Nicoleta Berbec, Anca Roxana Lupu, Silvana Angelescu, Diana Mandescu and Maria Bari
Andra Costache, Simona I. Avram, Alina Cernucan, Doina Barbu, Silvana Angelescu, Delia Mut Popescu and Anca R. Lupu
The first description of microparticles dates back to 1967, when Wolf reported platelet membrane fragments in human plasma and called them “platelet dust”. These vesicles were later called microparticles and the knowledge about their characterization and function has advanced since then. The generation of microparticles represents a mechanism of intercellular communication, playing various roles in both physiological and pathological conditions. Besides other multiple roles in pathology such as inflammation, atherogenesis and cancer spreading, platelet-derived microparticles are involved in thrombogenesis. Tissue factor and phosphatidylserine are both exposed on the outer membrane of platelet-derived microparticles, providing catalytic procoagulant surfaces. The evaluation of microparticles may represent a possible investigation and diagnostic tool. Their enumeration and characterization is challenging and flow cytometry remains the most widely used method for the analysis of microparticles. The aim of the authors is to review the most relevant information on the main properties, mechanisms of generation, and clinical relevance of platelet-derived microparticles, since their evaluation is increasingly considered as a diagnostic biomarker.
Andra Costache, Silvana Angelescu, Doina Barbu, Elena Popescu, Delia Ileana Mut Popescu and Anca Roxana Lupu
Patients with acute leukemia develop abnormalities of haemostasis, leading not only to bleeding, but also to thrombotic complications. The pathogenesis of these complications is complex and multifactorial. Because platelets and platelet derived microparticles are key players in haemostasis and thrombosis, we presumed their roles in the prediction of bleeding and thrombotic complications. Our study groups included 24 patients with acute leukemia and 16 healthy volunteers. Platelet aggregation evaluation was performed by impedance whole blood aggregometry and the ennumeration of platelet derived microparticles was done by means of flow cytometry. Eight patints developed hemorrhagic complications associated with reduced platelet aggregation response at hospital admission. Major thrombotic events occurred in 5 patients, being preceded by increased platelet aggregation in 3 cases and high level of platelet derived microparticles in 2 cases. Our findings reveal that whole blood platelet aggregometry could be a valuable tool especially in the detection of platelet hyperreactivity and in the prediction of thrombotic events. A high level of platelet derived microparticles could also predict thrombosis. These hypotheses need further evaluation and confirmation on larger number of patients.
Silvana Angelescu, Cristina Mambet, Delia I. Mut Popescu, Nicoleta M. Berbec, Andra Costache, Mihai Isaroiu and Anca R. Lupu
Eosinophils are leukocytes with multiple functions in physiologic and pathologic circumstances. Eosinophilia is typically associated with reactive conditions (helmintic infections, allergic or drug reactions and atopic disorders) and sometimes with hematologic and non- hematologic malignancies. Evaluation of a patient with eosinophilia requires numerous imaging investigations and laboratory tests for establishing the right treatment. We measured the degree of eosinophilic activation using serologic biomarkers such as serum eosinophil cationic protein (ECP) , interleukin-5 (IL-5) and eosinophilic cationic protein/eosinophil count (ECP/Eo) ratio in order to differentiate earlier among distinct eosinophilic conditions: clonal, non-clonal with malignancy and reactive eosinophilia with inflammation. The median ECP value in eosinophilic patients was significantly higher when compared to that of the control group (19.55 vs. 4.93 ng/mL, p<0.05). Within patients with eosinophilia, the clonal eosinophilia group showed a significantly higher median ECP value compared to the median ECP values of the non-clonal eosinophilia groups - (30.15 vs. 19.5 ng/mL, p<0.05 and respectively 30.15 vs. 13.3 ng/mL, p<0.05). Also patients having non-clonal eosinophilia with malignancy had a significantly higher median ECP value compared to those of reactive eosinophilia and inflammation (19.5 vs. 13.3 ng/mL, p<0.05). While ECP serum levels seemed to be a discriminatory tool for different groups of eosinophilic patients IL-5 and ECP/Eo were less useful for this purpose. However our results must be confirmed in larger studies
Nicoleta P. Berbec, Sorina M.F. Papuc, Andreea C.D.F. Tutulan-Cunita, Silvana M. Angelescu, Anca I. Lupu and Aurora A. Arghir
De novo acute myeloid leukemias (AML) represent a heterogeneous group of clonal hematopoietic disorders in which chromosomal abnormalities are detected in a majority of patients. At present, cytogenetic changes are recognized as important diagnostic markers and prognosis determinants. Complex karyotype changes are associated with resistance to treatment and unfavorable evolution. We report on an AML case with complex karyotype changes characterized by molecular genetic techniques (fluorescence in situ hybridization - FISH and array-based comparative genomic hybridization - array-CGH) and an extremely poor outcome. A 72 year-old female patient was admitted for genetic investigations with a clinical diagnosis of AML. Classical and molecular cytogenetic tests as well as array-CGH were performed. Complex chromosomal abnormalities were identified at diagnosis, consisting of genomic imbalances involving chromosomes 6, 7, 9, and 17. AML with complex karyotype changes is a heterogeneous disease, as a variety of genomic abnormalities are detected, involving virtually all chromosomes. The pathogenesis of AML with complex karyotype is poorly understood. The complexity of karyotypic changes in our case highlights the importance of using complementary genetic investigation in order to obtain a comprehensive view of AML genome.