Abstract
BackgroundPlatelets in patients with type 2 diabetes mellitus (DM2) are characterized by increased activation and aggregation, which tends to be associated with a high morbidity and mortality due to cardiovascular disease (CVD). Moreover, a large proportion of DM2 patients show an inadequate response to standard antiplatelet treatments, contributing to recurrent cardiovascular events. In our previous study, we indicated that Salvianolic acid A (SAA) presents an antiplatelet effect in healthy volunteers. However, whether it can inhibit “activated platelets” with a pathologic status has not been explored. Therefore, this study was designed to investigate the antiplatelet effect of SAA and its diabetic complication-related difference in DM2.MethodsForty patients diagnosed with DM2 from January 2018 to April 2018 were recruited. Fibrinogen-binding (PAC-1) and P-selectin (CD62p) flow cytometry reagents were measured under resting and stimulated conditions by flow cytometry, while agonist-induced platelet aggregation was conducted by light transmission aggregometry. Before all these measurements were conducted, all platelet samples were preincubated with a vehicle or SAA for 10 min. Additionally, the diabetic complication-related difference in the antiplatelet effect of SAA was further studied in enrolled patients.ResultsThe expressions of PAC-1 and CD62p were elevated in DM2, as well as the maximal platelet aggregation. In addition, SAA decreased the expressions of PAC-1 and CD62p, which were enhanced by ADP and thrombin (all P < 0.01). It also reduced the platelet aggregation induced by ADP (P < 0.001) and thrombin (P < 0.05). Comparing the antiplatelet effect of SAA on DM2, with and without diabetic complications, no statistically significant difference was found (all P > 0.05).ConclusionsThe present study demonstrated that SAA can inhibit platelet activation and aggregation in patients with DM2, and the inhibition did not abate for the existence of diabetic complications.
Highlights
Platelets in patients with type 2 diabetes mellitus (DM2) are characterized by increased activation and aggregation, which tends to be associated with a high morbidity and mortality due to cardiovascular disease (CVD)
Effects of Salvianolic acid A (SAA) on platelet aggregation The results showed that the mean maximal platelet aggregation was 90.33 ± 7.34% in the adenosine diphosphate (ADP) group, 86.10 ± 8.38% in the SAA + ADP group, 89.10 ± 7.80% in the Thrombin group, and 80.34 ± 21.27% in the SAA +
This antiplatelet effect is not less effective in Type 2 diabetes mellitus (DM2) patients with complications than in those without complications. All these findings enable a better understanding of the antiplatelet effect of SAA in DM2, which leads to the development of novel pharmaceutical strategies for the antiplatelet treatment of patients suffering from DM2
Summary
Platelets in patients with type 2 diabetes mellitus (DM2) are characterized by increased activation and aggregation, which tends to be associated with a high morbidity and mortality due to cardiovascular disease (CVD). We indicated that Salvianolic acid A (SAA) presents an antiplatelet effect in healthy volunteers. Whether it can inhibit “activated platelets” with a pathologic status has not been explored. A large proportion of DM patients, presenting “aspirin resistance” [6, 7] and the up-regulation of P2Y12 receptors, have a poor responsiveness to current antiplatelet agents, resulting in a high rate of adverse recurrent cardiovascular events. New antiplatelet agents are needed in to reduce the CVD risk of DM patients
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