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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Platelet activation and heterotypic platelet-leucocyte conjugate formation in the blood of glioblastoma patients

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  • Sascha Marx - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
  • Maximilian Splittstöhser - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
  • Heiko Paland - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
  • Andreas Boehm - Institut für Pharmakologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
  • Christoph A. Ritter - Institut für klinische Pharmazie, Universitätsmedizin Greifswald, Greifswald, Deutschland
  • Sandra Bien-Möller - Institut für Pharmakologie, Universitätsmedizin Greifswald, Greifswald, Deutschland
  • Henry W. S. Schroeder - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald, Deutschland
  • Bernhard Rauch - Institut für Pharmakologie, Universitätsmedizin Greifswald, Greifswald, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.24.07

doi: 10.3205/17dgnc146, urn:nbn:de:0183-17dgnc1463

Published: June 9, 2017

© 2017 Marx et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Glioblastoma patients (GBM) suffer from an increased incidence of cardiovascular events. Platelets are well known as main player of the primary haemostasis, but have a broad range of additional functions. The formation of heterotypic conjugates between platelets and leucocytes (PLC) represents a pro-inflammatory surrogate marker and is usually increased after platelet activation. The aim of the present study was to evaluate the platelet activation status and the rate of circulating PLC in GBM.

Methods: Blood samples were drawn of consecutive patients before surgery for a suspected glioblastoma. The formation of PLC and several parameters of platelet activation were determined by flow cytometry before and after stimulation with either ADP or the thrombin receptor-activating peptide (TRAP) in vitro: expression of P-Selectin, CD63, CD40L and fibrinogen-binding to the activated GPIIb/ IIIa. Blood samples from age and gender matched healthy volunteers were used as controls. Statistical analysis was done with the Mann-Whitney-Test.

Results: Final analysis included 22 patients with histopathological proven virgin glioblastoma (9f, 13m, mean age 67.5 years, range from 55 to 86 years) and their respective controls. Basal platelet activation and in vitro platelet reactivity was increased in GBM. The difference got significant in the basal expression of CD63 (2.8% versus 1.9%, p=0.008), the Fibrinogen-binding after ADP-stimulation (110.3 MFI versus 63.1 MFI, p=0.04) and the CD63 expression after TRAP-stimulation (38.4% versus 33.3%, p=0.04). Furthermore, a reduced number of circulating PLC and in vitro PLC formation was seen in GBM without getting statistically significant.

Conclusion: In this preliminary report, we show for the first time an increased level of platelet activation and agonist-induced platelet reactivity in GBM. Both could be a reflection of the pro-thrombotic status in these patients. Interestingly, the formation of PLC was not increased, but in tendency decreased. Whether this observation potentially mirrors the intra-tumoral, anti-inflammatory microenviroment in GBM remains unclear.