Akut Submaksimal Egzersizin Trombosit Aktivasyonu ve Endotel Üzerine Etkisi

Öz

Trombositlerin koroner hastalığın oluşumundaki önemli rolleri egzersizin trombosit fonksiyonları üzerine etkisinin yoğun olarak araştırılmasına yol açmıştır. Literatürde farklı süre ve şiddette, akut ve kronik egzersize trombosit yanıtlarına dair çok sayıda çalışma vardır. Katekolaminlerin artışı, α adrenerjik reseptör aktivasyonu, trombosit sayısında, PGI2/TxA2 dengesinde, trombositlerin NO ve PGI2’e duyarlılığındaki değişiklikler gibi farklı mekanizmalar trombositlerin egzersize verdiği yanıtın altında yatan mekanizmalar olarak öne sürülmektedir. Sunulan çalışmada, orta şiddette akut egzersizin trombosit aktivasyonuna etkileri ve bu etkide endotelin rolünün araştırılması amaçlandı. Bu amaçla, trombosit aktivasyon göstergesi olarak trombosit glikoprotein IIbIIIa (GPIIb/IIIa) düzeyleri, endotel fonksiyonunu değerlendirmek amacı ile plazma NO düzeyi ve trombositlerde NO yanıtına aracılık eden cGMP düzeyleri değerlendirildi. Çalışmaya 19 sedanter, sağlıklı erkek gönüllü katıldı. Gönüllülere 15 dakikalık %60 VO2max şiddetinde bisiklet egzersizi uygulandı. Egzersiz öncesi ve hemen sonrası alınan kan örneklerinden trombosit GPIIb/IIIa, plazma NO ve trombosit cGMP düzeyleri ELISA yöntemi ile ölçüldü. GPIIb/IIIa düzeyleri egzersiz sonrası istatistiksel olarak anlamlı derecede (p=0.024) düşük bulundu. Egzersiz öncesi ve sonrası plazma NO düzeyleri ile trombosit cGMP düzeylerinde istatistiksel olarak anlamlı bir değişim gözlenmedi. Plazma NO ve trombosit cGMP düzeyleri ile trombosit GPIIb/IIIA düzeyleri arasında korelasyon saptanmadı. Trombosit GPIIb/IIIa seviyelerinde düşüş literatürdeki şiddetli egzersiz ile trombosit fonksiyon artışı, orta şiddette egzersiz ile trombosit fonksiyonlarında değişme olmaması ya da trombositlerin baskılanması bulguları ile uyumludur. Plazma NO düzeyi ve trombosit cGMP düzeyinde değişiklik olmaması inhibisyonun farklı mekanizmalarla olabileceğini düşündürmüştür.

Anahtar Kelimeler

• Akut egzersiz,Submaksimal egzersiz,Trombosit,GPIIbIIIa,Endotel,NO

The Effect of Submaximal Acute Exercise on Platelet Activation and Endothelium

Öz

The key role of platelets in the pathogenesis of coronary heart disease prompted considerable interest on the effect of exercise on platelets. There are several studies shown the effects of various intensities and durations of acute or chronic exercise on platelets. The exact mechanisms and the regulatory pathways concerned in the effect of exercise on platelet function are not completely understood. Increase in plasma levels of cathecolamines, change in the performance of 􀁄􀀐adrenergic reseptors, increase in platelet count, PGI2/TxA2 imbalance, impaired sensity of platelets to prostacyclin (PGI2) and nitric oxide (NO) have been suggested as probable mechanisms. In the present study we aimed to examine the effect of submaximal exercise on platelet activation and the role of endothel. Platelet glycoprotein IIb/IIIa (GPIIb/IIIa) as a marker of platelet activation and NO as a marker of endothel activation, and cGMP which mediates the intracellular effects of NO in platelets were evaluated. Nineteen, sedentary male volunteers (aged 18-25) participated the study. Volunteers performed 15 minutes of cycling exercise at a workload that increased their heart rate to 60% of the maximal. Platelet GPIIb/IIIa, plasma NO and platelet cGMP were measured by enzyme-linked immunassay (ELISA) before and immediately after the exercise. Platelet GPIIb/IIIa significantly decreased after the exercise protocol (p=0.024). No significant difference was found between plasma NO and cGMP. There was no correlation between platelet GPIIb/IIIa and both plasma NO and platelet cGMP levels. The data was confirmed by the literature. The submaximal exercise performed in the present study was inhibited by the platelet activation since NO levels did not increase. We found no clear-cut relationship between platelet GPIIb/IIIa and plasma NO. It was thought that different mechanisms were involved in the inhibition of platelets.

Anahtar Kelimeler

• Acute,Submaximal,Exercise,Platelets,Endothel

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