Significance of Platelet-Derived Microparticles and Activated Platelets in Diabetic Nephropathy

Abstract

We measured levels of platelet-derived microparticles (PMP), which have coagulative activity and are produced by platelet activation or physical stimulation, and CD62P/CD63-positive platelets in patients with diabetes mellitus to determine their clinical significance and effects on complications of diabetes including diabetic nephropathy. We also compared these levels before and after administration of the antiplatelet drug cilostazol. Plasma PMP and CD62P/CD63-positive platelet levels were significantly higher in patients with diabetes mellitus than normal controls. CD62P-positive platelet levels were significantly higher in patients with nephropathy than in patients without complications. After administration of cilostazol, PMP and CD62P/CD63-positive platelet levels were significantly decreased. The increases in platelet activity and its related procoagulant activity appear to account in part for the hypercoagulability observed in diabetes mellitus. Our findings suggest that activated platelets might play a role in the development of diabetic nephropathy. Furthermore, antiplatelet therapy with cilostazol for diabetic patients may be useful as antithrombin therapy including antiplatelet therapy, since it suppresses the production of intrinsic coagulants produced by platelet activation.

Elevated Numbers of Tissue-Factor Exposing Microparticles Correlate With Components of the Metabolic Syndrome in Uncomplicated Type 2 Diabetes Mellitus

“…9,13,18 -21 Here, we found similar numbers of PMP in patients with uncomplicated type 2 diabetes and controls. The differential findings in diabetic patient populations may be explained by the presence of vascular complications, in particular diabetic nephropathy, 13 poor metabolic control, and the use of various drugs, including insulin. 21 In those studies, the authors suggested that PMP may play a role in vascular injury, as they reflect platelet activation and may stimulate endothelial cells to produce soluble vascular molecules.…”

“…Recently, increased numbers of platelet-derived MP (PMP) were reported in type 2 diabetic patients with poor metabolic control and microvascular complications. 13 To date, there are no data regarding the presence and function of MP in well-controlled patients with uncomplicated, recently diagnosed type 2 diabetes. Therefore, in this group of patients, we characterized MP with regard to numbers, cellular origin, TF exposure, and procoagulant properties.…”

Microvesicles and diabetic complications — novel mediators, potential biomarkers and therapeutic targets

“…[124] . A few studies have indicated that the levels of monocyte-derived MVs [14,55] , endothelial-derived MVs [74] , and platelet-derived MVs [70,125,126] are increased in patients with diabetic nephropathy. The increase in monocyte-derived MVs is most significant in patients with diabetic nephropathy among the T2DM patients with diabetic microangiopathy, ie, nephropathy, retinopathy, or neuropathy [14] .…”

“…The circulating platelet-derived MVs [70,125,126] , monocyte-derived MVs [14,55] , endothelial-derived MVs [74] , and MVs derived from renal mesangial cells [82] may act as mediators and influence endothelial function by simulating the release of cytokines and the expression of various adhesion molecules by endothelial cells, inducing the morphological changes that lead to angiogenesis induction in microvascular endothelial cells.…”

Fiberoptic bronchoscopy induces platelet activation

“…For example, soluble (s)P-selectin or platelet-derived microparticles have been detected in patients with diabetes mellitus, hypertension, hyperlipidemia and coronary artery diseases [1][2][3]. In addition, activated platelets are implicated in thrombosis after percutaneous coronary intervention [3,4].…”