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Effect of DDAVP on Platelet Activation and Platelet-Derived Microparticle Generation
Background The way by which 1-deamino-8-D-arginine vasopressin (DDAVP) acts on platelets remains unclear. Data from the literature tend to show that there is no definite effect on platelet activation, but recent work has suggested that a subtype of platelets, activated by the combined action of collagen and thrombin, was triggered by DDAVP. Moreover, platelet microparticles (PMPs), which have been shown to be procoagulant, have rarely been studied in this context. The goal of this study was to analyze the effects of DDAVP on PMPs' release through platelet activation.
Methods Fifteen out of 18 consecutive patients undergoing a therapeutic test with DDAVP were included. They were suffering from factor VIII deficiency or from von Willebrand disease. The expression of P-selectin and PAC-1 binding on platelets and the numbers of circulating PMPs were evaluated ex vivo before and after DDAVP infusion. Peripheral blood was collected on CTAD to limit artifactual platelet activation.
Results DDAVP induced a significant decrease of platelet counts and volume. Only small changes of P-selectin expression and PAC-1 binding were observed. Considering PMPs, two populations of patients could be defined, respectively, with (120%, n = 6) or without (21%, n = 7) an increase of PMPs after DDAVP. The decrease in platelet counts and volume remained significant in the group of responders.
Conclusion This study shows that DDAVP induces the generation/release of PMPs in some patients with factor VIII deficiency and von Willebrand disease 1 hour after DDAVP infusion.
Keywordsblood platelets - platelet activation - platelet function - platelet-derived microparticles - deamino D-arginine vasopressin
All authors had full access to the data. M.P. and N.A. performed the experiments and abstracted all the clinical and laboratory data and contributed equally to the work. M.T., M.S., and C.T. provided patients and analyzed the data. M.C.B. analyzed the data and wrote the manuscript. M.F. designed the study, analyzed the data, and wrote de manuscript. All authors read, gave comments on, and approved the final version of the manuscript.
* Both authors contributed equally to the work.
Received: 21 July 2020
Accepted: 06 April 2021
17 June 2021 (online)
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