Abstract
Abstract Platelets are the smallest and perhaps the most versatile components of human blood. Besides their role in coagulation and the maintenance of vascular integrity, they are involved in many physiological processes, ranging from immune response and leukocyte recruitment to the production of antimicrobial peptides and immune-suppressive factors like TGF-β. These versatile abilities make platelets interesting for researchers from different disciplines. However, beside profound investigation into platelets’ physiological role, there is a need for correct, standardized and thus reproducible quantification of platelet parameters. Mean platelet volume (MPV) is a widespread prognostic marker for several conditions, such as, acute coronary syndrome, chronic kidney disease and liver cirrhosis. Platelet activation is regarded as a marker for inflammatory processes, for example in autoimmune diseases such as type-1 diabetes, systemic lupus erythematosus and rheumatoid arthritis. The monitoring of platelet function is relevant for patients receiving antiplatelet medication. Platelet parameter measurement is affected by the choice of in vitro anticoagulant, the measurement technology and the time delay after sampling. This review focuses on the pre-analytical variability that arises as a result of the use of different in vitro anticoagulants and analyzer technologies when determining platelet parameters, since, even approximately 180 years after the discovery of platelets, there is still no standardized procedure.
Highlights
From “blood granules” and “colorless beads”It is not clear to whom the initial description of the platelet and its function is attributable
This review notes the pre-analytical variability that arises due to the choice of in vitro anticoagulation and measurement technology for the determination of platelet parameters
EDTA, the standard anticoagulant for platelet counting, causes a time-dependent platelet shape change with consecutive spontaneous platelet activation, and, in rare cases, the EDTA-dependent PTCP can lead to misdiagnosis
Summary
It is not clear to whom the initial description of the platelet and its function is attributable. As early as 1985, Towbridge and colleagues compared MPV and platelet count, as measured with an impedance-based analyzer (Coulter S Plus) and a light scattering-based analyzer (Technicon H6000) in K2-EDTA anti-coagulated blood samples. Mannuß and colleagues compared EDTA anticoagulated samples and MgSO4 anti-coagulated samples using impedance-based (XE 5000 and DxH 800) and a light-scattering-based analyzer (Advia 120) regarding platelet count and MPV measurement. The results of their investigation show that, in EDTA anti-coagulated samples, a significantly higher MPV is measured on the XE 5000 than on the DxH 800 and the Advia 120.
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