Abstract
Methods for identification of enhanced platelet function to date include measurements of spontaneous platelet aggregation, determinations for circulating platelet aggregates, and platelet hypersensitivity to the various aggregating agents. Platelet malonyldialdehyde (MDA) formation in the presence of either Nethyl maleimide (NEM) or Thrombin was evaluated as a method of identification of platelet hyperfunction. In 13 patients with either spontaneous aggregation (7/13), or enhanced sensitivity to minimal concentrations of ADP or Epinephrine (6/13), platelet MDA formation in the presence of NEM was markedly increased to 3.96 ± 0.16 (1SD) n moles/109 platelets when compared to a value of 3.10 ± 0.25 in 25 normal controls with normal aggregation patterns. Increased values (p<0.0005) were also observed when Thrombin induced MDA values in the patient group (1.82 ± 0.15) were compared to the values obtained in the control group (1.26± 0.19). Studies in all 13 abnormal subjects later revealed normal aggregation patterns in 7/13 on follow-up evaluation. Concomitant estimation of platelet MDA induced by either MDA or Thrombin now revealed a significant decrease into the normal range in these 7 patients. Since platelet MDA is a byproduct of the platelet endoperoxide PGG2, these results suggest that part of the phenomenon of platelet hypersensitivity is intrinsic to the platelet and involves an increase in platelet endoperoxide synthesis.
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