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Platelet number in different anticoagulants as a diagnostic biomarker for increased intestinal permeability

机译:不同抗凝血剂中的血小板数量作为诊断生物标志物,用于增加肠道渗透性

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The main pathological process associated to increased intestinal permeability is the translocation of toxic products, predominantly endotoxins/lipopolysaccharide (LPS), from the intestinal tract into the microcirculation. In blood, LPS binds to surface receptors on immune cells initiating an inflammatory response. LPS can also bind to platelets leading to preactivated platelets that have a lower threshold to be aggregated in presence heparin. The aim of this study was to validate a simple, fast and reliable test for screening LPS-loaded platelets. This test named PANDA (acronym for Platelet Number in Different Anticoagulants) consists in the measurement of the mean platelet number in blood samples collected into EDTA and heparin. We analyzed blood samples from 92 patients with gastrointestinal diseases and 23 healthy volunteers and found a markedly low number of platelets in heparinized blood compared to EDTA-anticoagulated blood in patients but not in healthy volunteers. Furthermore, ex vivo addition of endotoxin to blood samples induced a remarkable decrease in platelet count in heparinized blood of the volunteers but not in the patient's group, where platelets could be previously saturated by endotoxin circulating in blood. Platelet should be counted during the first hour after blood collection, in order to avoid false results due to a progressive platelet aggregation in heparinized blood in function of the time. Our results demonstrated that PANDA test can be used for screening LPS-loaded platelets as an indirect diagnostic biomarker for increased intestinal permeability and also for monitoring the gut barrier function during the treatment of gastrointestinal diseases.
机译:与肠道渗透率增加相关的主要病理过程是毒性产物的易位,主要是内毒素/脂多糖(LPS),从肠道进入微循环。在血液中,LPS与免疫细胞上的表面受体结合,引起炎症反应。 LPS还可以与血小板结合,导致血小板的血小板具有较低阈值的肝素在存在肝素中聚集。本研究的目的是验证筛选LPS加载血小板的简单,快速可靠的测试。该试验命名为熊猫(不同抗凝剂中的血小板号的首字母缩略词)包括测量收集到EDTA和肝素中的血液样本中的平均血小板号。我们分析了92例胃肠道疾病和23例健康志愿者的血液样本,并发现肝素化血液中的血小板数明显低,而不是在患者的EDTA-抗凝血液中,但不在健康的志愿者中。此外,前毒素对血液样品的前毒素添加到血液样品中的血小板计数显着降低,但不在患者的群体中,其中血小板可以通过血液中的内毒素循环饱和。血小板应该在血液收集后的第一个小时内计算,以避免由于肝素化血液中的渐进血小板聚集而导致的假结果。我们的研究结果表明,熊猫试验可用于筛选LPS加载的血小板作为间接诊断生物标志物,用于增加肠道渗透性,并且还用于在治疗胃肠疾病期间监测肠道屏障功能。

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