopathy / Q000097:blood / Q000188:drug therapy; D006801:Humans; D019007:P-Selectin / Q000097:blood; D015539:Platelet Activation / Q000187:drug effects / Q000502:physiology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D010980:Platelet Membrane Glycoproteins / Q000378:metabolism; D013347:Subcellular Fractions / Q000502:physiology; D060149:Tetraspanin 30; D013777:Tetrazoles / Q000008:administration & dosage
D015703:Antigens, CD; C554586:CD63 protein, human; D019007:P-Selectin; D010975:Platelet Aggregation Inhibitors; D010980:Platelet Membrane Glycoproteins; D060149:Tetraspanin 30; D013777:Tetrazoles; D000077407:Cilostazol