血小板活化因子与IgA肾病

IgA肾病是一种多发病,常见病,早期不予重视.最终将发展成为肾功能衰竭.给社会造成了很大的负担,研究探索IgA肾病的发病机制及治疗依然显得相当重要,本文将论述血小板活化因子在IgA肾病免疫损伤、治疗中的相关性,进一步明确血小板活化因子在IgA肾病发病中的重要作用.     

血小板活化因子与IgA肾病

IgA肾病是一种多发病,常见病,早期不予重视.最终将发展成为肾功能衰竭.给社会造成了很大的负担,研究探索IgA肾病的发病机制及治疗依然显得相当重要,本文将论述血小板活化因子在IgA肾病免疫损伤、治疗中的相关性,进一步明确血小板活化因子在IgA肾病发病中的重要作用.     

血小板活化因子与IgA肾病

IgA肾病是一种多发病,常见病,早期不予重视.最终将发展成为肾功能衰竭.给社会造成了很大的负担,研究探索IgA肾病的发病机制及治疗依然显得相当重要,本文将论述血小板活化因子在IgA肾病免疫损伤、治疗中的相关性,进一步明确血小板活化因子在IgA肾病发病中的重要作用.     

Platelet-activating factor contributes to postischemic vasospasm

BACKGROUND: The purpose of the present study was to determine if platelet-activating factor is an important mediator that produces vasospasm during reperfusion after ischemia in skeletal muscle. MATERIALS AND METHODS: A vascular isolated cremaster muscle in male Sprague-Dawley rats was coupled with local intraarterial drug infusion as a model to study microcirculation responses to ischemia/reperfusion injury. Arteriole diameters and capillary perfusion were measured using intravital microscopy. Group 1: platelet-activating factor dose response. Group 2: Effects of a cyclooxygenase inhibitor; indomethacin, and a thromboxane synthetase inhibitor, imidazole, on the response to platelet-activating factor. Group 3: Effects of nitric oxide synthesis inhibitor; N(omega)-nitro-L-arginine methyl ester, on the response to platelet-activating factor. Group 4: Effects of a platelet-activating factor receptor antagonist, CV-3988, indomethacin, and imidazole after 4 h of warm ischemia and reperfusion. RESULTS: Intraarterial infusion of platelet-activating factor produced a dose-related but mild vasoconstriction. Pretreatment with indomethacin or imidazole resulted in significant vasodilation actually emanating from platelet-activating factor infusion. Nitric oxide inhibition (with N(omega)-nitro-L-arginine methyl ester) enhanced the vasoconstriction produced by platelet-activating factor. Pretreatment with CV-3988, indomethacin, or imidazole significantly attenuated ischemia/reperfusion-induced vasospasm and capillary no-reflow in the cremaster muscles. CONCLUSIONS: Ischemia/reperfusion-induced vasoconstriction is at least in part mediated by platelet-activating factor and thromboxane A(2).     

Platelet-activating factor and antiphospholipid antibodies in subarachnoid haemorrhage

Summary The purpose of this study was to measure plasma platelet-activating factor (PAF) concentration, PAF-acetylhydrolase activities, anti-phospholipid antibody (aPLs) titers, and platelet function in patients with subarachnoid haemorrhage (SAH) and to assess the association of these variables with the development of cerebral vasospasm.Thirty-two patients with SAH due to ruptured cerebral aneurysm were studied. Plasma PAF concentration, PAF-acetylhydrolase activity, platelet count and aggregability, and plasma factor 4 (PF 4) concentrations were measured regularly until approximately 2 weeks after SAH. aPLs, including lupus anticoagulant and anti-cardiolipin IgG and IgM were measured within 3 days after SAH.Plasma PAF concentration in patients with SAH showed the highest value on the occasion during 5 to 9 days after SAH. The concentrations were higher in patients with infarction due to vasospasm than in patients without cerebral infarction on any occasions after SAH. Plasma PAF-acetylhydrolase activities did not change in patients, regardless of the presence of cerebral infarction after SAH. Increased platelet consumption and aggregability and higher concentrations of PF 4 were detected in patients with cerebral infarction and not in patients without cerebral infarction. The patients with cerebral infarction due to cerebral vasospasm had aPLs more frequently than the control volunteers.Our findings indicate that increased plasma PAF and aPLs may contribute to the pathogenesis of cerebral vasospasm after SAH.     

Platelet-activating factor primes endotoxin-stimulated macrophage procoagulant activity

Macrophage procoagulant activity (PCA) at the site of inflammation may be induced by several stimuli including bacteria and endotoxin (LPS). The local factors controlling PCA induction are poorly defined. The lipid mediator platelet-activating factor (PAF) is ubiquitous to inflammatory sites. To determine the effect of PAF on LPS-induced PCA, thioglycolate-elicited murine peritoneal macrophages were exposed to PAF (10(-7) M) or control medium for 30 min and then stimulated with LPS (10 micrograms/ml) for 2, 4, or 6 hr. The ability of macrophages to shorten the clotting time of plasma (ie., PCA) was then measured and clotting times were converted to PCA units using a thromboplastin standard. Cytosolic calcium ([Ca2+]i) measurements were made using the calcium-sensitive fluorescent dye indo-1. PAF alone did not induce a rise in PCA expression (medium alone, 47 +/- 11 mU/10(6) cells; PAF alone, 49 +/- 12 mU/10(6) cells at t = 4 hr), but PAF treatment prior to LPS exposure resulted in a significant increase in the LPS-stimulated expression of PCA (LPS alone, 190 +/- 29 mU/10(6) cells; PAF/LPS, 329 +/- 57 mU/10(6) cells at t = 4 hr, P less than 0.05). This priming effect was reversed by the PAF antagonist WEB 2086 (WEB/PAF/LPS, 196 +/- 31 mU/2 x 10(6) cells). Stimulation of cells with PAF alone resulted in a rapid rise in [Ca2+]i (resting, 213 +/- 19 nmole; peak, 577 +/- 35 nmole). This effect was also inhibited by WEB 2086. These data suggest that PAF plays an important role in the modulation of PCA production by macrophages.(ABSTRACT TRUNCATED AT 250 WORDS)     

Platelet-activating factor in porcine Pseudomonas acute lung injury

We investigated the role of platelet-activating factor (PAF) in acute septic lung injury by examining the effects of the selective PAF antagonist SRI 63-675 and by measuring PAF in lung tissue in the porcine model. Four groups of pigs (15-25 kg) were studied: saline control (C, n = 5); Pseudomonas (Ps, n = 9), given 5 x 10(8) CFU/ml at 0.3 ml/20 kg/min intravenously over 1 hr; SRI (n = 3), given SRI 63-675 in a 40 mg/kg bolus; and SRI + Ps (n = 5). Ps infusion produced a fulminant lung injury characterized by a threefold increase in pulmonary arterial pressure at 30 min and persistent pulmonary hypertension (P less than 0.05 vs C), a significant (P less than 0.05 vs C) decrease in arterial oxygen tension (PaO2) from 60 min, a significant (P less than 0.05 vs C) increase in extravascular lung water (EVLW) from 120 min, and a significant (P less than 0.05 vs C) increase in albumin flux determined scintigraphically as slope index at 150-180 min. Systemic arterial pressure and cardiac index (CI) decreased significantly (P less than 0.05) in the Ps group vs C at 60 and 180 min, respectively. Bolus injection of SRI 63-675 at the time of Ps infusion blocked the early pulmonary hypertension, attenuated the early and late fall in PaO2, ameliorated the increase in EVLW, and prevented the late (150-180 min) increase in albumin flux. SRI 63-675 had minimal effects on Ps-induced hypotension or alterations in CI.(ABSTRACT TRUNCATED AT 250 WORDS)     

Platelet-activating factor and progressive brain damage following focal brain injury

The effects of a platelet-activating factor (PAF) antagonist on brain edema, cortical microcirculation, blood-brain barrier (BBB) disruption, and neuronal death following focal brain injury are reported. A neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used to induce highly reproducible focal cortical lesions in anesthetized rats. Secondary brain damage in this model was characterized by progressive cortical hypoperfusion, edema, and BBB disruption in the vicinity of the hemispheroid lesion occurring acutely after injury. The histopathological evolution was followed for up to 4 days. Neuronal damage in the cortex and the hippocampus (CA-1) was assessed quantitatively, revealing secondary and progressive loss of neuronal tissue within the first 24 hours following injury. Pretreatment with the PAF antagonist BN 50739 ameliorated the severe hypoperfusion in 12 rats (increasing local cerebral blood flow from a mean +/- standard error of the mean of 40.5% +/- 8.3% to 80.2% +/- 7.8%, p less than 0.01) and reduced edema by 70% in 10 rats (p less than 0.05) acutely after injury. The PAF antagonist also reduced the progression of neuronal damage in the cortex and the CA-1 hippocampal neurons (decrease of neuronal death from 88.0% +/- 3.9% to 49.8% +/- 4.2% at 24 hours in the cortex and from 40.2 +/- 5.0% to 13.2% +/- 2.1% in the hippocampus in 30 rats; p less than 0.05). This study provides evidence to support progressive brain damage following focal brain injury, associated with secondary loss of neuronal cells. In this latter process, PAF antagonists may provide significant therapeutic protection in arresting secondary brain damage following cerebral ischemia and neurological trauma.     

Platelet-activating factor: improvement in wound healing by a chemotactic factor.

Platelet-activating factor (PAF) is chemotactic for inflammatory cells and activates macrophages but, unlike growth factors, which have been demonstrated to accelerate healing, it has no effects on cell proliferation. The possible role of PAF in wound healing has not been explored previously. We examined the effect of different topical concentrations of PAF on the paired rat surgical incision model. Samples harvested on different days after wounding were evaluated for tensiometry and histology. Samples treated with 1 microgram, but not with 0.1 or 10 micrograms, showed an increase in maximal breaking strength (33.2%, 25.6%, and 4.9% by days 5, 7, and 12, respectively), reaching significance on days 5 and 7. Samples treated with 1 microgram PAF demonstrated a greater cellular infiltration (fibroblasts and monocytes) on day 7. Further histochemical studies revealed an increase of macrophages by day 7. Treatment with PAF receptor antagonist blocked the response to PAF but had no effect on normal wound healing, suggesting that, although PAF can accelerate healing, its endogenous production does not play a key role in normal wound repair. Our results demonstrate promotion of wound healing by PAF, a phospholipid chemotactic factor not previously shown to have wound-healing properties. This study gives new insights into how cytokines act to promote healing and suggests a strategy for improving wound repair with a monocyte chemotactic factor.     

Platelet-activating factor priming of inflammatory cell activity requires cellular adherence

BACKGROUND: Platelet-activating factor (PAF) primes tissue-fixed inflammatory cells, but has no effect on circulating cells. Adherence of inflammatory cells leads to cytoskeletal reorganization, which is essential for optimal inflammatory function. The purpose of this study was to investigate whether cellular adherence plays a role in PAF priming of inflammatory cells. METHODS: Differentiated THP-1 cells were maintained under adherent and nonadherent conditions. Selected cells were pretreated with PAF, followed by endotoxin stimulation. Cellular and nuclear proteins were analyzed by Western blot for components of the Toll-like receptor-mediated signaling cascade. Cytokine analysis was performed by enzyme-linked immunosorbent assay. RESULTS: Endotoxin led to activation of interleukin (IL)-1-associated kinase, extracellular signal-regulated kinase 1/2 and p38, and nuclear translocation of nuclear factor-kappaB, all of which were significantly enhanced by previous cellular adherence. PAF led to priming only under adherent conditions, demonstrated by increased IL-1-associated kinase and extracellular signal-regulated kinase 1/2 activity; nuclear factor-kappaB translocation; and IL-6, IL-8, and tumor necrosis factor-alpha production over non-PAF-treated cells. PAF had no significant effect on p38 activity or IL-10 production under any condition. CONCLUSIONS: PAF primes mononuclear cells by increasing Toll-mediated signaling only under adherent conditions. This, therefore, would limit PAF-induced priming in vivo to foci of stimulated adherent inflammatory cells with little effect systemically on circulating cells.     

Chronic thromboembolic pulmonary hypertension and pulmonary thromboendarterectomy

Chronic thromboembolic pulmonary hypertension results from incomplete resolution of a pulmonary embolus or from recurrent pulmonary emboli. Its incidence is underappreciated, and it is currently an undertreated phenomenon. Pulmonary thromboendarterectomy is currently the safest and most effective treatment for this condition. The surgery involves midline sternotomy, profound hypothermic circulatory arrest, and complete endarterectomy of the pulmonary vascular tree. Success depends on effective coordination of multiple medical teams, including pulmonary medicine, anesthesiology, and surgery. This review, based on the past 30 years of experience at University of California San Diego Medical Center, includes information about the clinical history, diagnostic workup, anesthesia, surgical approach, and postoperative care. Outcome data are discussed, as are avenues for future research.     

Platelet-activating factor acetylhydrolase in the male reproductive tract: origin and properties

The properties and origin of platelet-activating factor acetylhydrolase- (PAF-AH)-like activity in the male reproductive tract were investigated. Seminal plasma (SP) and serum were obtained from normal donors and infertile patients while prostatic fluid (PF), seminal vesicle fluid (SVF) and vas deferens fluid were collected at autopsy. PAF-AH-like activity was found in all fluids tested. The specific activity of the enzyme in SP and PF was twice that of PAF-AH in serum and 15–fold higher than that in SVF and vas deferens fluid. In SP, PAF-AH-like activity was Ca++-independent, acid and heat labile, stable to freezing, not inhibited by phosphatidylcholine, but was inhibited by 10 mM disopropylfluoro-phosphate (DFP) and 13 mM phenylmethylsulfonylfluoride (PMSF). These data indicate that the properties of the enzyme in SP are similar to those reported for PAF-AH in serum. The variation in specific activity of PAF-AH in reproductive tract fluids suggest that there are either activators of PAF-AH in SP or inhibitors in one or several of the other reproductive tract fluids.     

Platelet-activating factor (PAF) and the formation of chronic subdural haematoma

Summary In order to estimate the contribution of platelet-activating factor (PAF) to the formation of chronic subdural haematomas (CSH), we measured plasma PAF and anti-PAF antibody levels in head-injured patients with and without CSH and normal volunteers. Plasma PAF and anti-PAF IgG levels were higher in patients with CSH than in patients without CSH or in normal volunteers. Furthermore, plasma PAF and anti-PAF IgG levels increased in a time-dependent manner over the first 35 days following head injury. These data suggest that PAF may be involved in the generation of CSH.     

Platelet-activating factor (PAF) and the development of chronic subdural haematoma

Summary Platelet activating factor (PAF) content and PAF-acetylhydrolase (PAFAH) activity were measured in the plasma and haematoma of 34 chronic subdural haematoma (CSH) patients. The plasma PAF level in patients with CSH was higher than that in healthy controls. Although there was no correlation between the plasma PAF levels and the interval between the onset of symptoms and the day of sampling, namely, the interval after bleeding, the haematoma PAF level gradually decreased according to the interval after the onset of symptoms. There was no difference between plasma PAFAH activity in patients with CSH and that in healthy controls, and haematoma enzyme activity gradually increased correlated with the interval between the onset of symptoms and surgery. In addition, the localization of PAF in haematoma capsules was histochemically determined. PAF was solely localized to the peri-sinusoidal vessels in the outer membrane of haematoma capsules. Based on these biochemical and histochemical studies, we speculated that PAF may play a role in the development of chronic subdural haematomas.