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      Comparison of the Effects of Cellulose Triacetate and Polysulfone Membrane on GPIIb/IIIa and Platelet Activation


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          Background: During hemodialysis session, several adverse reactions can occur on platelets, which are attributable to bioincompatibility of the dialysis membrane. Glycoprotein IIb/IIIa (GPIIb/IIIa) is the receptor for fibrinogen, which mediates platelet aggregation and adhesion. Accordingly, we compared the influence of a cellulose triacetate (CTA) and polysulfone (PS) membrane on GPIIb/IIIa and platelet activation. Methods: Blood samples from 5 patients on hemodialysis were taken at 0 time, 15 min, 30 min, 60 min and 240 min, during a single hemodialysis session, by a crossover design using CTA or PS. Platelet count and plasma concentration of GPIIb/IIIa, β-thromboglobulin (β-TG) and platelet factor 4 (PF-4) were measured. GPIIb/IIIa was measured by flow cytometry. β-TG and PF-4 were measured by ELISA. Results: There was no significant change in the total amount of GPIIb/IIIa during dialysis session between the CTA and PS. However, the level of bound GPIIb/IIIa was significantly (p < 0.0002) increased from 1,426 ± 435 to 40,446 ± 2,777 mol/PLT with PS. In contrast, there was no significant change with CTA (3,258 ± 1,469 to 4,301 ± 1,422 mol/PLT). The platelet counts and β-TG and PF-4 behavior during the dialysis session did not show significant change between the PS and CTA. Conclusion: The characterization of changes in platelet membrane receptor (GPIIb/IIIa) may be a useful marker for studying the biocompatibility of dialysis membranes. On platelet aggregation, CTA might be more biocompatible membrane than PS.

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          Most cited references3

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          Platelet glycoprotein IIb/IIIa receptors in cardiovascular medicine.

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            Novel antiplatelet therapies for treatment of patients with ischemic heart disease: inhibitors of the platelet glycoprotein IIb/IIIa integrin receptor.

            Blood platelets play essential roles in normal coagulation and in coronary atherosclerotic disease and its complications. Various antiplatelet therapies, including aspirin, ticlopidine, and dipyridamole, have been developed for use in patients with known coronary artery artery disease to prevent ischemic complications. More recently a more complete anti-aggregation effect has been accomplished by the use of monoclonal antibodies and specific peptide and nonpeptide compounds that bind to the platelet GP IIb/IIIa surface receptor. This receptor becomes activated by platelet stimulation and binds fibrinogen molecules between platelets in the aggregation process. These new antiplatelet drugs are now being evaluated in clinical trials in patients undergoing balloon coronary angioplasty, in whom fewer ischemic events occur when the receptor blocker is used intravenously than with standard therapy, and in patients with stable and unstable angina. Excessive bleeding is an important problem with these agents, and efforts must be made to eliminate this side effect.
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              GPIIbIIIa inhibitors as adjunctive therapy in acute myocardial infarction


                Author and article information

                Blood Purif
                Blood Purification
                S. Karger AG
                26 February 2003
                : 21
                : 2
                : 176-182
                aSecond Department of Internal Medicine, Nihon University School of Medicine, and bNihon University Graduate School of Business, Tokyo, Japan
                69157 Blood Purif 2003;21:176–182
                © 2003 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                : 26 November 2002
                Page count
                Figures: 8, Tables: 1, References: 21, Pages: 7
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/69157
                Self URI (text/html): https://www.karger.com/Article/FullText/69157
                Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
                Original Paper

                Cardiovascular Medicine,Nephrology
                Platelet factor-4,Biocompatibility,Cellulose triacetate membrane,Polysulfone membrane,Glycoprotein IIb/IIIa,β-Thromboglobulin


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