Platelet Aggregation and Plasma Lipoproteins in Alcoholics During Alcohol Withdrawal

K Desai; J S Owen; D T Wilson; R A Hutton

doi:10.1055/s-0038-1661516

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 1986; 55(02): 173-177
DOI: 10.1055/s-0038-1661516

Original Article

Schattauer GmbH Stuttgart

Platelet Aggregation and Plasma Lipoproteins in Alcoholics During Alcohol Withdrawal

Autor*innen

K Desai

The Departments of Haematology and Medicine, Royal Free Hospital School of Medicine, London, and The Regional Alcoholism and Drug Dependence Unit, St. Bernard’s Hospital, London, UK
J S Owen

The Departments of Haematology and Medicine, Royal Free Hospital School of Medicine, London, and The Regional Alcoholism and Drug Dependence Unit, St. Bernard’s Hospital, London, UK
D T Wilson

The Departments of Haematology and Medicine, Royal Free Hospital School of Medicine, London, and The Regional Alcoholism and Drug Dependence Unit, St. Bernard’s Hospital, London, UK
R A Hutton

The Departments of Haematology and Medicine, Royal Free Hospital School of Medicine, London, and The Regional Alcoholism and Drug Dependence Unit, St. Bernard’s Hospital, London, UK

Abstract

als PDF herunterladen

Summary

Platelet aggregation, platelet lipid composition and plasma lipoprotein concentrations were measured each week in a group of seventeen alcoholics, without overt liver disease, for one month, following acute, total alcohol withdrawal. The platelets were initially hypoaggregable but, within 1-2 weeks of cessation of drinking, they became hyperaggregable and then gradually returned towards normal values. Hyperaggregability could not be explained by increases in either the cholesterol or the arachidonic acid content of the platelets. Plasma very-low-density lipoprotein cholesterol levels remained high throughout the study, but the initially raised levels of high-density lipoprotein (HDL) cholesterol fell by 26%. Low-density lipoprotein (LDL) cholesterol concentration rose by 10% after two weeks of withdrawal but then returned to about the starting level. The resulting changes in the plasma LDL-cholesterol: HDL-cholesterol ratio, which had increased by more than 50% after two weeks of abstinence, essentially paralleled the time course of enhanced platelet reactivity in all but four of the alcoholics. These findings suggest that alterations in plasma lipoprotein concentrations during acute alcohol withdrawal may be a contributory factor to the haemostatic disorders present in such patients.

Key words

Alcoholism - HDL - Lipoprotein - Platelet aggregation - Platelet lipids

PDF (261 kb)

Referenzen

References
1 Cowan DH, Hines JD. Thrombocytopenia of severe alcoholism. Ann Intern Med 1971; 74: 37-43
2 Cowan DH. Effect of alcohol on haemostasis. Semin Hematol 1981; 17: 137-147
3 Hutton RA, Fink R, Wilson DT, Marjot DH. Platelet hyperaggrega-bility during alcohol withdrawal. Clin Lab Haemat 3 1981; 3: 223-229
4 Fink R, Hutton RA. Changes in the blood platelets of alcoholics during alcohol withdrawal. J Clin Pathol 1983; 36: 337-340
5 Haselager EM, Vreeken J. Rebound thrombocytosis after alcohol abuse. A possible factor in the pathogenesis of thromboembolic disease. Lancet 1977; 1: 774-775
6 Harker L. Platelet survival time: its measurement and use. Prog Hemost Thromb 1978; 4: 321-347
7 Marcus AJ. The role of lipids in platelet function: with particular reference to the arachidonic acid pathway. J Lipid Res 1978; 19: 793-826
8 Owen JS, Hutton RA, Day RC, Bruckdorfer KR, McIntyre N. Platelet lipid composition and platelet aggregation in human liver disease. J Lipid Res 1981; 22: 423-430
9 Shattil SJ, Anaya-Galindo R, Bennett J, Colman RW, Cooper RA. Platelet hypersensitivity induced by cholesterol incorporation. J Clin Invest 1975; 55: 636-643
10 Hassall DG, Forrest LA, Bruckdorfer KR, Marenah CB, Turner P, Cortese C, Miller NE, Lewis B. Influence of plasma lipoproteins on platelet aggregation in a normal male population. Arteriosclerosis 1983; 3: 332-338
11 Hassall DG, Owen JS, Bruckdorfer KR. The aggregation of isolated human platelets in the presence of lipoprotein and prostacyclin. Biochem J 1983; 216: 43-49
12 Hardisty RM, Hutton RA, Montgomery DC, Rickard S, Trebilcock H. Secondary platelet aggregation: a quantitative study. Brit J Haematol 1970; 19: 307-319
13 Born GV R. Aggregation of blood platelets by adenosine diphosphate and its reversal. Nature 1962; 194: 927-929
14 Bligh EG, Dyer WJ. A rapid method of total lipid extraction and purification. Can J Biochem Physiol 1959; 37: 911-917
15 Richmond W. Preparation and properties of a cholesterol oxidase from Nocardia Sp and its application to the enzymatic assay of total cholesterol in serum. Clin Chem 1973; 19: 1350-1356
16 Bartlett GR. Phosphorus assay in column chromatography. J Biol Chem 1959; 234: 466-468
17 Owen JS, Goodall H, Mistry P, Harry DS, Day RC, McIntyre N. Abnormal high density lipoproteins from patients with liver disease regulate cholesterol metabolism in cultured human skin fibroblasts. J Lipid Res 1984; 25: 919-931
18 Stuart MJ, Gerrard JM, White JG. Effect of cholesterol on production of thromboxane B2 by platelets in vitro. N Eng J Med 1980; 302: 6-10
19 Kramer RM, Jakubowski JA, Vaillancourt R, Deykin D. Effect of membrane cholesterol on phospholipid metabolism in thrombin stimulated platelets. J Biol Chem 1982; 257: 6844-6849
20 Shattil SJ, Bennett JS, Colman RW, Cooper RA. Abnormalities of cholesterol-phospholipid composition in platelets and low-density lipoproteins of human hyperbetalipoproteinemia. J Lab Clin Med 1977; 89: 341-353
21 Farbiszewski R, Skrzydlewski Z, Worowski K. The effect of lipoprotein fractions on adhesiveness and aggregation of blood platelets. Thrombos Diathes Haemorrh 1969; 21: 89-92
22 Koller E, Vukovich Th, Doleschel W, Auerswald W. Uber den EinfluB von Lipoproteinen auf die ADP-induzierte Thrombozyten-aggregation. Artherogenese 4 1979; 4 (Suppl. 04) 53-68
23 Day RC, Harry DS, Owen JS, Foo AY, McIntyre N. Lecithin-cholesterol acyltransferase and the lipoprotein abnormalities of parenchymal liver disease. Clin Sci 1979; 56: 575-583
24 Wiedman SW, Ragland JB, Sabesin SM. Plasma lipoprotein composition in alcoholic hepatitis: accumulation of apolipoprotein Erich high density lipoprotein and preferential reappearance of “light” -HDL during partial recovery. J Lipid Res 1982; 23: 556-569
25 Haskell WL, Camargo Jr C, Williams PT, Vranizan KM, Krauss RM, Lindgren FT, Wood PD. The effect of cessation and resumption of moderate alcohol intake on serum high density lipoprotein subfractions. N Eng J Med 1984; 310: 805-810
26 Johansson B, Medhus A. Increase in plasma α-lipoproteins in chronic alcoholics after acute abuse. Acta Med Scand 1974; 195: 273-277
27 Devenyi P, Robinson GM, Kapur BM, Roncari DA K. High density lipoprotein cholesterol in male alcoholics with and without severe liver disease. Am J Med 1981; 71: 589-594
28 Taskinen MR, Valimaki M, Nikkila EA, Kussi T, Ehnholm C, Ylikahari R. High density lipoprotein subfractions and postheparin plasma lipases in alcoholic men before and after ethanol withdrawal. Metabolism 1982; 31: 1168-1174
29 Ekman R, Fex G, Johansson BG, Nilsson-Ehle P, Wadstein J. Changes in plasma high density lipoproteins and lipolytic enzymes after long-term heavy ethanol consumption. Scand J Clin Lab Invest 1981; 41: 709-715
30 Avogaro P, Cazzolato G, Belussi F, Bittolo Bon G. Altered apoprotein composition of HDL₂ and HDL₃ in chronic alcoholics. Artery 1982; 10: 317-328
31 Wiedmann SW, Beard JD, Sabesin SM. Plasma lipoprotein changes during abstinence in chronic alcoholics. Atherosclerosis 1984; 52: 151-166
32 Danielsson B, Ekman R, Fex G, Johansson BG, Kristensson H, Nilsson-Ehle P, Wadstein P. Changes in plasma high density lipoproteins in chronic male alcoholics during and after abuse. Scand J Clin Lab Invest 1978; 38: 113-119
33 Nilsson-Ehle P. Alcohol induced alterations in lipoprotein lipase activity and plasma lipoproteins. In: Metabolic effects of alcohol. Avogaro P, Sirtori CR, Tremoli E. (Eds). Elsevier; Amsterdam: 1979. pp 175-186
34 Nordoy A, Refsum N, Thelle D, Jaeger S. Platelet function and serum high density lipoproteins. Thromb Haemostas 1979; 42: 1181-1186
35 Koller E, Koller F, Doleschel W. Specific binding sites on human blood platelets for plasma lipoproteins. Hoppe-Seyler’s Z Physiol Chem 1982; 363: 395-405
36 Curtiss LR, Plow EF. Interaction of plasma lipoproteins with human blood platelets. Blood 1984; 64: 365-374
37 Weisgraber KH, Mahley RW. Subfractionation of human high density lipoproteins by heparin-Sephrarose affinity chromatography. J Lipid Res 1980; 21: 316-325