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(Stroke. 2007;38:1636.)
© 2007 American Heart Association, Inc.

Research Reports

Are Circulating Endothelial-Derived and Platelet-Derived Microparticles a Pathogenic Factor in the Cisplatin-Induced Stroke?

Daniel Periard, MD; Chantal M. Boulanger, PhD; Stephan Eyer, MD; Nicolas Amabile, MD; Paul Pugin, MD; Christiane Gerschheimer Daniel Hayoz, MD

From the Service of Angiology (D.P., D.H.), University Hospital, Lausanne, Switzerland; INSERM (C.M.B., N.A.), Centre de Recherche Cardiovasculaire, Hôpital Lariboisière, Paris, France; the Department of Internal Medicine (S.E.), University Hospital, Lausanne, Switzerland; the Department of Internal Medicine (P.P., D.H.), Hôpital Cantonal, Fribourg, Switzerland; and the Laboratory of Hemostasis (C.G.), University Hospital, Lausanne, Switzerland.

Correspondence to Dr Daniel Periard, Service of Angiology, PMU 07, Bugnon 44, Lausanne, Switzerland 1011. E-mail Daniel.Periard{at}chuv.ch

Background and Purpose— To evaluate whether cisplatin-induced stroke is mediated by vascular toxicity with release of prothrombotic endothelial and platelet-derived microparticles (MPs).

Methods— Endothelial (CD31⁺CD41^–), platelets (CD31⁺CD41⁺) and prothrombotic (Annexin V⁺) circulating MPs were quantified by flow cytometry in 18 patients with cancer, before and 3 days after administration of cisplatin, and compared with 18 healthy controls. Thrombin-antithrombin complex and prothrombin fragments (F₁₊₂) were measured as markers of the activation of the coagulation.

Results— In patients with cancer, baseline levels of circulating prothrombotic, endothelial and platelet-derived MPs were similar to healthy controls and decreased significantly after administration of cisplatin. High-baseline MPs levels were observed in 5 patients who received cisplatin for a second or third cycle. A high-baseline activation of the coagulation was observed in all patients without further increase after cisplatin infusion.

Conclusion— Cisplatin treatment is immediately followed by a decrease in circulating levels of endothelial and platelet-derived MPs. However, a transient increase in MPs is observed at the second and third infusion, and this may contribute to the cisplatin-induced stroke.

Key Words: brain infarction • cancer & stroke • cisplatin • microparticles

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