Correlation between Serum IgG, Platelet Membrane IgG, and Platelet Function in Hypergammaglobulinaemic States

S ummary . Platelet membrane IgG levels were measured by the complement lysis inhibition test, and were correlated with serum IgG levels in 29 patients with elevated immunoglobulins due to multiple myeloma, benign monoclonal gammopathy, systemic lupus erythematosis, rheumatoid arthritis, benign hypergammaglobulinaemic purpura and systemic infection. Platelet membrane IgG was increased in proportion to the elevation of serum IgG with a highly significant correlation coefficient (0.5615, P ≤0.01), irrespective of the underlying disease state. Further washing of the platelets did not significantly alter the amount of membrane bound IgG. Qualitative platelet defects were present in nine of the 10 myeloma patients in whom platelet aggregation, platelet factor 3 availability, platelet adhesion to glass beads and bleeding times were studied. The most severe abnormalities occurred in those patients having the highest levels of platelet membrane IgG. Platelet function was normal despite markedly elevated platelet bound IgG in one patient with benign hypergammaglobulinaemic purpura. These findings indicate that elevation of serum IgG must be excluded before inferring the presence of platelet autoantibodies in patients with elevated platelet bound IgG. They also support the concept that the qualitative platelet abnormalities seen in multiple myeloma result from platelet coating by abnormal immunoglobulins or are secondary to myeloma effect on bone marrow.     

Alpha-tocopherol, an effective inhibitor of platelet adhesion

Platelet adhesiveness was tested ex vivo in a group of six normal individuals receiving varying doses of alpha-tocopherol. Adhesion to glass slides coated with fibronectin, collagen, fibrinogen, or plasma proteins was studied by perfusing platelet-rich plasma through a flow chamber that allowed time- and space-resolved observations of platelet adhesion. Platelet adherence was measured in an area of parallel flow lines and low shear rate under standardized conditions before and after dietary supplementation with vitamin E at doses of 200 and 400 IU/d. Platelet adherence differed in magnitude depending on the adhesive surface. There was a distinct preference of platelets to adhere to sites that had been previously occupied. A remarkable decrease in platelet adherence was observed after vitamin E supplementation. The average decrease in adhesion after 2 weeks of 200 IU vitamin E was 75%. After 2 weeks of 400 IU vitamin E, platelet adhesion was reduced by 82%. The inhibitory activity of alpha-tocopherol was dose dependent and correlated well with the increase in alpha-tocopherol concentration in platelets after supplementation. Scanning electron microscopy revealed a striking decrease of pseudopodium formation in alpha-tocopherol- enriched platelets. Our results suggest that vitamin E may also be an effective antiadhesive agent in vivo.     

Platelet interaction with subendothelial extracellular matrix: platelet- fibrinogen interactions are essential for platelet aggregation but not for the matrix-induced release reaction

Cultured endothelial cells produce an extracellular matrix (ECM) to which platelets adhere and spread, ultimately resulting in platelet aggregation, thromboxane B2 production, and serotonin release. We have investigated the role of fibrinogen binding to the platelet GPIIb/IIIa complex in these reactions by comparing normal platelet-rich plasma (PRP), PRP from patients with Glanzman's thrombasthenia (whose platelets lack the GPIIb/IIIa complex), PRP in the presence of a monoclonal antibody that blocks the binding of fibrinogen to the GPIIb/IIIa complex, platelets washed free of fibrinogen, and washed platelets to which fibrinogen was added. Although platelet aggregation was virtually completely inhibited in the samples in which the normal interaction between fibrinogen and GPIIb/IIIa was impaired, adhesion of platelets to the matrix, spreading, and release of [14C]-serotonin were not affected. All of the platelet preparations released significant amounts of T X B2 with time, but there was a decrease in the amount produced by both the thrombasthenic and antibody-treated platelets. We conclude that the interaction of fibrinogen with platelet GPIIb/IIIa is not required for platelet adhesion to ECM or for adhesion-induced shape change or serotonin release. On the other hand, the platelet-fibrinogen interaction may play some role in augmenting adhesion-induced T X B2 production, and it is absolutely required for adhesion-induced platelet aggregation.     

A Study of Platelet Retention by Glass Bead Columns (''Platelet Adhesiveness'' in Normal Subjects)

S ummary . Platelet adhesiveness tests using glass bead columns were performed in 54 normal subjects. Native blood was forced through the columns by a syringe pump at a flow rate of 6 ml/min, and effluent blood was collected in four aliquots of 2 ml each. The first two aliquots demonstrated a progressive increase in per cent platelet adhesiveness with maximum adhesiveness achieved in the second aliquot. The third and fourth aliquots showed decreased adhesiveness with a progressive broadening of the range of normal. In 11 of the 54 normal subjects the fourth aliquot of effluent blood contained more platelets than the original whole blood and indicated that platelets previously retained by the column were being returned to the effluent. The per cent platelet adhesiveness in the first aliquot did not vary with the platelet count. However, the absolute number of platelets retained by the column increased as the platelet count increased. Moreover, the number of platelets retained from a given aliquot was directly proportional to the number of platelets retained from previous aliquots. The return of platelets to the effluent in the fourth aliquot was associated with the smallest number of platelets retained from the first three aliquots. Adenosine inhibited the retention of platelets by glass bead columns. Retention of platelets by glass bead columns appears to be determined by platelet adhesion to glass surfaces, platelet to platelet aggregation due to released ADP, and spontaneous platelet disaggregation which becomes evident when the initial number of retained platelets provides an insufficient amount of ADP to sustain aggregation.     

Adhesion of platelets to surface-bound fibrinogen under flow

After platelet activation, fibrinogen mediates platelet-platelet interactions leading to platelet aggregation. In addition, fibrinogen can also function as a cell adhesion molecule, providing a substratum for adhesion of platelets and endothelial cells. In this report, we studied the adhesion of platelets to surface-immobilized fibrinogen under flow in different shear rates. Heparinized whole blood containing mepacrine-labeled platelets was perfused for two minutes at various wall shear rates from 250 to 2,000 s-1 in a parallel plate flow chamber. The number of adherent fluorescent platelets was quantitated every 15 seconds with an epifluorescent videomicroscope and digital image processing system. When compared with platelet adhesion and aggregation seen on glass surfaces coated with type I bovine collagen, a significant increase in platelet adhesion was observed on immobilized fibrinogen up to wall shear rates of 800 s-1. The adherent platelets formed a single layer on fibrinogen-coated surfaces. Under identical conditions, no significant adhesion was observed on fibronectin- or vitronectin-coated surfaces. Although platelet adhesion to collagen was substantially inhibited by the platelet inhibitors prostaglandin E1 and theophylline, these inhibitors had no effect on platelet adhesion to fibrinogen. Platelets adhered to recombinant homodimeric wild-type (gamma 400-411) fibrinogen, but not to the recombinant homodimeric gamma' variant of fibrinogen. Platelet adhesion to recombinant fibrinogen with RGD to RGE mutations at positions alpha 95-97 and alpha 572-574 was similar to that with plasma-derived fibrinogen. These results show that platelets adhere to fibrinogen-coated surfaces under moderate wall shear rates, that the interaction is mediated by the fibrinogen 400-411 sequence at the carboxy-terminus of the gamma chain, and that the interaction is independent of platelet activation and the RGD sequences in the alpha chain.     

Platelet satellitism and phagocytosis by neutrophils: Association with antiplatelet antibodies and lymphoma

Satellitism and phagocytosis of platelets by neutrophils in EDTA anticoagulated blood have been considered in vitro phenomena without clinical significance. We observed these in a patient with acute, severe thrombocytopenic purpura who subsequently proved to have malignant lymphoma. Wide oscillations in the platelet count were noted and recurrent, severe gastrointestinal bleeding occurred even when the platelet count was normal. Platelet function was abnormal as shown by decreased platelet adhesion to glass beads, absence of a secondary wave of aggregation in response to ADP and epinephrine, and no aggregation with collagen. Suspension of control platelets in the patient's plasma induced similar aggregation defects in the control platelets. Combination chemotherapy resulted in regression of lymphadenopathy, but platelet abnormalities and bleeding persisted. Platelet satellitism and phagocytosis by neutrophils seen on peripheral blood films may be associated with true thrombocytopenia, abnormal platelet function and bleeding with an underlying systemic disease.     

Hereditary Giant Platelet Syndrome

The platelets from two related patients with the hereditary giant platelet syndrome were examined. They were larger than normal but otherwise ultrastructurally normal; they contained increased storage pools of adenine nucleotides and heparin-neutralizing activity and took up serotonin at an increased rate. They aggregated normally with ADP and collagen but failed to aggregate with bovine factor VIII and Ristocetin. Some change in shape occurred with ADP, and the reduction in adenylate energy change after addition of ADP to platelet-rich plasma was smaller than normal. Platelet coagulant activities including contact product forming activity, intrinsic factor-Xa forming activity and platelet factor 3 activity were normal or increased, but collagen-induced coagulant activity was absent whether tested in washed platelet suspensions or platelet-rich plasma. Platelet washing experiments showed decreased binding of factors V and VIII to hereditary giant platelets and no detectable factor XI in washed platelet suspensions. It is concluded that (1) the hereditary giant platelets studied lacked a binding mechanism for factors, V, VIII and XI; (2) the normal development of collagen-induced coagulant activity apparently depends upon the binding of factor XI to the platelet membrane; and (3) the defective prothrombin consumption observed in these patients may have resulted from the failure of their platelets to bind factor XI.     

Thrombospondin inhibits adhesion of platelets to glass and protein- covered substrata

Glass and protein-covered surfaces when treated with the platelet- secreted glycoprotein thrombospondin lose their capacity to bind unstimulated platelets. In comparison to the number that bind to fibronectin-covered glass surfaces, less than 3% bind to thrombospondin- covered glass surfaces. When the fibronectin-covered surface is incubated with thrombospondin, it loses 87% of its binding capacity for platelets. The inhibitory effect of thrombospondin on platelet binding increases with increasing amounts of the adsorbed protein and reaches maximal values at 65% saturation of the adsorption of thrombospondin to the surface. Platelet spreading on the surface is also completely inhibited by thrombospondin. These data suggest that thrombospondin is nonthrombogenic and can modulate platelet adhesion to the subendothelium.     

The potent platelet inhibitory effects of S-nitrosated albumin coating of artificial surfaces

OBJECTIVES: We studied the antithrombotic effect of coating glass, collagen and metal stent surfaces with bovine serum albumin (BSA) covalently modified to carry S-NO functional groups denoted (pS-NO-BSA). METHODS: Video-enhanced light microscopy was used to visualize canine blood platelet adhesion and aggregation in a parallel plate glass chamber. Platelet adhesion was observed for 60 min on glass, glass coated with BSA, glass coated with pS-NO-BSA, collagen I (CO) surface, CO coated with BSA and CO coated with pS-NO-BSA. We also coated Palmaz-Shatz (P-S) stents with pS-NO-BSA. Coated and uncoated stents were then immersed in porcine platelet-rich plasma for two min and the platelet cyclic GMP level was measured. In six anesthetized pigs, coated and uncoated stents were placed in the carotid arteries and [111In]-labeled platelets were circulated for 2 h. The stented arteries were then removed and placed in a gamma well counter. RESULTS: There was significantly less platelet attachment, adhesion and aggregation on the pS-NO-BSA coated surfaces compared with the BSA coated and uncoated surfaces. The pS-NO-BSA coating increased the platelet cGMP levels to 5.9+/-0.7 pmoles/10(8) platelets compared with 2.7+/-0.9 pmoles/10(8) platelets for control (p < 0.01). The average gamma ray count from [111In]-labeled platelets that attached to the coated stents was 90,000+/-42,000/min and 435,000+/-290,000/min for the uncoated stents (p < 0.01). CONCLUSIONS: The pS-NO-BSA coating of thrombogenic surfaces reduces platelet adhesion and aggregation, possibly by increasing the platelet cGMP. This inhibitory effect appears to be a consequence of the direct antiplatelet actions of NO combined with the antiadhesive properties of albumin.     

ADP-Induced Aggregation of Washed Platelets Effect of Platelet and Plasma Fibrinogen

ADP-induced aggregation of washed human and porcine platelets has been studied. Plasma from a patient genetically deficient in fibrinogen lacked ADP-cofactor activity. Apyrase totally inhibited the small platelet aggregation observed after addition of fibrinogen to washed platelets. Lysates of washed porcine platelets contained 1.34 mg/10⁹ platelets of protein in the soluble form and 0.44 mg/10⁹ platelets as insoluble protein. Platelet fibrinogen in soluble fraction was 0.16 mg/10⁹ platelets. Partly purified porcine platelet fibrinogen showed cofactor activity for ADP-induced aggregation of washed porcine platelets, but compared to plasma fibrinogen a higher concentration of the platelet fibrinogen was needed to obtain the same effect.     

The Fluid-phase SC5b-9 Terminal Complement Complex Binds to the GPIIb/IIIa Complex of Thrombin-stimulated Human Blood Platelets Inhibiting Platelet Aggregation

We have investigated interactions between human blood platelets and the vitronectin-containing fluid-phase terminal complement complex, the SC5b-9, which is a non-cytolytic variant of the membrane attack complex C%9(m). SC5b-9 affinity for the platelet membrane glycoprotein IIb/IIIa (GPIIb/IIIa) complex was demonstrated by crossed radio-immunoelectrophoresis of solubilized, washed platelets followed by incubation of the immunoplates with ¹²⁵I-labelled SC5b-9 and exposure to X-ray films. Platelet adhesion to surfaces of polystyrene coated with the SC5b-9 complex was studied under static conditions in an enzyme immunoassay (EIA). Thrombin-stimulated platelets but not non-stimulated platelets adhered to the SCSb-9coated surface, and platelet adherence was inhibited in a dose-dependent manner by the tetrapeptide RGDS (Arg-Gly-Asp-Ser). This indicates an interaction between platelet GPIIb/IIIa and an RGD sequence in SC5b-9, possibly in its vitronectin moiety. The effect of the SC5b-9 complex on platelet aggregation was examined in a dual-channel aggregometer. Here the SC5b-9 complex inhibited both ADP-and thrombin-induced platelet aggregation in a dose-dependent manner. These results were confirmed by electron microscopical examination of the contents of the aggregometer cuvettes. Platelets which had been thrombin-stimulated in the presence of SC5b-9 appeared activated and had undergone secretion, but showed no aggregation. By contrast, platelets from the control experiments which had been thrombin-stimulated in the absence of SC5b-9 were aggregated. To the best of our knowledge, this is the 6rst report on a biological role of the SC5b-9 complex in platelet function.     

Platelet and Fibrinogen Sequestration

1. Small amounts of thromboplastin intravenously cause platelet sequestration. This is followed by fibrinogen sequestration. Large doses of intravenously administered thromboplastin lead to irreversible destruction or utilization of platelets and fibrinogen.

2. The following theories are advanced: (a) This platelet sequestration maybe due to platelet clumping caused by coagulation occurring on the plateletsurface. Surface coagulation may be initiated by the action of thromboplastinor thrombin on the plasma proteins and calcium adsorbed on the plateletsurface. The platelet clumps may be filtered out in the sinusoidal spaces of thebody, especially in liver and spleen. (b) The coagulation on the platelet surface may lead to partial polymerization of the fibrinogen molecule. (c) As longas this polymerization is reversible, the entire process remains reversible. Whenpolymerization proceeds far enough so as to become irreversible, the plateletsand fibrinogen can no longer return to the circulation. (d) This same mechanism may explain other examples of platelet sequestration.

     

Albumin Density Gradient Separation and Washing of Platelets and the Study of Platelet Coagulant Activities

Summary: Platelets were centrifuged into a specific gravity gradient made by mixing the interface between platelet rich plasma (PRP) and a 40–45% aqueous solution of bovine albumin. By this method of albumin density gradient separation (ADGS) it was possible to centrifuge platelets without disruptive squashing upon a hard surface. The separated platelets were washed in calcium-free Tyrode's solution without releasing coagulant activity. Platelet yields after multiple washings were high. Morphology and ADP-induced aggregation of platelets washed by ADGS (in contrast to platelets washed by conventional methods) were indistinguishable from those of unwashed platelets tested as PRP.
The activities of factors V and XI remained in close association with platelets after four successive washes by ADGS, whereas factors VIII, IX and XII were entirely removed.     

Fibronectin is required for platelet adhesion and for thrombus formation on subendothelium and collagen surfaces

Fibronectin (FN) plays a role in several adhesion mediated functions including the interaction of platelets with subendothelium. We investigated the role of plasma FN in platelet adhesion and platelet thrombus formation under flow conditions. We used two different perfusion models: the annular chamber with alpha-chymotrypsin-treated rabbit vessel segments, and the flat chamber with coverslips coated with fibrillar purified human collagen type III. Perfusates consisted of washed platelets and washed RBCs, suspended in normal or FN-depleted plasma. Perfusions were carried out for ten minutes at shear rates of 300 or 1,300 s-1. Platelet deposition and thrombus dimensions were evaluated morphometrically by a computerized system. We found that depletion of plasma fibronectin significantly reduced the percentage of total coverage surface and percentage of platelet thrombus, at both shear rates studied, and in both perfusion systems (P less than .01) (P less than .01). The dimensions of the platelet thrombi formed in perfusions at high shear rate were also significantly reduced in perfusions carried out with FN depleted plasma (P less than .01). Addition of purified FN to FN-depleted perfusates restored all values to those measured in the control perfusions. These results indicate that plasma FN is required for platelet aggregate and thrombus formation following adhesion under flow conditions.     

Effects of Cephalothin and Penicillin G on Platelet Function in Vitro

High concentrations of cephalothin or penicillin G inhibit a number of the functions of human or rabbit platelets in citrated platelet-rich plasma (PRP) and in suspensions of washed platelets. The reactions shown to be inhibited are: ADP-induced shape change and the primary and secondary phases of aggregation and release induced by ADP or adrenaline in human citrated PRP; release and aggregation of washed human platelets exposed to collagen, thrombin, vasopressin, or the ionophore A23,187; aggregation of washed human platelets exposed to phytohaemagglutinin from Phaseolus vulgaris (PHA) or polylysine; release induced by concanavalin A or PHA in suspensions of washed platelets from rabbits; platelet adherence to a collagen-coated surface or to the damaged intimal surface of the rabbit aorta; platelet factor 3 availability; lysis of rabbit platelets by an antiserum directed against them; and clot retraction. Neither antibiotic affected serotonin-induced aggregation; a high concentration of cephalothin slightly inhibited the initial rate of serotonin uptake. Penicilloic acid showed about half the inhibitory effect of penicillin G on ADP-induced aggregation. In citrated human platelet-rich plasma, ampicillin and oxacillin inhibited ADP-induced aggregation to the same extent as similar concentrations of penicillin G; in suspensions of washed platelets, however, ampicillin was less inhibitory than penicillin G or oxacillin. Platelet ultrastructure, assessed by transmission electron microscopy, was not visibly altered. Evidence that the antibiotics become bound to platelets is the finding that platelets incubated with the antibiotics and resuspended in fresh media showed less response to aggregating agents compared with control platelets. Penicillin G and related antibiotics may be inhibitory because they coat the platelet surface. Their effects on platelet functions are probably responsible for excessive bleeding and increased bleeding times observed in patients and volunteers receiving high doses of these antibiotics.     

The Fluid-phase SC5b-9 Terminal Complement Complex Binds to the GPIIb/IIIa Complex of Thrombin-stimulated Human Blood Platelets Inhibiting Platelet Aggregation

We have investigated interactions between human blood platelets and the vitronectin-containing fluid-phase terminal complement complex, the SC5b-9, which is a non-cytolytic variant of the membrane attack complex C%9(m). SC5b-9 affinity for the platelet membrane glycoprotein IIb/IIIa (GPIIb/IIIa) complex was demonstrated by crossed radio-immunoelectrophoresis of solubilized, washed platelets followed by incubation of the immunoplates with (125)I-labelled SC5b-9 and exposure to X-ray films. Platelet adhesion to surfaces of polystyrene coated with the SC5b-9 complex was studied under static conditions in an enzyme immunoassay (EIA). Thrombin-stimulated platelets but not non-stimulated platelets adhered to the SCSb-9coated surface, and platelet adherence was inhibited in a dose-dependent manner by the tetrapeptide RGDS (Arg-Gly-Asp-Ser). This indicates an interaction between platelet GPIIb/IIIa and an RGD sequence in SC5b-9, possibly in its vitronectin moiety. The effect of the SC5b-9 complex on platelet aggregation was examined in a dual-channel aggregometer. Here the SC5b-9 complex inhibited both ADP-and thrombin-induced platelet aggregation in a dose-dependent manner. These results were confirmed by electron microscopical examination of the contents of the aggregometer cuvettes. Platelets which had been thrombin-stimulated in the presence of SC5b-9 appeared activated and had undergone secretion, but showed no aggregation. By contrast, platelets from the control experiments which had been thrombin-stimulated in the absence of SC5b-9 were aggregated. To the best of our knowledge, this is the 6rst report on a biological role of the SC5b-9 complex in platelet function.     

Defective platelet adhesion on vessel subendothelium in uremic patients

Bleeding time, platelet retention on glass beads, and ristocetin- induced platelet agglutination (RIPA) in platelet-rich plasma were simultaneously determined for 20 patients with chronic renal failure and previous hemorrhagic history. In seven patients chosen at random out of a group of 16 in whom the three tests were abnormal, RIPA of uremic-isolated platelets in presence of normal platelet-poor plasma (PPP) and of normal platelets in presence of patient PPP were performed. In all cases, the first assay showed diminished agglutination, suggesting a platelet defect; however, uremic PPP did not inhibit the agglutination of normal platelets. In the same patients, the interaction of platelets with subendothelium was evaluated using Baumgartner's perfusion method. The subendothelial surface covered by platelets was significantly decreased in experiments with uremic whole blood when compared to normal controls. The interaction of platelets with subendothelium was also decreased when perfusions were carried out with platelet-plasma mixtures containing either normal washed platelets and uremic PPP or uremic washed platelets and normal PPP. These results show an impaired platelet adhesion caused both by a platelet and a plasmatic abnormality. Since uremic PPP decreased the adhesion of normal platelets to subendothelium but did not inhibit RIPA, it seems probable that the plasmatic defect could result in a defective binding between vWF and subendothelium. The influence of the red cell count on the platelet adhesion to subendothelium was reconfirmed by comparing perfusions of reconstituted blood with hematocrit values of 20% to 23% and 40% to 45%. In summary, a defective platelet adhesion to subendothelium has been postulated in uremic patients, caused by platelet and plasmatic alterations that are influenced by a low hematocrit.     

Vitamin E reduces platelet adhesion to human endothelial cells in vitro

Although it has been reported that vitamin E (alpha-tocopherol) can reduce platelet adhesiveness and aggregation in vivo, the mechanism is still unknown. Therefore, the aim of the present study was to determine whether incubations of platelet-rich plasma (PRP) with vitamin E influence platelet adhesion to cultured endothelial cells. To exclude blood plasma involvement, also washed platelets were pretreated with alpha-tocopherol. Vitamin E (0.5-1.0 mM) was added to PRP or washed platelets. Endothelial cells in monolayer were incubated with thrombin-activated platelets (1 or 2 U/ml). After 1 hr of incubation, non-adhered platelets were removed and counted. Treating of PRP with alpha-tocopherol inhibited platelet adhesion to endothelial cell monolayer. This effect was dose dependent on concentrations of alpha-tocopherol and thrombin. In our experiments PRP was treated with alpha-tocopherol and endothelial cell monolayer was used as test surface. These findings agree with previous observations on the adhesivity of platelets to synthetic surfaces after dietary vitamin E in healthy volunteers. When washed platelets were incubated with alpha-tocopherol, no significant reduction of adhesion was detectable. As preincubation of washed platelets with alpha-tocopherol does not inhibit platelet adhesion, it may be supposed that the effect of vitamin E does not occur in a directly cellular mechanism. The data suggest that alpha-tocopherol may reduce platelet adhesiveness probably after incorporation by plasma lipoproteins.     

Platelet adhesion onto a polystyrene surface under static conditions: role of specific platelet receptors and effect of divalent cations

An experimental model was used to elucidate the basic mechanisms involved in the interaction of platelets with an artificial surface. The role of divalent cations and the involvement of specific platelet membrane receptors were evaluated. Isolated platelets were allowed to interact with a polystyrene surface for 20 min in the presence of divalent cations (Ca2+, Mg2+ or Zn2+), a chelating agent (ethylenediaminetetraacetic, EDTA), and specific antibodies to the main platelet receptors, glycoproteins (GP) Ib and IIb-IIIa. The degree of platelet interaction was evaluated using light and electron microscopy. Morphometric analysis was performed to follow up the progression of platelet shape changes after surface activation. Neither Ca2+ nor Mg2+ influenced the number of adherent platelets or the degree of spreading on the polymer. Only Zn2+ induced a statistically significant increase in the rate of platelet adhesion (P<0.01) with higher proportion of fully spread platelets (P<0.01). Chelation of internal pools of divalent cations did not modify the rates of platelet adhesion but prevented platelet spreading. Presence of monoclonal antibodies to GPIb and GP IIb-IIIa did not result in significant differences in the studied parameters. These results suggest that platelet adhesion onto artificial surfaces, in the absence of flow and plasma proteins, is more dependent on cellular motility, where Zn2+ could play an important role, and less dependent on major receptorial mechanisms.     

EDTA-induced changes in platelet structure and function: adhesion and spreading

Ethylenediamine tetraacetic acid (EDTA) is an effective anticoagulant, but unfortunately causes structural, biochemical and functional damage to human platelets. Some of the functional injuries, such as adhesion to and spreading on surfaces, are considered irreversible. The present investigation has evaluated that hypothesis. Our findings indicate that platelets from EDTA platelet-rich plasma (PRP) or CCD PRP to which EDTA has been added do not adhere to glass or plastic surfaces. However, when platelets from EDTA PRP or CCD PRP containing added EDTA are washed and resuspended under conditions reported to cause irreversible dissociation ofthe fibrinogen receptor, GPIIb/IIIa, then washed and resuspended in buffer containing Ca 2+ and Mg 2+ ions will adhere and spread in the same manner as platelets not exposed to EDTA. The ability to recover adhesive function may explain why EDTA platelets are able to sustain clot retraction as well as CCD platelets.