Platelet activation adhesion

The in vitro study of the hemocompatibility of biomaterials requires the consideration of many parameters, static or dynamic contact, flow rate, wall shear rate, form of biomaterial to be tested, pathway to consider (platelet adhesion, platelet activation, complement activation, contact phase activation etc..) and duration of contact(39). It has previously been demonstrated t t hemodynamic circumstances play a significant role in determining localization, growth and fiagmentation of thrombi and platelet adhesion in vivo, and that flow rate controls platelet transport to a surface and their adhesion (40). This evidence is siqtpoited by observed differences in platelet activity predominance in venous and arterial flow (41). Qearly, defining the blood compatibility of a material is a conqrromise between a number of these factors. 

The antiinflammatory effects of statins likely result from their ability to inhibit the formation of mevalonic acid. Downstream products of this molecule include not only the end product, cholesterol, but also several isoprenoid intermediates that covalently modify ( pre-nylate ) certain key intracellular signaling molecules. Statin treatment reduces leukocyte adhesion, accumulation of macrophages, MMPs, tissue factor, and other proinflammatory mediators. By acting on the MHC class II transactivator (CIITA), statins also interfere with antigen presentation and subsequent T-cell activation. Statin treatment can also limit platelet activation in some assays as well. All these results support the concept that in addition to their favorable effect on the lipid profile, statins can also exert an array of antiinflammatory and immunomodulatory actions. 

Collagen is a major component of connective tissue that becomes exposed at the subendothelium of injured blood vessels. It contributes to platelet adhesion and also plays a role in platelet activation by binding to several receptors on platelets such as integrin a 2(3 1 or glycoprotein VI (GP VI). 

Schafer A, Schulz C, Eigenthaler M, et al. Novel role of the membrane-bound chemokine fractalkine in platelet activation and adhesion. Blood 2004 103(2) 407—412. 

CD62P or P-selectin, which is a component of the platelet a granule membrane of resting platelets. It is expressed on the platelet surface membrane only after a granule secretion. P-selectin mediates the adhesion of activated platelets to neutrophils and monocytes. 

For pH sensors used in in-vivo applications, especially those in continuous pH monitor or implantable applications, hemocompatibility is a key area of importance [150], The interaction of plasma proteins with sensor surface will affect sensor functions. Thrombus formation on the device surface due to accelerated coagulation, promoted by protein adsorption, provided platelet adhesion and activation. In addition, variation in the blood flow rate due to vasoconstriction (constriction of a blood vessel) and sensor attachment to vessel walls, known as wall effect , can cause significant errors during blood pH monitoring [50, 126],... 

In practice, some anticoagulation agents such as heparin or antiplatelet agents, e.g. nitric oxide (NO) are delivered to sensor sites in order to reduce the risk of thrombus formation. Nitric oxide (NO), which is a potent inhibitor of platelet adhesion and activation as well as a promoter of wound healing in tissue, has been incorporated in various polymer metrics including PVC (poly(vinyl-chloride)), PDMS (poly-dimethyl-siloxane) and PU (poly-urethanes). Those NO release polymers have been tested in animals as outer protection coatings and have shown promising effects for the analytical response characteristics of the sensor devices [137],... 

Some active materials are carriers for drugs (drug delivery systems), some have immobilized peptides to enable cell adhesion or migration, some are degradable by hydrolysis or by specific enzyme action. Some contain bioactive agents (e.g., heparin, thrombomodulin) to prevent coagulation or platelet activation while others incorporate bioactive groups to enhance osteo-conduction. Many include polyethylene oxide to retard protein adsorption and this is perhaps the closest we have come to a kind of inertness. 

A partially or completely occlusive clot forms on top of the raptured plaque. Exposure of collagen and tissue factor induce platelet adhesion and activation, which promote release of adenosine diphosphate and thromboxane A2 from platelets. These produce vasoconstriction and potentiate platelet activation. A change in the conformation of the glycoprotein (GP) Ilb/IIIa surface receptors of platelets occurs that cross-links platelets to each... 

Von Willebrand factor Platelet-activating factor Adhesion molecules... 

Fig. 9.1. A dysfunctional or injured endothelium is at the basis for initiation of and progression to atherosclerosis. Several mechanisms, such as adhesion molecules or liberation of von Willebrand factor (vWf, upper panel), determine a series of phenomena, including platelet activation and aggregation. This participation of platelets involves the implication of molecules like glycoprotein Ilb/IIIa, fibrinogen, and von Willebrand factor. The endothelium also acts as a source of signals that regulate local functions, including VSMCs (lower panel). A list of the most relevant messengers produced by a functional and a dysfunctonal endothelium is presented in the lower panel...

Lewis, M. S. et al., Hydrogen peroxide stimulates the synthesis of platelet-activating factor by endothelium and induces endothelial cell-dependent neutrophil adhesion, J. Clin. Invest. 82, 2045-2055, 1988. 

DETA/NO is a stable NO-donor with the longest NO generation half-life of approximately 20 h. Thrombelastography performed on rabbit blood showed that DETA NONOate-derived NO significantly decreased coagulation activity and platelet activation [48]. Monitoring by intravital microscopy showed that DETA/NO attenuated the platelets/endothelial cells adhesion response to endotoxins (e.g. lipopolysaccharides) in murine intestinal venules [49]. The main mechanism of the antiadhesive action of DETA/NO on platelets was activation of soluble guanylate cyclase [49]. 

The balance of opposing pro- and anti-platelet forces determines the overall hemostatic response. Successful hemostasis is achieved when assorted signal-transduction systems, mediators, white blood cells, and platelet receptors for agonists and adhesion molecules overcome the local resistance against platelet activation to generate... 

The result was that albumin passivation came into vogue for sometime. In fact, artificial kidneys and blood oxygenators were often treated with albumin solutions prior to clinical use 118,119). There is considerable evidence that such pre-treatment did indeed result in decreased platelet adhesion and activation for short periods, perhaps up to several hours, but that the effect was relatively short-lived. 

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