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This model, however, does not account for observed inhibition of the first wave of aggregation in patients with sepsis.
The first wave of aggregation generally correlated with the activity of several platelet mitochondrial respiratory chain enzymes.> -wrap-foot> Data reported as mean ± standard deviation.
In fact, the first wave of aggregation precedes secretion and is usually normal even in patients with δ storage pool disease [ 40, 41].
In patients with sepsis, the platelet first wave of aggregation (in response to ADP), maximal aggregation and secretion of ATP (in response to ADP, collagen, U46619 and thrombin receptor activating peptide) were significantly lower than those of controls (Table 2).
At this dose, ADP elicits a biphasic platelet response: the first wave of aggregation in response to exogenous ADP is followed by δ-granule secretion and the second wave of aggregation in response to released endogenous adenine nucleotides.
Platelet maximal aggregation and secretion (in response to ADP, collagen, thromboxane A2 analogue U46619 and thrombin receptor activating peptide) and first wave of aggregation (in response to ADP) were measured in healthy volunteers and patients with sepsis (within 48 hours from admission to intensive care).
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By contrast, with other agonists, aggregation and secretion occur at the same time, so that the first wave cannot be distinguished from the second wave of aggregation [ 21].
Nonmetabolic ATP and ADP are segregated into dense granules with a ratio of around 1 and represent the other two-thirds of total adenine nucleotides; they are secreted upon cellular stimulation and are essential for the late phase (or second wave) of aggregation [ 10].
Study of the heterozygous P2Y12 defect revealed platelets that undergo a normal first wave of ADP induced aggregation but abnormal ATP secretion with different agonists [ 3, 42].
Delta granule pool storage deficiency is a heterogeneous disorder presenting with abnormalities in the second wave of platelet aggregation, a bleeding tendency and a decreased number of delta granules in platelets.
The first wave of S.O.E.
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