Effects of platelet exosomes on coagulation function in severe burn patients: a preliminary study

doi:10.3877/cma.j.issn.2095-9133.2023.03.004

Abstract

Abstract:

Objective

To analyze the regulating effect of platelet exosomes on coagulation function in patients with severe burns.

Methods

Six patients with severe burns and six healthy volunteers were selected from the Department of Burn Surgery, the Third Affiliated Hospital of Inner Mongolia Medical University. All of them were male. The age of the experimental group was 32-54 years, with an average of (46±9) years, while the age of the control group was 28-59 years, with an average of (48±12) years. There was no significant difference in age between the two groups (P<0.05). The platelet exosomes of burn patients were obtained by high-speed centrifugation and identified by transmission electron microscopy, nanoparticle analysis and Western blot analysis. The blood of burn patients was collected in the experimental group; that of volunteers collected in the control group; Exosomes group was the experimental group that platelet exosomes were randomly added to the blood of the control group. Thrombelastography (TEG) and conventional coagulation test (CCA) were used to compare the coagulation function of the three groups.

Results

The exosomes showed a typical double-layer membrane-like circular particle structure under transmission electron microscope. Western blot showed that the marker proteins TSG101 and CD63 were positive. Particle analysis showed that the average particle size was (120±30) nm, indicating that the extracellular vesicles were exosomes. PT value, APTT value, DD value, R value and K value in the experimental group were higher than those in the control group; [16.1(15.0, 19.4)s vs 10.8(10.7, 11.1)s, 44.7(37.3, 53.7)s vs 28.1(26.6, 29.0)s, 7.4(6.5, 8.9)ng/mL vs 0.3(0.2, 0.3)ng/mL, 12.3(10.4, 18.3)min vs 5.8(4.5, 7.0)min and 3.7(2.9, 11.3)min vs 2.1(1.7, 2.3)min, all P<0.05]. PLT value α Angle, Ma value, CI value and ly30 value of the two groups were lower than that of the control group [85.5(70.3, 98.5) 10^9/L vs 166.0(157.0, 178.0) 10^9/L, 44.2(22.7, 54.1)°, 59.6(57.6, 61.3)°, 46.6(37.9, 49.7)mm vs 56.5(54.0, 57.6)mm, -2.1(-3.0, -1.3) vs 1.3(1.2, 1.4), 4.8(1.2, 7.9)% vs 0.0(0.0, 0.0)%, all P<0.05]. The values of APPT and MA in exosomes group were higher than those in control group; [25.2(23.9, 26.0)s vs 28.1(26.6, 29.0)s, 59.4 (57.0, 61.4)mm vs. 56.5 (54.0, 57.6) mm, all P<0.05]. PT value and R value were lower than those in the control group [10.3 (9.9, 10.6)s vs 10.8(10.7, 11.1)s, 4.4(3.9, 5.0)min vs 5.8(4.5, 7.0)min, all P<0.05].

Conclusions

TEG detection shows that severe burn patients are in a low coagulation state after the shock phase, accompanied by decreased platelet function; platelet exosomes from severe burn patients play a procoagulant role in vitro experiments.

Key words: Burn, Platelet, Exosomes, Thrombelastogram

Lei Gao, Quan Li, Yaliga Ba, Qiang Chen, Zhihui Hou, Shengjun Cao, Te Ba. Effects of platelet exosomes on coagulation function in severe burn patients: a preliminary study[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2023, 09(03): 149-154.

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Figures/Tables 8

References 20

1	Zhang TN，Ba T，Li F，et al.Coagulation dysfunction of severe burn patients：a potential cause of death[J]．Burns，2023，49(3)：678-687.
2	Franco AT，Corken A，Ware J．Platelets at the interface of thrombosis，inflammation，and cancer[J]．Blood，2015，126(5)：582-588.
3	St John AE，Newton JC，Martin EJ，et al.Platelets retain inducible alpha granule secretion by p-selectin expression but exhibit mechanical dysfunction during trauma-induced coagulopathy[J]．J Thromb Haemost，2019，17(5)：771-781.
4	van der Meijden PEJ，Heemskerk JWM.Platelet biology and functions：new concepts and clinical perspectives[J]．Nat Rev Cardiol，2019，16(3)：166-179.
5	Yu H，Sun T，An J，et al.Potential roles of exosomes in parkinson's disease：from pathogenesis，diagnosis，and treatment to prognosis[J]．Front Cell Dev Biol，2020(8)：86.
6	Mathieu M，Martin-Jaular L，Lavieu G，et al.Specificities of secretion and uptake of exosomes and other extracellular vesicles for cell-to-cell communication[J]．Nat Cell Biol，2019，21(1)：9-17.
7	Saumell-Esnaola M，Delgado D，García Del Caío G，et al.Isolation of platelet-derived exosomes from human platelet-rich plasma：biochemical and morphological characterization[J]．Int J Mol Sci，2022，23(5)：2861.
8	陶冬连，邓珊，胡越，等．血小板外泌体在动脉粥样硬化血栓形成中的作用[J]．中国实验血液学杂志，2022，30(3)：975-978.
9	Witwer KW，Goberdhan DC，O'driscoll L，et al.Updating MISEV：evolving the minimal requirements for studies of extracellular vesicles[J]．J Extracell Vesicles，2021，10(14)：e12182.
10	Mathieu M，Névo N，Jouve M，et al.Specificities of exosome versus small ectosome secretion revealed by live intracellular tracking of CD63 and CD9[J]．Nat Commun，2021，12(1)：4389.
11	Ball RL，Keyloun JW，Brummel-Ziedins K，et al.Burn-induced coagulopathies：a comprehensive review[J]．Shock，2020，54(2)：154-167.
12	Li Q，Ba T，Wang L-F，et al.Stratification of venous thromboembolism risk in burn patients by caprini score[J]．Burns，2019，45(1)：140-145.
13	Kalluri R，Lebleu VS.The biology，function，and biomedical applications of exosomes[J]．Science，2020，367(6478)：eaau6977.
14	Vigstedt M，Baksaas-Aasen K，Henriksen HH，et al.Thrombelastography(TEG® 6s)early amplitudes predict maximum amplitude in severely injured trauma patients[J]．Scand J Clin Lab Invest，2022，82(6)：508-512.
15	Li Q，Zhang T，Wang L，et al.Clinical significance of R-TEG in severe burn patients with coagulation dysfunction[J]．Injury，2022，53(12)：3993-3999.
16	陈志鹏，张铁凝，高雷，等．血栓弹力图在早期烧伤后凝血功能障碍诊断的应用研究[J/CD]．中华卫生应急电子杂志，2022，8(5)：257-261.
17	Bal SH，Sağdilek E，Karaçay M，et al.The effect of exosomes released from apheresis platelet concentrates under the impact of gamma irradiation and storage time upon platelet aggregation and hemostasis[J]．Blood Transfus，2023，21(3)：257-267.
18	Srikanthan S，Li W，Silverstein RL，et al.Exosome poly-ubiquitin inhibits platelet activation，downregulates CD36 and inhibits pro-atherothombotic cellular functions[J]．J Thromb Haemost，2014，12(11)：1906-1917.
19	Sang Y，Roest M，De Laat B，et al.Interplay between platelets and coagulation[J]．Blood Reviews，2021(46)：100733.
20	Li J，Tan M，Xiang Q，et al.Thrombin-activated platelet-derived exosomes regulate endothelial cell expression of ICAM-1 via microRNA-223 during the thrombosis-inflammation response[J]．Thromb Res，2017(154)：96-105.

组别	例数	PT(s)	APTT(s)	TT(s)	FIB(g/L)	DD (ng/mL)	PLT(10^9/L)
对照组	6	10.8(10.7，11.1)	28.1(26.6，29.0)	18.0(16.8，19.0)	2.6(2.1，3.1)	0.3(0.2，0.3)	166.0(157.0，178.0)
实验组	6	16.1(15.0，19.4)	44.7(37.3，53.7)	19.9(18.0，31.0)	3.3(1.8，3.6)	7.4(6.5，8.9)	85.5(70.3，98.5)
Z值		－2.89	－2.89	－1.62	－1.29	－2.89	－2.89
P值		<0.05	<0.05	>0.05	>0.05	<0.05	<0.05

组别	例数	PT(s)	APTT(s)	TT(s)	FIB(g/L)	DD (ng/mL)	PLT(10^9/L)
对照组	6	10.8(10.7，11.1)	28.1(26.6，29.0)	18.0(16.8，19.0)	2.6(2.1，3.1)	0.3(0.2，0.3)	166.0(157.0，178.0)
实验组	6	16.1(15.0，19.4)	44.7(37.3，53.7)	19.9(18.0，31.0)	3.3(1.8，3.6)	7.4(6.5，8.9)	85.5(70.3，98.5)
Z值		－2.89	－2.89	－1.62	－1.29	－2.89	－2.89
P值		<0.05	<0.05	>0.05	>0.05	<0.05	<0.05

组别	例数	PT(s)	APTT(s)	TT(s)	FIB(g/L)	DD(ng/mL)	PLT(10^9/L)
对照组	6	10.8(10.7，11.1)	28.1(26.6，29.0)	18.0(16.8，19.0)	2.6(2.1，3.1)	0.3(0.2，0.3)	166.0(157.0，178.0)
外泌体组	6	10.3(9.9，10.6)	25.2(23.9，26.0)	16.5(16.0，18.3)	2.8(2.6，3.1)	0.3(0.2，0.3)	168.0(148.8，172.8)
Z值		－2.25	－2.33	－1.23	－0.66	0.00	－0.80
P值		<0.05	<0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	PT(s)	APTT(s)	TT(s)	FIB(g/L)	DD(ng/mL)	PLT(10^9/L)
对照组	6	10.8(10.7，11.1)	28.1(26.6，29.0)	18.0(16.8，19.0)	2.6(2.1，3.1)	0.3(0.2，0.3)	166.0(157.0，178.0)
外泌体组	6	10.3(9.9，10.6)	25.2(23.9，26.0)	16.5(16.0，18.3)	2.8(2.6，3.1)	0.3(0.2，0.3)	168.0(148.8，172.8)
Z值		－2.25	－2.33	－1.23	－0.66	0.00	－0.80
P值		<0.05	<0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	R(min)	K(min)	α(°)	MA(mm)	CI	LY30(%)
对照组	6	5.8(4.5，7.0)	2.1(1.7，2.3)	59.6(57.6，61.3)	56.5(54.0，57.6)	1.3(1.2，1.4)	0.0(0.0，0.0)
实验组	6	12.3(10.4，18.3)	3.7(2.9，11.3)	44.2(22.7，54.1)	46.6(37.9，49.7)	－2.1(－3.0，－1.3)	4.8(1.2，7.9)
Z值		－2.88	－2.59	－2.40	－2.89	－2.88	－3.08
P值		<0.05	<0.05	<0.05	<0.05	<0.05	<0.05

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