Çocuklarda Astım Atağında Trombosit Aktivasyonun Değerlendirilmesi

Öz

Amaç: Astım havayollarının kronik inflamatuvar bir hastalığıdır. Allerjik inflamasyon özellikle mast hücreler, eozinofiller, T lenfositler ve trombositlerin toplanmasıyla karakterizedir. Astımlı çocuklarda atak anında ve ataktan en az 1 ay sonraki dönemde ortalama trombosit hacmi (MPV), trombosit dağılım aralığı (PDW), plateletcrit ve p-selektin düzeylerindeki değişimlerin belirlenerek atak sırasında bir belirteç olarak kullanılabilirliğinin olup olmadığını araştırdık.Gereç ve Yöntemler: Çalışmaya astım atağındaki 40 çocuk alındı. Hastalardan atak anında ve ataktan en az 1 ay sonra MPV, PDW, PCT, p-selektin, eozinofil ve trombosit sayılarını değerlendirmek için kan örnekleri alındı.Bulgular: Atak anındaki MPV, PCT ve p-selektin düzeyleri ataktan bir ay sonrası ile karşılaştırıldığında daha düşük bulundu.Sonuç: Bulgularımız rutin pratikte sık kullanılan parametreler olan MPV ve PCT değerlerinin astım atağını belirlemede kullanılabileceğini göstermiştir.

Anahtar Kelimeler

• Astım, Ortalama trombosit hacmi (MPV), Trombosit dağılım aralığı (PDW), Plateletcrit, P-selektin

Evaluation of Platelet Activation During an Asthmatic Attack in Children

Öz

Objective: Asthma is a chronic inflammatory disease of the airways. Allergic inflammation is characterized by accumulation of various cells, particularly mast cells, eosinophils, T lymphocytes and platelets. We investigated whether changes in mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT) and p-selectin levels of children with asthma during and at least 1 month after the attack can be used as a marker.Material and Methods: The study was performed in 40 children who suffered asthma attacks. Blood samples were taken for MPV, PDW, PCT, p-selectin, eosinophil and platelet values during and at least 1 month after the attack. Results: Mean platelet volume, PCT, and p-selectin levels were significantly lower at the time of the attack when compared to those at least 1 month after the attack. Conclusion: Our findings suggest that MPV and PCT, common parameters in routine practice, can be used to determine an asthma attack

Anahtar Kelimeler

• Asthma, Mean platelet volume (MPV), Platelet distribution width (PDW), Plateletcrit (PCT), P-selectin

Kaynakça

1. Eder W, Ege MJ, von Mutius E. The asthma epidemic. N Engl J Med 2006; 355: 2226-35.
2. Akçakaya N, Kulak K, Hassanzadeh A, Camcioğlu Y, Cokuğraş H. Prevalence of bronchial asthma and allergic rhinitis in Istanbul school children. Eur J Epidemiol 2000;16: 693-9.
3. Panettieri RA Jr, Covar R, Grant E, Hillyer EV, Bacharier L. Natural history of asthma: Persistence versus progression-does the beginning predict the end? J Allergy Clin Immunol 2008;121:607- 13.
4. Robinson DS. The role of the mast cell in asthma: Induction of airway hyperresponsiveness by interaction with smooth muscle? J Allergy Clin Immunol 2004;114:58-65.
5. Larche M, Robinson DS, Kay AB. The role of T lymphocytes in the pathogenesis of asthma. J Allergy Clin Immunol 2003;111:450-63.
6. Metzger WJ, Sjoerdsma K, Richerson HB, Moseley P, Zavala D, Monick M, et al. Platelets in bronchoalveolar lavage from asthmatic patients and allergic rabbits with allergen-induced late phase responses. Agents Actions Suppl 1987;21:151-9.
7. Pitchford SC, Page CP. Platelet activation in asthma: Integral to the inflammatory response. Clin Exp Allergy 2006;36:399-401.
8. Kasperska-Zajac A, Rogala B. Platelet activation during allergic inflammation. Inflammation 2007;30:161-6.

9. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: Methodological issues. Platelets 2002;13:301-6.
10. Wiwanitkit V. Plateletcrit, mean platelet volume, platelet distribution width: Its expected values and correlation with parallel red blood cell parameters. Clin Appl Thromb Hemost 2004;10:175-8.
11. Thompson CB, Jakubowski JA. The pathophysiology and clinical relevance of platelet heterogeneity. Blood 1988;72:1-8.
12. Vagdatli E, Gounari E, Lazaridou E, Katsibourlia E, Tsikopoulou F, Labrianou I. Platelet distribution width: A simple, practical and specific marker of activation of coagulation. Hippokratia 2010;14:28-32.
13. Tomer A, Harker LA, Kasey S, Eckman JR. Thrombogenesis in sickle cell disease. J Lab Clin Med 2001;137:398-407.
14. Zietkowski Z, Skiepko R, Tomasiak MM, Bodzenta-Lukaszyk A. Soluble CD40 ligand and soluble P-selectin in allergic asthma patients during exercise-induced bronchoconstriction. J Invest Allerg Clin 2008; 18: 272-8.
15. Makay B, Türkyilmaz Z, Unsal E. Mean platelet volume in children with familial Mediterranean fever. Clin Rheumatol 2009; 28: 975-8.
16. results in consumption of large volume platelets with small
17. Tuncel T, Uysal P, Hocaoglu AB, Erge DO, Karaman O, Uzuner N. Change of mean platelet volume values in asthmatic children as an inflammatory marker. Allergol Immunopathol (Madr) 2012; 40:104- 7.
18. Bath PM, Butterworth RJ. Platelet size: Measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157-61.
19. Yilmaz Z, Eralp O, Ilcol YO. Evaluation of platelet count and its association with plateletcrit, mean platelet volume, and platelet size distribution width in a canine model of endotoxemia. Vet Clin Pathol 2008;37:159-63.
20. Benton AS, Kumar N, Lerner J, Wiles AA, Foerster M, Teach SJ, et al. Airway platelet activation is associated with airway eosinophilic inflammation in asthma. J Investig Med 2010;58:987.
21. Johansson MW, Mosher DF. Activation of beta1 integrins on blood eosinophils by P-selectin. Am J Respir Cell Mol Biol 2011;45:889- 97.
22. Kowal K, Pampuch A, Kowal-Bielecka O, DuBuske LM, Bodzenta- Łukaszyk A. Platelet activation in allergic asthma patients during allergen challenge with Dermatophagoides pteronyssinus. Clin Exp Allergy 2006;36:426-32
23. Kose S, Karaman O, Islekel H, Uzuner N, Babayigit A, Olmez D, et al. Circulating adhesion molecules in sera of asthmatic children before and after steroid therapy. Allergy Asthma Proc 2007;28:199- 203.