Large platelets circulate in an activated state in diabetes mellitus

D Tschoepe, P Roesen, J Esser… - … in thrombosis and …, 1991 - thieme-connect.com
D Tschoepe, P Roesen, J Esser, B Schwippert, HK Nieuwenhuis, B Kehrel, FA Gries
Seminars in thrombosis and hemostasis, 1991thieme-connect.com
It has been suggested that platelets play a key role in the pathogenesis of accelerated
vasculopathy in patients with diabetes mellitus. 1 Figure 1 shows some of multiple reported
functional and ultrastructural deviations on different levels of the megakarocyte platelet
system, which may basically contribute to the increased func tional response of platelets in
diabetes mellitus. Partic ularly, the finding of increased numbers of membrane glycoprotein
receptors IB and IIB/IIIA for cytoadhesive plasma proteins is regarded as reflecting a primary …
It has been suggested that platelets play a key role in the pathogenesis of accelerated vasculopathy in patients with diabetes mellitus. 1 Figure 1 shows some of multiple reported functional and ultrastructural deviations on different levels of the megakarocyte platelet system, which may basically contribute to the increased func tional response of platelets in diabetes mellitus. Partic ularly, the finding of increased numbers of membrane glycoprotein receptors IB and IIB/IIIA for cytoadhesive plasma proteins is regarded as reflecting a primary change on the level of megakaryocytic thrombopoiesis (Fig. 2). This could then result in the release of platelets with increased functional properties, which means an increased peripheral thrombotic mass. 2 However, it is controversial whether increased platelet functional prop erties or intravascular activation contributes to pathogen esis and progression of angiopathic complications in diabetes mellitus. 3-6 So far, the crucial question remains as to whether an increased functional potential of plate lets has any particular pathophysiologic relevance: Do platelets circulate in an activated state in patients with diabetes mellitus?
Diagnostic identification of individual patients with increased in vivo platelet activation might have direct therapeutic implications. 7 Elevated plasma levels of β-thromboglobulin and platelet factor 4 as indirect mark ers of in vivo platelet activation were demonstrated in patients with diabetes mellitus. 8-10 Interpretation of these
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