Methoden zur Messung der Azetylsalizylsäure- bzw. Clopidogrelresistenz

Zusammenfassung

Basierend auf der Prämisse, wonach eine so genannte Resistenz gegenüber Thrombozytenfunktionshemmern vorliegt, wenn das Pharmakon den für die klinische Wirksamkeit entscheidenden pharmakodynamischen Effekt nicht ausübt, sollten zur Evaluation der Wirkung von Thrombozytenfunktionshemmern Laborteste eingesetzt werden, die den pharmakodynamischen Effekt möglichst direkt erfassen.

Für die Evaluation von Azetylsalizylsäurewirkungen scheint die Messung von Thromboxan B2 oder die der Arachidonsäure- induzierten Aggregation (Turbidimetrie oder Vollblutaggregometrie) angebracht. Für die Evaluation von Clopidogrelwirkungen scheint die Messung der VASP-Phosphorylierung (Durchflusszytometrie) oder die der ADPinduzierten Thrombozytenaggregation (Turbidimetrie oder Vollblutaggregometrie) sinnvoll.

Summary

Based on the concept that the so-called resistance to antiplatelet drugs is meant to describe a phenomenon where the drug does not hit its direct pharmacodynamic target, assays, used to evaluated the effects of anti-platelet drugs, should as closely as possible measure the direct pharmacodynamic effect of a particular drug.

Thus, for the detection of aspirin effects, thromboxane concentrations or arachidonic acid-induced responses (light aggregometry, whole-blood aggregometry) should be measured. For the detection of clopidogrel actions, VASP phosphorylation (flow cytometry) or ADP-induced responses (light aggregometry, whole blood aggregometry) should be analysed.

Schlüsselwörter

Azetylsalizylsäureresistenz - Clopidogrelresistenz - VASP - Thrombozytenaggregation

Keywords

Aspirin resistance - clopidogrel resistance - VASP - platelet aggregation

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