Platelet-derived microparticles and their cargos: The past, present and future

All eukaryotic cells can secrete extracellular vesicles, which have a double-membrane structure and are important players in the intercellular communication involved in a variety of important biological processes. Platelets form platelet-derived microparticles (PMPs) in response to activation, injury, or apoptosis. This review introduces the origin, pathway, and biological functions of PMPs and their importance in physiological and pathological processes. In addition, we review the potential applications of PMPs in cancer, vascular homeostasis, thrombosis, inflammation, neural regeneration, biomarkers, and drug carriers to achieve targeted drug delivery. In addition, we comprehensively report on the origin, biological functions, and applications of PMPs. The clinical transformation, high heterogeneity, future development direction, and limitations of the current research on PMPs are also discussed in depth. Evidence has revealed that PMPs play an important role in cell-cell communication, providing clues for the development of PMPs as carriers for relevant cell-targeted drugs. The development history and prospects of PMPs and their cargos are explored in this guidebook.

Effect of treatment with Fufang Huangqi decoction(复方黄杞汤剂) on dose reductions and discontinuation of pyridostigmine bromide tablets, prednisone, and tacrolimus in patients with type Ⅰ or Ⅱ myasthenia gravis

OBJECTIVE: To investigate the clinical efficacy of Fufang Huangqi decoction(复方黄杞汤剂) in combination with pyridostigmine bromide tablets, prednisone, and tacrolimus in the treatment of type Ⅰ and Ⅱ myasthenia gravis(MG) through changes in the clinical symptom scores of 100 patients with type Ⅰ and Ⅱ MG. This study also aimed to examine dose reductions and discontinuation of these 3 Western medicines after administration of Fufang Huangqi decoction. METHODS: The clinical data on 100 patients with type I or II MG who were treated in the outpatient department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, China, between June 2017 and June 2020 were collected. The patients were divided into 4 groups based on whether they had taken pyridostigmine bromide tablets, prednisone, and/or tacrolimus at the time of their hospital visit: the Fufang Huangqi decoction group(group A), the pyridostigmine bromide tablets + Fufang Huangqi decoction group(group B), the pyridostigmine bromide tablets + prednisone + Fufang Huangqi decoction group(group C), and the pyridostigmine bromide tablets + tacrolimus + Fufang Huangqi decoction group(group D). The average treatment time was(15.6 ± 11.5) months(range: 0.5-55 months). Changes in the clinical symptom scores of the 4 groups of patients after medication administration and dose reductions and discontinuation of the 3 Western medicines were analyzed. RESULTS: An overall effectiveness rate of 86.00% was achieved in the 100 patients after treatment for(15.6 ± 11.5) months(range 0.5-55 months). The effectiveness rates were 85.71% in group A, 88.24% in group B, 76.92% in group C, and 80.00% in group D. The dosage of pyridostigmine bromide was reduced for 69.12% of the patients in group B for the first time after(4.2 ± 4.1) months, and 45.59% of the patients in group B discontinued pyridostigmine bromide after(8.8 ± 6.1) months. The dosage of pyridostigmine bromide was reduced for 46.15% of the patients in group C for the first time after(5.3 ± 3.4) months, and 23.08% of the patients in group C discontinued pyridostigmine bromide after(19.8 ± 11.0) months;76.92% reduced hormone dosage after(2.8 ± 1.9) months, and 23.08% discontinued hormone treatment after(6.7 ± 2.9) months. The dosage of pyridostigmine bromide was reduced for 1 patient in group D after 1 month;this patient discontinued pyridostigmine bromide after 3 months and reduced tacrolimus dosage after 5 months. One patient in group D discontinued pyridostigmine bromide and tacrolimus on his own initiative at 0.5 months and took Fufang Huangqi decoction for 2 months without discontinuing Western medicine. CONCLUSION: Fufang Huangqi decoction is effective for the treatment of type Ⅰ and Ⅱ MG and improves the associated clinical symptoms. Moreover, this agent is conducive to dose reductions and discontinuation of basic Western medicines, thereby reducing the side effects experienced by patients.