How does measurement of platelet P-selectin compare with other methods of measuring platelet function as a means of determining the effectiveness of antiplatelet therapy?

Measurement of P-selectin on activated platelets as a means of measuring platelet function utilizing the technology described here has the advantage of not requiring immediate access to specialist equipment and expertise. Blood samples are activated, fixed, stored, and transported to a central laboratory for flow cytometric analysis. Here we have compared P-selectin with other more traditional approaches to measuring platelet function in blood and/or platelet-rich plasma (PRP) from patients with acute coronary syndromes on treatment for at least 1 month with either aspirin and clopidogrel or aspirin with prasugrel. The comparators were light transmission aggregometry (LTA), VerifyNow and Multiplate aggregometry (for determining the effects of aspirin) and LTA, VerifyNow and Multiplate together with the BioCytex VASP phosphorylation assay (for the P2Y₁₂ antagonists). The P-selectin Aspirin Test revealed substantial inhibition of platelet function in all but three of 96 patients receiving aspirin with clopidogrel and in none of 51 patients receiving aspirin and prasugrel. The results were very similar to those obtained using LTA. There was only one patient with high residual platelet aggregation and low P-selectin expression. The same patients identified as “non-responders” to aspirin also presented with the highest residual platelet activity as measured using the VerifyNow system, although not quite as well separated from the other values. With the Multiplate test only one of these patients clearly stood out from the others. The results obtained using the P-selectin P2Y₁₂ Test in 102 patients taking aspirin and clopidogrel were similar to the more traditional approaches in that a wide scatter of results was obtained. Generally, high values seen with the P-selectin P2Y₁₂ Test were also high with the LTA, VerifyNow, Multiplate, and BioCytex VASP P2Y₁₂ Tests. Similarly, low residual platelet function using the P2Y₁₂ test was seen irrespective of the testing procedure used. However, there were differences in some patients. Prasugrel was always more effective than clopidogrel in inhibiting platelet function with none of 56 patients (P-selectin and VerifyNow), only 2 of 56 patients (Multiplate) and only 3 of 56 patients (Biocytex VASP) demonstrating high on-treatment residual platelet reactivity (HRPR) defined using previously published cut-off values. The exception was LTA where there were 11 of 56 patients with HRPR. It remains to be seen which experimental approach provides the most useful information regarding outcomes after adjusting therapies in treated patients.     

Temperature-influenced ordering of mesogens in comb-like liquid-crystalline poly(methylsiloxane) macromolecules with side groups consisting of “phenyl benzoate” moieties in solution

Comb-like poly(methylsiloxane) macromolecules P4, P6, and P11, with side groups consisting of “phenyl benzoate” moieties and different alkyl spacers (from 4 to 11 C-atoms) between the backbone and the mesogenic side groups have been synthesized and investigated as well as low-molar-mass compounds M4, M6, and M11, as model molecules analogous to side chains of the macromolecule. The liquid-crystalline phase transition temperatures have been determined. Mobility of the mesogens and the macromolecule as a whole in dilute solution was studied in external fields (electric and mechanical shear field). In dilute solution under the influence of a sinusoidal electric field, the polymer behaviour is typical of flexible-chain polymer molecules where each mesogenic unit is oriented independently of the other ones. This is in contrast to the effect observed in a mechanical shear flow field. The Maxwell constant in positive for the solutions of compounds M4, M6, M11 and negative in polymers P4, P6, P11. This indicates the orientation of the macromolecule as a whole in the shear flow field, the mesogenic group main axis being oriented in the direction preferably normal to the macromolecular axis of primary polarizability. Temperature effects are also discussed.