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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.
This model, however, does not account for observed inhibition of the first wave of aggregation in patients with sepsis.
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].
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).
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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.
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].
rRLN-treated PRP was able to produce a wave of platelet activation and aggregation that was not observed in PRP treated with ADP alone.
A similar partitioning of Dictyostelium D. cells into sustained pacemakers (the cites where waves originate) at the center of aggregation and signal transducing cells elsewhere has been first theoretically predicted by Geberth et al. [ 28] and later experimentally shown by Gregor et al. [ 29].
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