Published Online
on August 3, 2006

A more recent version of this article appeared on September 1, 2006

This Article Full Text (PDF) All Versions of this Article: 37/9/2283    most recent 01.STR.0000236638.75591.61v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Htun, P. Articles by Gawaz, M. Search for Related Content PubMed PubMed Citation Articles by Htun, P. Articles by Gawaz, M. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Stroke Transient Ischemic Attack Related Collections Pathophysiology Aggregation Acute Cerebral Infarction Acute Stroke Syndromes Antiplatelets Transient Ischemic Attacks Platelets

Submitted on January 13, 2006
Revised on May 3, 2006
Accepted on May 30, 2006

Course of Platelet Activation and Platelet-Leukocyte Interaction in Cerebrovascular Ischemia

Patrik Htun MD; Suzanne Fateh-Moghadam MD; Bernd Tomandl MD; René Handschu MD; Kathrin Klinger MD; Konstantinos Stellos MD; Christoph Garlichs MD; Werner Daniel MD; and Meinrad Gawaz MD^*

From the Medizinische Klinik mit Schwerpunkt Nephrologie und Intensivmedizin (P.H.), Medizinische Klinik mit Schwerpunkt Kardiologie (S.F.-M), Charité-Campus Virchow-Klinikum, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin und Freie Universität Berlin, Berlin; Klinik für Neuroradiologie (B.T.), Klinikum Bremen Mitte, Bremen; Neurologische Klinik (R.H.), Friedrich Alexander Universität, Erlangen-Nürnberg; Medizinische Klinik mit Schwerpunkt Nephrologie IV (K.K.), Friedrich Alexander Universität, Erlangen Nürnberg; Medizinische Klinik III (K.S., M.G.), Universitätsklinikum, Tübingen; and Medizinische Klinik mit Schwerpunkt Kardiologie (C.G., W.D.), Friedrich Alexander Universität, Erlangen-Nürnberg, Germany.

^* To whom correspondence should be addressed. E-mail: meinrad.gawaz{at}med.uni-tuebingen.de.

Background and Purpose--Platelet activation plays a crucial role in the pathophysiology of cerebral ischemia. The aim of this study was to investigate the contribution of platelet activation and leukocyte-platelet interactions to the disease.

Methods--One hundred thirty-five patients with transient ischemic attack (TIA) or stroke were enrolled in this single-center study. They underwent cranial computer tomography within 24 hours of clinical onset and after 3 months, and systemic venous blood samples were drawn. Platelet activation (CD62P expression), leukocyte activation (L-selectin expression), and the appearance of platelet-specific antigens on leukocytes as an index of platelet-leukocyte aggregation were measured by flow cytometric techniques in the acute state and at 3-month follow-up.

Results--Patients with a completed stroke or TIA had significantly increased circulating platelet-leukocyte aggregates, increased P-selectin expression on platelets, and decreased L-selectin expression in the acute state compared with the control group (healthy volunteers). No differences in regard to the tested activation markers could be detected between patients with stroke or TIA in the acute phase of the disease. However, platelet and leukocyte activations were normalized after 3 months in patients with TIA, whereas leukocyte activation (reduced L-selectin expression) remained in stroke patients.

Conclusions--In patients with TIA and completed stroke, platelet and leukocyte activation is substantially enhanced in the acute phase of the disease. The sustained leukocyte activation observed in stroke but not in TIA patients at 3-month follow up might play a pathophysiological role in the course of the disease.

Key words: cerebral ischemia, transient • leukocytes • platelet activation • platelets • stroke

This article has been cited by other articles:

				H.-K. Yip, L.-T. Chang, W.-N. Chang, C.-H. Lu, C.-W. Liou, M.-Y. Lan, J. S. Liu, A. A. Youssef, and H.-W. Chang Level and Value of Circulating Endothelial Progenitor Cells in Patients After Acute Ischemic Stroke Stroke, January 1, 2008; 39(1): 69 - 74. [Abstract] [Full Text] [PDF]

				J. Villagra, S. Shiva, L. A. Hunter, R. F. Machado, M. T. Gladwin, and G. J. Kato Platelet activation in patients with sickle disease, hemolysis-associated pulmonary hypertension, and nitric oxide scavenging by cell-free hemoglobin Blood, September 15, 2007; 110(6): 2166 - 2172. [Abstract] [Full Text] [PDF]