title: Elevated platelet count, C-reactive protein and thromboxane analog-induced platelet aggregation in patients with Gulf War veterans' illnesses: evidence of a chronic inflammatory state?
abstract: A previous study of Gulf War veteran's illnesses (GWVI) observed evidence of platelet activation in a majority of patients with GWVI. To further characterize platelet function, we studied 43 patients (40 men) with GWVI (GWVI+) and 21 veterans who served concurrently in the Gulf War but who lacked criteria for GWVI (GWVI-). All participants were free of infection and known inflammatory diseases. Studies performed included platelet count, immature platelet fraction (IPF), plasma thrombopoietin (TPO), C-reactive protein (CRP), platelet aggregation and ATP secretion in response to six agonists, and spontaneous aggregation. Platelet counts and CRP were significantly elevated in GWVI+ compared to GWVI- patients without elevation in IPF or TPO. Platelet aggregation did not differ between GWVI+ and GWVI- patients except for spontaneous aggregation that was significantly greater in GWVI+ patients. Platelet ATP secretion was similar in the two groups, except the response to 50 μmol/l thrombin receptor agonist peptide 6 (TRAP 6) was significantly greater in GWVI+ patients. When platelet aggregation was analyzed in relation to CRP, the response to 0.5 μmol/l U46619 was significantly greater in patients whose CRP was at least 2 μg/ml. Therefore, GWVI+ patients had elevated platelet counts, spontaneous aggregation, TRAP 6-induced secretion, and CRP, but no impairment of platelet function. The increased platelet counts and U46619-induced aggregation appear to be consequences of an underlying inflammatory state in GWVI.
authors.affiliation: aVA Healthcare System, Minneapolis and University of Minnesota bResearch Service, Minneapolis Veterans Affairs Healthcare System, United States Department of Veterans Affairs cDivision of Hematology, Oncology and Transplant, Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Gerhard J
authors.initials: GJ
authors.lastname: Johnson
authors.forename: Linda A
authors.initials: LA
authors.lastname: Leis
authors.forename: Billie C S
authors.initials: BC
authors.lastname: Slater
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Bach
mesh_terms: D019796:15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid / Q000008:administration & dosage*; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D002908:Chronic Disease; D005260:Female; D047830:Gulf War; D006801:Humans; D007249:Inflammation / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D010976:Platelet Count; D013926:Thrombopoietin / Q000097:blood*; D013931:Thromboxanes / Q000008:administration & dosage*; D014728:Veterans
chemical_list: D013931:Thromboxanes; D019796:15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid; D002097:C-Reactive Protein; D013926:Thrombopoietin