Summary
Adenosine diphosphate (ADP) and thrombin are agonists of platelet aggregation in which
intracellular calcium plays a significant role as a signal transducer. Lead is a well
established toxicological agent affecting intracellular mechanisms controlling free
ionized calcium concentration in a number of cell lines. This epidemiological study
is the first demonstration of a significant relationship between the extent of primary
ADP-induced platelet aggregation measured by optical densitometry in platelet rich
plasma (PRP) and blood lead concentration. High blood lead levels are associated with
decreased aggregation in this population of 2,150 men aged 49-65 years. This is reflected
by a negative regression relationship of –0.19% of maximal extent (PRP vs platelet
poor plasma) of aggregation per εg of Pb/dl (T = –3.82, p <0.001). In contrast, no relationship is noted between thrombin-induced aggregation
and blood lead concentration. Smoking behaviour represents a potential confounder
which may be the explanation for the observed relationship. However, because smoking
status is simultaneously related to both ADP- and thrombin-induced aggregation, but
is simultaneously related to ADP-induced aggregation and blood lead concentration
in a different way, the observed relation is likely to be causal. The mechanisms by
which ADP and thrombin effect intracellular calcium transduction signals appear to
be distinctively different. The findings in this population-based study are not inconsistent
with this difference.