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DOI: 10.1055/s-0038-1661667
Prolonged Bleeding Time, Reduced Platelet Aggregation, Altered PAF-Acether Sensitivity and Increased Platelet Mass Are a Trait of Asthma and Hay Fever
Publikationsverlauf
Received 01. Mai 1986
Accepted after revision 22. August 1986
Publikationsdatum:
18. Juli 2018 (online)
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Summary
In a case control study 31 asymptomatic patients with asthma and/or hay fever and 31 normal controls had their bleeding time measured using the Simplate II device and venostasis. Mean bleeding time in the atopic group (527 s) was significantly prolonged compared to the controls (393 s) (p <0.0005). Platelet aggregation to collagen and ADP (but not to PAF-acether) was significantly depressed in the atopies. Mean circulating platelet mass was significantly greater in atopies than in the controls (p = 0.006). Stepwise multiple regression analysis showed that within the control group bleeding time was best predicted by platelet mass (p = 0.007). No such relationship was found in the atopies. However stepwise multiple regression analysis showed that bleeding time in the atopies (but not in the controls) was best predicted by PAF-acether induced platelet aggregability (p <0.05). In neither group was bleeding time related to collagen induced platelet thromboxane B2 production.
It is hypothesised that in respiratory atopy the depressed aggregatory function of platelets is not compensated for sufficiently by an increase in platelet mass, leading to prolongation of the bleeding time. This haemostatic imbalance, whose cause remains to be established, appears to constitute a trait of atopy.
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References
- 1 Martin JF, Slater DN, Trowbridge EA. Abnormal intrapulmonary platelet production: a possible cause of vascular and lung disease. Lancet 1983; 1: 793-796
- 2 Morley J, Sanjar S, Page CP. The platelet in asthma. Lancet 1984; 2: 1142-1144
- 3 Knauer KA, Lichtenstein LM, Adkinson Jr NF, Fish J. Platelet activation during antigen-induced airway reactions in asthmatic subjects. N Eng J Med 1981; 304: 1404-1407
- 4 Cela G, Girolami A. Platelet activation during antigen-induced bronchoconstriction. N Eng J Med 1981; 305: 892-893
- 5 Gresele P, Graselli S, Todisco T, Nenci GG. Platelets and asthma. Lancet 1985; 1: 347
- 6 Green IA, Winter JH, Gaffney D. et al Platelets in asthma. Lancet 1984; 2: 1479
- 7 Durham SR, Dawes J, Kay AB. Platelets in asthma. Lancet 1985; 2: 36
- 8 Braquet P, Etienne A, Touvay C, Bourgain RH, Lefort J, Vargaftig BB. Involvement of platelet activating factor in respiratory anaphylaxis, demonstrated by PAF-acether inhibitor BN 52021. Lancet 1985; 1: 1501
- 9 Harker L, Slichter S. The bleeding time as a screening test for evaluation of platelet function. N Eng J Med 1972; 287: 155-159
- 10 Milner PC, Martin JF. Shortened bleeding time in acute myocardial infarction and its relation to platelet mass. Br Med J 1985; 290: 1767-1770
- 11 Martin JF, Trowbridge LA, Salmon G, Plumb J. The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. Throm Res 1983; 32: 443-460
- 12 Lind SE. Prolonged bleeding time. Am J Med 1984; 77: 305-312
- 13 Mielke Jr Ch, Kaneshiro MM, Mather IA, Weiner JM, Rappaport SI. The standardised normal Ivy bleeding time and its prolongation by aspirin. Blood 1969; 352: 204-215
- 14 Mielke Jr Ch. Aspirin prolongation of the template bleeding time; influence of venostasis and direction of incision. Blood 1982; 605: 1139-1142
- 15 Martin JF, Shaw T, Heggie J, Penington DG. Measurement of the density of human platelets and its relationship to platelet volume. Br J Haematol 1983; 54: 337-352
- 16 Bull BS, Schneiderman MA, Brecher G. Platelet counts with the coulter counter. Am J Clin Path 1965; 44: 678-688
- 17 Martin JF, Plumb J, Kilbey RS, Kishk YT. Changes in volume and density of platelets in myocardial infarction. Br Med J 1983; 287: 456-459
- 18 Jackson CA, Greaves M, Patterson AD, Brown CB, Preston FE. Relationship between platelet aggregation, thromboxane synthesis and albumin concentration in nephrotic syndrome. Br J Haematol 1982; 52: 69-77
- 19 Ni NH, Fry J, Hadlai Hull C. et al Statistical package for the social sciences (SPSS-X). New York: McGraw Hill: 1983
- 20 Levin J, Bessman D. The inverse relation between platelet volume and platelet number. J Lab Clin Med 1983; 101: 295-307
- 21 Meade TW, Vickers MV, Thompson SG, Stirling Y, Haines AP, Miller GJ. Epidemiological characteristics of platelet aggregability. Br Med J 1985; 290: 428-432
- 22 Solinger A, Bernstein IL, Glueck HI. The effect of epinephrine on platelet aggregation in normal and atopic subjects. J Allergy Clin Immunol 1973; 51: 29
- 23 Harwell WB, Patterson JT, Lieberman P, Beachey E. Platelet aggregation in normal and atopic subjects. J Allergy Clin Immunol 1973; 51: 274
- 24 McDonald JR, Tan EM, Stevenson DD, Vaughan JH. Platelet aggregation in asthmatic and normal subjects. J Allergy Clin Immunol 1974; 54: 200
- 25 Maccia CA, Gallagher JA, Ataman G, Glueck HI, Brooks SM, Bernstein IL. Platelet thrombopathy in asthmatic patients with elevated immunoglobulin E. J Allergy Clin Immunol 1977; 59: 101-108
- 26 Szczeklik A, Nizankowski R, Mruk J. Myocardial Infarction in status asthmaticus. Lancet 1977; 1: 658
- 27 Chapell AG. Painless myocardial infarction in asthma. Br J Dis Chest 1984; 78: 174-179
- 28 Jorgensen KA, Dyerberg J. Platelets and atherosclerosis. Dan Med Bull 1980; 27: 253-259
- 29 Harker LA, Ritchie JL. The role of platelets in acute vascular events. Circulation 1980; 62 (Suppl. 05) V-13-V-18
- 30 Holgate ST, Howarth PH. Treating hay fever. Br Med J 1985; 291: 92