Irving, P.M.; Macey, M.G.; Shah, U.; Webb, L.; Langmead, F.L.; Rampton, D.S.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA64
Academic Journal
Background: We have previous]y shown that formation of platelet-leucocyte aggregates (PLAs) is increased in patients with IBD (UEGW 2000) and correlates with platelet activation (BSG 2001). Aims: To see if drugs commonly used to treat IBD affect PLA formation, platelet and neutrophil activation. Methods: Of 66 patients with IBD (31 Crohn's, 35 ulcerative colitis),17 patients were on thiopurines (11 azathioprine, 2 6-mercaptopurine), 17 prednisolone or hydrocortisone and 53 5-ASAs. Venous blood was drawn into F:DTA/CTAD anticoagulants. Samples were immediately mixed and then analysed by flow cytometry for P-selectin (CD62P for plate[et activation), L-selectin (CD62L for neutrophil activation) and CD42a/CD45 (plateletleucocyte aggregates). Results: Patients taking thiopurines had fewer PLAs (median (IQR)) (0.26 (0.20-0.38) × 10[sup 9]/L, n=17) than those that were not (0.37 (0.25-0.60), n=49, P<0.05). The number of platelets expressing P-selectin was similar in both groups (thiopurines 3.1 (1.4-6.0) × 109/L, no thiopurines 3.7 (1.9-8.7) × 10[sup 9]/L) as was expression of bselectin on neutrophils (thiopurines 802 (793-814), no thiopurines 792 (780-808)). There was no difference in any of these variables between patients taking and not taking corticosteroids or 5-ASAs. Conclusions: Thiopurines, but not corticosteroids or 5-ASAs, decrease the number of platelet-leucocyte aggregates in patients with BD; none of these agents appeared to affect platelet and neutrophil activation. It is conceivable that inhibition of platelet-leucocyte aggregate formation could contribute to the therapeutic efficacy of thiopurines in IBD.


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