Enhanced platelet activation by prolactin in patients with ischemic stroke

Henri Wallaschofski; Tobias Lohmann; Eva Hild; Anna Kobsar; Annelie Siegemund; E. Spilcke-Liss; Betina Hentschel; Christian Stumpf; Werner G. Daniel; Christian D. Garlichs; Martin Eigenthaler

doi:10.1160/TH05-09-0634

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(01): 38-44
DOI: 10.1160/TH05-09-0634

Platelets and Blood Cells

Schattauer GmbH

Enhanced platelet activation by prolactin in patients with ischemic stroke

Authors

Henri Wallaschofski

¹Department of Gastroenterology, Endocrinology and Nutrition, University of Greifswald
Tobias Lohmann

²City Hospital Dresden-Neustadt
Eva Hild

³Institute of Clinical Biochemistry and Pathobiochemistry, University of Würzburg
Anna Kobsar

³Institute of Clinical Biochemistry and Pathobiochemistry, University of Würzburg
Annelie Siegemund

⁴Laborgemeinschaft Reisig Ackermann Leipzig
E. Spilcke-Liss

¹Department of Gastroenterology, Endocrinology and Nutrition, University of Greifswald
Betina Hentschel

⁵Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig
Christian Stumpf

⁶Department of Internal Medicine II, University of Erlangen, Germany
Werner G. Daniel

⁶Department of Internal Medicine II, University of Erlangen, Germany
Christian D. Garlichs

⁶Department of Internal Medicine II, University of Erlangen, Germany
Martin Eigenthaler

³Institute of Clinical Biochemistry and Pathobiochemistry, University of Würzburg

Abstract

Summary

Prolactin and leptin are newly recognised platelet co-stimulators due to potentiation of ADP-induced platelet aggregation. Elevated leptin levels have recently been found to be a risk factor for ischemic stroke in both men and women, and especially in combination with increased blood pressure for hemorrhagic stroke in men. Until now an association between hyperprolactinemia and ischemic stroke has not been investigated systematically.We determined plasma prolactin and leptin levels as well as platelet P-selectin expression in 36 patients with ischemic stroke or transient ischemic attack and detecteda significant correlation between increased prolactin values and enhanced ADP stimulated P-selectin expression on platelets. In contrast, no correlation of leptin values with platelet P-selectin expression was found. Next we determined plasma prolactin and leptin as well as acquired and congenital risk factors of thrombophilia in patients with first-ever non-hemorrhagic stroke with or without atrial fibrillation. Excluding patients with such preexisting risk factors,21 patients with and 59 patients without atrial fibrillation were identified. Patients without atrial fibrillation revealed significantly higher plasma prolactin levels than patients with atrial fibrillation. Furthermore, the influence of aspirin or clopidogrel on prolactin stimulated P-selectin expression in vitro was tested, showing that aspirin was without effect,whereas clopidogrel significantly inhibited platelet P-selectin expression. In conclusion, hyperprolactinemia might be a novel risk factor for stroke mediating its thrombogenic effect through enhanced platelet reactivity, and this might correspond to a higher efficacy of antiplatelet combination therapy with clopidogrel compared to aspirin therapy alone.

Keywords

Platelets - CD62p - stroke - prolactin - leptin

Full Text

References

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