抗GPIbα抗体对维持性血液透析患者血小板膜糖蛋白Ibα和CD62P、CD63表达的影响

Effects of Anti-GPIbαantibody on the expression of platelet GPIbα,CD62P and CD63 in maintenance hemodialysis patients

目的研究抗GPIbα抗体对维持性血液透析患者外周血血小板膜糖蛋白Ibα(GPIbα)、α颗粒膜糖蛋白(CD62P)和溶酶体膜蛋白(CD63)表达量的影响,分析其与未添加抗体组、健康对照组的差异。方法选取2016年3月—2018年3月期间在中山大学附属第八医院接受维持性血液透析治疗的慢性肾衰竭患者37例和健康人群31例作为研究对象,采用流式细胞术检测健康人群、血液透析患者血小板加用抗GPIbα抗体前后血小板膜糖蛋白GPIbα、CD62P和CD63的表达变化情况。结果未添加抗GPIbα抗体实验组血小板GPIbα的阳性率(29.9±4.9)%明显低于对照组(63.8±9.0)%和添加抗GPIbα抗体实验组(42.3±6.5)%,差异具有统计学意义(均P<0.01)。未添加抗GPIbα抗体实验组血小板CD62P的阳性率为(50.9±7.5)%,明显高于对照组(23.3±8.7)%和添加抗GPIbα抗体实验组(36.5±2.0)%,差异具有统计学意义(P<0.01,P<0.05)。未添加抗GPIbα抗体实验组血小板CD63的阳性率为(54.1±5.5)%,明显高于对照组(30.9±6.2)%和添加抗GPIbα抗体实验组(47.2±2.2)%,具有统计学差异(P<0.01,P<0.05)。结论抗GPIbα抗体可以上调血小板GPIbα的表达和下调CD62P、CD63的表达,可调节血小板功能和活性,抑制血小板黏附、聚集和血栓形成,降低维持性血液透析患者血栓栓塞发生的可能性。

Objective To explore the effects of anti-platelet membrane glycoprotein Ib alpha(GPIbα)antibody on the expression of peripheral GPIbα,alpha particle membrane glycoprotein(CD62P)and lysosomal membrane protein(CD63)in maintenance hemodialysis(MHD)patients.Methods Thirty-seven patients with chronic renal failure undergoing MHD from March 2016 to March 2018 in the Department of Nephrology in Eighth Affiliated Hospital of Sun Yat-sen University and 31 healthy people in the Physical Examination Center were enrolled in this study.Using flow cytomery,the expression of platelet member GPIbα,CD62P and CD63 was detected before and after addition of anti-GPIbα antibody in MHD patients.Results The expression of platelet membrane GPIbα in no antibody treatment group(29.9±4.9)% was significantly lower than in control group(63.8±9.0)% and antibody treatment group(42.3±6.5)%(both P<0.01).The expression of CD62P and CD63 in no antibody treatment group(50.9±7.5)% and(54.1±5.5)% was significantly higher than that in the control group(23.3±8.7% and 30.9±6.2%)and antibody treatment group(36.5±2.0)% and(47.2±2.2)%(P<0.01,P<0.05).Conclusions Anti-GPIbα antibody can regulate platelet function and activity by up-regulating the expression of platelet membrane GPIbα,and down-regulating the expression of CD62P and CD63 in MHD patients,as a result to suppress adhesion and aggregation of platelets and thrombosis,and reduce the possibility of thromboembolism events in MHD patients.