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Plasma P-selectin is increased in thrombotic consumptive platelet disorders
BH Chong, B Murray, MC Berndt, LC Dunlop, T Brighton and CN Chesterman
Department of Haematology, Prince of Wales Hospital, Sydney, NSW,
Australia.
P-selectin is a 140-kD protein found in the alpha-granules of platelets and
the Weibel-Palade bodies of endothelial cells that on cell activation is
expressed on the cell surface and also secreted into the plasma. The
secreted form of P-selectin, like plasma P-selectin, differed from platelet
membrane P-selectin in that its molecular mass was approximately 3 kD lower
under reducing conditions. Both the secreted and plasma forms of P-selectin
contained cytoplasmic sequence as determined by Western blot analysis with
an affinity-purified rabbit anti-P-selectin cytoplasmic peptide antibody.
We have measured plasma P- selectin and beta-thromboglobulin (beta TG)
concurrently in (1) patients with consumptive thrombotic disorders,
including disseminated intravascular coagulation (DIC), heparin-induced
thrombocytopenia (HIT), and thrombotic thrombocytopenic purpura
(TTP)/haemolytic uremic syndrome (HUS); (2) patients with idiopathic
thrombocytopenic purpura (ITP); and (3) healthy controls. Patients with
DIC, HIT, and TTP/HUS, but not ITP, had significantly elevated plasma
P-selectin and beta TG levels when compared with their age-matched healthy
controls. The increased plasma P-selectin and beta TG in patients with
thrombotic disorders were likely to be the result of in vivo platelet and
endothelial cell damage or activation. We also found that avoidance of
veno-occlusion and other tedious measures customarily taken during blood
collection and sample preparation to prevent in vitro platelet activation
did not affect plasma P-selectin assay results. In addition, plasma
P-selectin levels were not influenced by the presence of renal failure or
heparin administration. These results indicate that plasma P- selectin may
be a useful new marker for thrombotic diseases.
Volume 83,
Issue 6,
pp. 1535-1541,
03/15/1994
Copyright © 1994 by The American Society of Hematology
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