Immune thrombocytopenia (ITP) is an autoimmune condition primarily induced by the loss of immune tolerance to the platelet glycoproteins. Here we develop a novel flow cytometry approach to analyze integrin α_IIbβ₃ functioning in ITP in comparison with Glanzmann thrombasthenia (GT) (negative control) and healthy pediatric donors (positive control). Continuous flow cytometry of Fura-Red-loaded platelets from whole hirudinated blood was used for the characterization of platelet responses to conventional activators. Calcium levels and fibrinogen binding were normalized to ionomycin-induced responses. Ex vivo thrombus formation on collagen was observed in parallel-plate flow chambers. Platelets from all ITP patients had significantly higher cytosolic calcium concentration in the quiescent state compared to healthy donors (15 ± 5 nM vs. 8 ± 5 nM), but calcium increases in response to all activators were normal. Clustering analysis revealed two subpopulations of ITP patients: the subgroup with high fibrinogen binding (HFB), and the subgroup with low fibrinogen binding (LFB) (8% ± 5% for LFB vs. 16% ± 3% for healthy donors in response to ADP). GT platelets had calcium mobilization (81 ± 23 nM), fibrinogen binding (5.1% ± 0.3%) and thrombus growth comparable to the LFB subgroup. Computational modeling suggested phospholipase C-dependent platelet pre-activation for the HFB subgroup and lower levels of functional integrin molecules for the LFB group.

Platelets, which are anucleate blood cells, should have the capacity to respond to an external stimulus within 1 second. This capacity is maintained by calcium signaling, the process of...

Background: Genetic and epigenetic changes, oxidative stress and inflammation influence the rate of aging, which diseases, lifestyle and environmental factors can further accelerate. In accelerated aging (AA), the biological age exceeds the chronological age. Objective: The objective of this study is to reappraise the AA concept critically, considering its weaknesses and limitations. Methods: We reviewed more than 300 recent articles dealing with the physiology of brain aging and neurodegeneration pathophysiology. Results: (1) Application of the AA concept to individual organs outside the brain is challenging as organs of different systems age at different rates. (2) There is a need to consider the deceleration of aging due to the potential use of the individual structure–functional reserves. The latter can be restored by pharmacological and/or cognitive therapy, environment, etc. (3) The AA concept lacks both standardised terminology and methodology. (4) Changes in specific molecular biomarkers (MBM) reflect aging-related processes; however, numerous MBM candidates should be validated to consolidate the AA theory. (5) The exact nature of many potential causal factors, biological outcomes and interactions between the former and the latter remain largely unclear. Conclusions: Although AA is commonly recognised as a perspective theory, it still suffers from a number of gaps and limitations that assume the necessity for an updated AA concept.

Background. Children and adolescents undergoing treatment in the hospital for blood diseases are at risk of thrombotic complications. However, to date no major studies of the prevalence of thrombosis in this category of patients have been conducted in Russia. The objective: to determine the incidence of symptomatic and asymptomatic deep vein thrombosis (DVT), as well as their distribution by gender and age in children with various blood disorders. Materials and methods. Medical records of 1962 patients, aged from 0 to 17 years, were retrospectively analyzed. All DVT cases were confirmed by visualization methods. The presence of thrombosis clinical signs detected during physical examination, allowed identifying symptomatic DVT. Results. DVT was diagnosed in 429 patients; the symptomatic (n = 110) and asymptomatic (n = 337) DVT were considered as two independent groups with cases of thrombosis. The highest incidence of thrombotic complications was found in children with acute lymphoblastic leukemia (ALL) – 30.77 %, non-Hodgkin’s lymphomas – 22.58 %, other malignant blood disorders – 18.75 %, myeloid leukemia – 15.63 %, Hodgkin’s lymphoma – 16.50 %, histiocytosis – 12.5 %, aplastic anemia – 7.94 %, other leukemia – 7.14 %. Symptomatic episodes were more common in patients with lymphomas, especially non-Hodgkin’s, and ALL, while asymptomatic DVT were more common among children with ALL. Conclusion. The DVT prevalence in children with blood disorders exceeds 20 %, most of them are asymptomatic thrombosis, while symptomatic DVT are much less common. Patients receiving treatment for lymphomas and ALL have the highest number of venous thrombotic complications. Further research is needed to address the need for primary thrombotic prophylaxis in children with blood disorders.

Background: Aging rate is affected by genetic changes, epigenetic modifications, oxidative stress, inflammation, lifestyle and environmental factors. In accelerated aging (AA), biological age exceeds the chronological one. Objective: To undertake a critical reappraisal of the AA concept and to reveal its weaknesses and limitations. Methods: We reviewed over 300 recent articles dealing with physiology of brain aging and pathophysiology of neurodegeneration. Results: (1) Organ systems age at different rates, which interferes with application of the AA concept to individual organs. (2) Aging rate can be decelerated due to individual structure–functional reserves built with cognitive, physical training or pharmacological interventions. (3) The AA concept lacks standardised terminology and methodology. (4) Specific molecular biomarkers (MBM) reflect aging. To consolidate the AA theory, researchers should validate numerous MBM candidates. (5) Aging factors, mechanisms and the exact nature of their biological outcomes are not well understood. Conclusion: Although considered as a perspective theory, the AA concept has serious limitations and it requires an update.

Wiskott–Aldrich syndrome (WAS) is a rare X-linked immunodeficient disease accompanied by microthrombocytopenia, which leads to spontaneous/post-traumatic haemorrhages. It has been demonstrated that WAS is caused by gene mutation of WASP protein, which is participating in the processes of actin polarization and actin cytoskeleton re-organisation. It is yet unknown how this mutation affects intracellular signalling and functional responses of platelets of patients with WAS. Assessment of the intracellular calcium signalling, shape change and fibrinogen binging by the platelets of WAS patients. The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. Three patients with WAS and three healthy volunteers were included in the study. Intracellular signaling and platelet functional responses were observed on a BD Facs Canto II flow cytometer. To measure the calcium concentration in the platelet cytosol, the Fura-Red fluorophore was used, platelet shape change upon activation was evaluated by side scattering of cells at a wavelength of 488 nm, platelet integrin activation was evaluated by binding of fluorescently-labeled fibrinogen. During activation, the platelet concentration was 1000 cells per ul to avoid the effects of secondary activation. In quescent state of platelets, an increased concentration of calcium in the cytosol of platelets of patients was observed compared with platelets of healthy donors. In response to stimulation, the highest achievable calcium concentrations were comparable in both cases. The binding of fibrinogen to platelets in patients was not significantly changed compared to healthy donors. On the other hand, the change in the shape of the cells in response to activation, expressed as a percentage, was more significant in patients than the change in the shape of the platelets of healthy donors. With similar maximum responses to stimulation by all agonists, the concentration of calcium in resting platelets, as well as the change in the platelet shape of patients with WAS is significantly higher than that of healthy platelet donors. These results can be explained by the increased ratio of the platelet membrane area to their volume.