Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions

Tumor-educated platelets in lung cancer

Non-invasive diagnostic monitoring techniques have become essential for treating lung cancer (LC), which continues to be the primary cause of cancer-related death worldwide. The new diagnostic biomarkers called tumour-educated platelets (TEPs) show strong prospects for providing vital information about tumor biology, tumor spread pathways, and treatment reaction patterns. Despite lacking a nucleus, platelets exhibit an active RNA profile that develops through interactions with tumor-derived compounds and the tumor microenvironments (TME). This review explains platelet-tumour interaction regulatory mechanisms while focusing on platelet contributions toward cancer development, immune system avoidance, and blood clot formation. The detection and classification of LC show promise through the analysis of RNA molecules extracted from platelets that encompass mRNAs and non-coding RNAs. RNA sequencing technology based on TEP demonstrates excellent diagnostic power by correctly identifying LC patients alongside their oncogenic alterations of EGFR, KRAS, and ALK. Treatment predictions have proven successful using platelet RNA profiles, specifically in immunotherapy and targeted therapy. Integrating next-generation sequencing with machine learning and artificial intelligence enhances TEP-based diagnostic tools, improving detection accuracy. Standardizing platelet extraction methods and vesicle purification from tumor material needs better development for effective and affordable clinical use. Future investigations should combine TEPs with circulating tumor DNA and exosomal RNA markers to enhance both earliest-stage LC diagnosis and patient-specific therapeutic approaches. TEPs introduce a groundbreaking technique in oncology since they can transform non-invasive medical diagnostics and therapeutic monitoring for cancer.

Biochemical and hematological reference intervals in rhesus and cynomolgus macaques and implications for vaccine and drug development

Nonhuman primates have a key role in the evaluation of novel therapeutics including vaccine and drug development. Monitoring biochemical and hematological parameters of macaques is critical to understand toxicity and safety, but general reference intervals following standardized guidelines remain to be determined. Here we compiled multiple internal datasets to define normal ranges of classical biochemical and hematological parameters in Indian and Chinese rhesus macaques as well as cynomolgus macaques. Furthermore, the combination of hematological data with phenotypic information of cells obtained by flow cytometry enabled analyses of specific immune cell subsets. We found that vaccination generally induced transient changes at 24 h in cell frequencies accompanied by fluctuation in selected liver enzymes and metabolites. However, most parameters remained within our identified reference intervals. These deviations did not lead to noticeable side effects. Fluctuation in selected biochemical and hematological parameters was accompanied with differentiation of CD14+CD16+ intermediate monocytes and upregulation of genes associated with interleukin-1 signaling. By contrast, two animals with noticeable side effects showed sustained deviations. This study provides insights into baseline and vaccine-induced biochemical and hematological profiles of healthy macaques, facilitating the interpretation of toxicity and safety assessments in preclinical trials of novel therapies.

Inactivation of antibiotic resistant bacteria by ruthenium-doped carbon dots capable of photodynamic generation of intracellular and extracellular reactive oxygen species

Wound infections caused by methicillin-resistant Staphylococcus aureus (MRSA) present a significant challenge to wound healing. This has motivated the development of novel antibiotic-free agents. In this study, ruthenium-doped carbon dots (Ru-CDs) with photodynamic antibacterial activity were synthesized to treat MRSA-infected skin wounds. The Ru-CDs were prepared via a hydrothermal method using Ru-Aphen as the nitrogen source and citric acid as the carbon source, resulting in uniform spherical nanoparticles with an average size of 2.7 ± 0.8 nm. Singlet oxygen generation was observed when the Ru-CDs were exposed to light. In vitro experiments showed concentration- and light-dependent antibacterial activity of the Ru-CDs against MRSA, with 99.9 % bacterial reduction when treated with 100 μg/mL Ru-CDs under light for 10 min. A significant level of intracellular ROS was observed, and microscopy confirmed bacterial membrane disruption. Biocompatibility tests showed no significant toxicity, and in vivo studies on rabbit wound models demonstrated effective antibacterial activity under light conditions and enhanced wound healing compared to controls. The results collectively highlight the potential of Ru-CDs as an antibiotic-free agent for treating antibiotic resistant bacterial infections through photodynamic generation of extracellular ROS and induction of intracellular ROS.

Platelet Count and Platelet Hematocrit Correlate to the Occurrence and Postoperative Recurrence in Intrauterine Adhesion Patients

Background

Platelet count (PLT) has been identified as a predictor for the development of pelvic adhesions. However, it remains unclear whether platelet-related parameters can also serve as indicators for the occurrence of intrauterine adhesions (IUA).

Methods

Patients diagnosed with IUA were included for further analysis, with platelet-related parameters assessed through routine blood tests. The predictive value of PLT and platelet hematocrit (PCT) was evaluated using receiver operating characteristic (ROC) curve analysis. Recurrence of IUA was determined based on a one-year follow-up.

Results

Our study included 69 IUA patients and 60 matched healthy women. We found that PLT and PCT levels were significantly elevated in IUA patients compared to the healthy controls. ROC analysis demonstrated that both PLT and PCT effectively predicted the occurrence of IUA. Additionally, higher PLT and PCT levels were noted in patients with recurrent IUA, suggesting their potential for predicting recurrence.

Conclusion

Elevated PLT and PCT levels were observed in patients with IUA and were further increased in those with recurrent cases. These findings suggest that high PLT and PCT levels may serve as valuable predictors for both the occurrence and recurrence of IUA. Specifically, the study is limited by the small sample size of recurrent IUA cases and potential confounders. These limitations should be considered when interpreting the findings.

Correlation Analysis of Coagulation and Platelet Parameters with Clinical Outcomes in Rheumatoid Arthritis Patients and the Interventional Effect of Jianpi Huashi Tongluo Formula - Xinfeng Capsule: A Post Hoc Analysis Based on an Randomized Controlled Trial

Background

Rheumatoid arthritis (RA) patients frequently present coagulation and platelet abnormalities. Jianpi Huashi Tongluo Prescription - Xinfeng Capsule (XFC), a traditional Chinese medicine compound preparation, has demonstrated efficacy in improving RA disease activity and inflammation in clinical trials (Clinical Trial.gov: NCT01774877), but its effects on coagulation and platelet parameters remain unclear.

Objective

To explore the relationship between coagulation/platelet parameters and RA disease activity, quality of life, and inflammatory indicators, and to assess the improvement effect of XFC treatment over 12 weeks.

Methods

A post-hoc analysis of 304 RA patients assessed disease activity (DAS28), quality of life (SAS/SDS), and coagulation/platelet parameters. Spearman correlation, logistic regression, restricted cubic spline (RCS), and ROC analyses explored relationships between parameters. Mediation analysis was performed to explore the mediating effects of inflammatory indicators. XFC and leflunomide (LEF) were compared for coagulation and platelet parameters improvements after 12 weeks.

Results

Coagulation and platelet parameters were significantly correlated with immune-inflammatory indicators, as well as with DAS28, SAS, and SDS scores. Logistic regression identified ESR/CRP as DAS28 risk factors, FBG/DD/PLT/PCT/CRP as SAS risks, and FBG/CRP as SDS risks. Specific combinations of parameter levels significantly increased the risks of DAS28, SAS, and SDS. RCS revealed non-linear relationships. Mediation analysis indicated that CRP/ESR mediated the relationship between coagulation parameters and disease activity, as well as quality of life. ROC indicated CRP best predicted DAS28, PLT for SAS, and ESR for SDS. The XFC group exhibited significant improvements in APTT, TT, PLT, PCT, and PDW, while the LEF group showed improvements in APTT, TT, FBG, and MPV. XFC outperformed LEF in improving FBG, PLT, PCT, PDW, and MPV.

Conclusion

Coagulation/platelet parameters in RA patients are closely associated with increased disease activity and decreased quality of life. Furthermore, XFC exhibits significant advantages over LEF in improving FBG, PLT, PCT, PDW, and MPV.

The Clinical Features of Otitis Media with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and the Role of Routine Blood Tests in Its Diagnosis

BACKGROUND

To study the clinical features of otitis media with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) and its differences with other forms of ANCA-associated vasculitis (non-OMAAV) and to explore whether routine blood tests could be beneficial to diagnosing OMAAV.

METHODS

A retrospective study was conducted on 18 patients with OMAAV, 15 patients with non-OMAAV, and 23 patients with otitis media with effusion (OME). Basic and clinical information, laboratory data, and treatment outcomes were collected. The differences in the clinical characteristics between OMAAV and non-OMAAV patients were explored. Furthermore, the red cell distribution width (RDW), mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were compared between OME and OMAAV patients. The optimal cutoff values for the routine blood indicators were estimated via receiver operating characteristic (ROC) curve analysis.

RESULTS

All eighteen OMAAV patients (100%) were initially misdiagnosed. Compared with non-OMAAV patients, involvement of nose, throat, and facial nerve was more common in OMAAV patients, whereas kidney damage was less common. However, neither of these differences was statistically significant. Relapse and disease-related death rates did not differ between the OMAAV and non-OMAAV groups. OMAAV patients presented with a lower MPV but a higher PLR and NLR than OME patients (P < 0.05).

CONCLUSION

OMAAV is often misdiagnosed as OME in elderly patients, but unlike OME, OMAAV is characterized by mixed hearing loss over its course. Low-cost routine blood tests may help otolaryngologists distinguish OMAAV from OME in the early stage. An abnormal middle ear condition with mixed hearing loss and a PLR ≥ 203.3 or NLR ≥ 4.7 may suggest a potential OMAAV diagnosis.

Exploring the Inflammatory Basis of Endometrial Polyps: Clinical Implications of Hematological Biomarkers in a Retrospective Study

Background/Objectives: Endometrial polyps (EPs) are common benign endometrial lesions often linked to abnormal uterine bleeding and infertility. While hormonal factors play a key role in their development, recent studies suggest a potential inflammatory component. This retrospective study aimed to assess systemic inflammatory markers, including mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), in EP patients. Methods: A total of 180 patients were classified into three groups: EP (n = 60), chronic endometritis (n = 60), and control (n = 60). Preoperative hematological parameters were retrieved from medical records. Group comparisons were performed using one-way ANOVA, with Tukey's post hoc test applied when significant. Multinomial logistic regression was used to identify independent predictors of EPs. Results: MPV and PLR were significantly higher in the EP group compared to other groups (p = 0.014 and p = 0.015, respectively), while NLR differences were not statistically significant (p = 0.086). Logistic regression identified MPV (p = 0.004) and PLR (p = 0.045) as independent predictors of EPs. Conclusions: These findings suggest that systemic inflammation may contribute to EP development, with MPV and PLR serving as potential inflammatory biomarkers. Further prospective studies with histopathological validation are needed to clarify the role of inflammation in EP pathogenesis.

Effects of Non-Surgical Treatment on Hematological Indices in Stage III/IV Grade C Periodontitis

OBJECTIVE

To investigate the short-term effects of non-surgical periodontal treatment (NSPT) on clinical and hematological indices in stage III/IV grade C periodontitis patients.

METHODS

A total of 121 systemically healthy patients with generalized stage III/IV, grade C periodontitis were enrolled. Clinical indices (plaque index, probing depth, bleeding index, attachment loss) and hematological biomarkers [white blood cell count (WBC), mean platelet volume (MPV), neutrophil count (NEUT), neutrophil percentage (NEUT%), lymphocyte percentage (LYM%)] were measured before and 6-8 weeks after NSPT. Patients were divided into younger (≤ 35 years) and elder (> 35 years) groups, further stratified by systemic antibiotics usage. Analyses were performed using chi-squared tests, paired t-tests, and Pearson's correlation.

RESULTS

NSPT resulted in clinical indices improvement, as well as a reduction in WBC, NEUT, NEUT%, and an increase in MPV and LYM% in both groups. SRP-with-antibiotics subgroups showed more significant changes. SRP-without-antibiotics subgroups showed six significant correlations in both groups (p < 0.05); SRP-with-antibiotics subgroups showed 11 correlations in the younger and five in the elder group (p < 0.05).

CONCLUSIONS

NSPT improved clinical and hematological outcomes in stage III/IV grade C periodontitis patients over 6-8 weeks. Younger patients exhibited more significant changes than elder patients, especially in the SRP-without-antibiotics subgroup.

Diagnostic and Prognostic Value of Hematological Parameters in Necrotizing Enterocolitis: A Systematic Review

Background/Objectives: Necrotizing enterocolitis (NEC) is a severe, potentially fatal gastrointestinal disease that primarily affects preterm neonates, especially those with very low birth weight (<1500 g). Despite extensive research, its pathophysiology remains unclear, with NEC considered a spectrum of disorders driven by systemic inflammation, microbiota dysregulation, and intestinal hypoxic injury. Diagnosis is challenging due to its subtle presentation and reliance on clinical and radiographic findings, underscoring the urgent need for reliable early biomarkers. Complete blood count (CBC) is one of the most frequently performed laboratory tests in neonatal care, providing valuable insights associated with hematologic alterations associated with NEC. Given its cost-effectiveness, accessibility, and rapid turnaround time, CBC parameters have been increasingly investigated for their diagnostic and prognostic potential in NEC. This systematic review consolidates existing evidence on the diagnostic and prognostic utility of CBC parameters in NEC, examining their association with disease onset, progression, and outcomes. Methods: A systematic review of the literature in PubMed and Scopus databases was conducted, between February 25 and December 2024. Results: Following a PRISMA-compliant search strategy, 77 eligible studies were included, analyzing data from 295,195 neonates, of whom 14,570 had NEC. Among the 77 studies, 17 examined NEC-associated mortality as a primary outcome, while 13 studies focused on the development of predictive models incorporating CBC parameters alongside other clinical and laboratory data to assess NEC severity and prognosis in neonates. The findings highlight the potential of CBC-derived markers to facilitate early NEC detection and risk stratification. However, variations in study design and diagnostic criteria highlight the need for prospective studies to validate their clinical use. Conclusions: Despite advancements in understanding NEC, its diagnosis remains challenging due to the absence of fully reliable biomarkers. CBC parameters show promise in offering early diagnostic and prognostic insights. However, further validation is needed for their routine integration into NICU practice. Given the persistent challenges in NEC diagnosis and management, our findings highlight the necessity for integrated scoring systems that combine hematologic, clinical, and radiologic data to enhance early detection and optimize neonatal care. Further research is essential to refine these predictive models, enabling timely interventions and improving survival rates in NEC-affected neonates.

Machine Learning Insight: Unveiling Overlooked Risk Factors for Postoperative Complications in Gastric Cancer

BACKGROUND

Since postoperative complications after gastrectomy for gastric cancer are associated with poor clinical outcomes, it is important to predict and prepare for the occurrence of complications preoperatively. Conventional models for predicting complications have limitations, prompting interest in machine learning algorithms. Machine learning models have a superior ability to identify complex interactions among variables and nonlinear relationships, potentially revealing new risk factors. This study aimed to explore previously overlooked risk factors for postoperative complications and compare machine learning models with linear regression.

MATERIALS AND METHODS

We retrospectively reviewed data from 865 patients who underwent gastrectomy for gastric cancer from 2018 to 2022. A total of 85 variables, including demographics, clinical features, laboratory values, intraoperative parameters, and pathologic results, were used to conduct the machine learning model. The dataset was partitioned into 80% for training and 20% for validation. To identify the most accurate prediction model, missing data handling, variable selection, and hyperparameter tuning were performed.

RESULTS

Machine learning models performed notably well when using the backward elimination method and a moderate missing data strategy, achieving the highest area under the curve values (0.744). A total of 15 variables associated with postoperative complications were identified using a machine learning algorithm. Operation time was the most impactful variable, followed closely by pre-operative levels of albumin and mean corpuscular hemoglobin. Machine learning models, especially Random Forest and XGBoost, outperformed linear regression.

CONCLUSIONS

Machine learning, coupled with advanced variable selection techniques, showed promise in enhancing risk prediction of postoperative complications for gastric cancer surgery.

Mean Platelet Volume-to-Albumin Ratio as a Predictor of Mortality in Patients with Febrile Neutropenia: An Observational Study

Background and Objectives: Febrile neutropenia (FN) is a life-threatening complication in cancer patients, necessitating early risk stratification for optimal management. While the Multinational Association for Supportive Care in Cancer (MASCC) risk index is commonly used for mortality prediction, novel biomarkers that integrate inflammatory and nutritional status may improve prognostic accuracy. This study evaluates the mean platelet volume (MPV)-to-albumin (ALB) ratio as a predictor of mortality in patients with febrile neutropenia. Materials and Methods: A prospective study was conducted on patients diagnosed with febrile neutropenia. The MPV/ALB ratio was calculated at admission, and its predictive value for mortality was assessed using receiver operating characteristic (ROC) curve analysis. The results were compared with the MASCC risk index for predicting mortality both during the FN episode and within 28 days. Statistical analysis included sensitivity, specificity, and negative predictive value assessments. Results: The MPV/ALB ratio was significantly lower in non-survivors compared to survivors. A threshold of 0.245 effectively stratified patients at high risk, demonstrating strong specificity and high negative predictive value. The MPV/ALB ratio outperformed the MASCC risk index in predicting mortality during febrile neutropenia, whereas the MASCC index showed slightly better performance for 28-day mortality prediction. Conclusions: The MPV/ALB ratio is a promising biomarker for mortality prediction in febrile neutropenia, offering a simple and accessible tool for early risk assessment. Its superior performance in predicting mortality during FN highlights its potential clinical utility. Further prospective studies are needed to validate these findings and explore the integration of the MPV/ALB ratio into existing risk assessment models.

Independent and Combined Associations between Metals Exposure and Inflammatory Markers among the General U.S. Adults

Exposure to metals can trigger a series of diseases by dysregulating the human immune system, but there is still a lack of systematic studies assessing the independent and combined effects of exposure to metals on immune function in the general population, particularly concerning inflammation markers. This cross-sectional study was designed to mainly examine the associations between urinary metal mixtures and inflammatory markers, including white blood cell (WBC), platelet count (PLT), mean platelet volume (MPV), MPV/PLT ratio (MPR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR). A total of 3451 participants aged ≥20 years were selected from the 2013-2016 National Health and Nutrition Examination Survey. Generalized linear models were used to investigate the relationships of exposure to single metals on inflammatory markers. Associations between coexposure to multiple metals and inflammatory markers were determined using weighted quantile sum regression and quantile g-computation. Barium, cadmium, lead, thallium, and cobalt showed significant associations with MPV, PLR, and NLR. Metal mixtures showed a negative association with MPV, while they had positive associations with PLR and NLR. Overall, our study highlights the significant effects of multiple metals exposure on inflammation markers, including MPV, PLR, and NLR, among U.S. adults. Thereinto, uranium, cadmium, and cobalt were identified as major contributors. Further prospective studies representative of other countries are warranted to either validate or refute our findings.

Determination of the relationships between hyperemesis gravidarum and systemic inflammation markers: a case‒control study

BACKGROUND

We conducted our study to investigate the relationships between hyperemesis gravidarum (HEG) and inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR).

MATERIALS AND METHODS

A total of 150 pregnant women diagnosed with HEG and 150 controls were included in our study. The data analysed included demographic variables, complete blood count results, and urinary ketonuria levels.

RESULTS

We found that the NLR, PLR and MLR were significantly greater in HEG patients than in controls (p < 0.05), indicating a potential role of systemic inflammation in the pathophysiology of HEG. Receiver operating characteristic (ROC) analysis revealed that these markers had moderate discriminative power, suggesting their utility as adjunctive diagnostic tools in clinical settings. However, no correlation was found between inflammatory markers and the severity of ketonuria.

CONCLUSIONS

The NLR, PLR and MLR can be used as indicators of HEG as a result of the inflammatory process in pregnant women with HEG.

Research advances in inflammation and oxidative stress in varicocele-induced male infertility: a narrative review

ABSTRACT

Varicocele, the most common and treatable cause of male infertility, significantly impacts fertility. The pathophysiological mechanisms of varicocele have not been fully understood yet. Recent studies have focused on the pathophysiology of varicocele-induced infertility, highlighting inflammation and oxidative stress as key contributing factors. We reviewed recent research on the roles of inflammation and oxidative stress in the pathophysiology of varicocele and found that they negatively impact semen parameters, spermatogenesis, and testicular and epididymal function. In addition, this article summarizes the related factors of inflammation and oxidative stress caused by varicocele. Finally, a brief consideration on the treatments to address inflammation and oxidative stress is proposed. This review may provide treatment options and targets for varicocele-induced infertility. However, the relationship between inflammation and oxidative stress in varicocele still needs further study.

Altered platelet phenotype in patients with type II endoleaks following abdominal aortic aneurysm repair

BACKGROUND

Endovascular abdominal aortic aneurysm repair (EVAR) is a preferred surgery to prevent aneurysm sac enlargement and minimize the risk of life-threatening rupture in patients with AAA. Serious complications of type II endoleaks following EVAR can cause sac expansion and increase rupture risk. This study focused on evaluating clinical and blood characteristics in patients with type II endoleaks to refine our understanding of systemic fluctuations associated with unsuccessful EVAR.

METHODS

This retrospective study included 146 patients with AAA who underwent primary elective endovascular procedures (EVAR/fEVAR) between 2013 and 2021. Clinical characteristics, complete blood count (CBC) and imaging data were analyzed from patients who did and did not develop type II endoleaks.

RESULTS

Mean platelet volume (MPV) was significantly increased in patients who developed type II endoleaks after EVAR. Receiver operating characteristic analysis showed that MPV has a satisfactory discriminatory performance in distinguishing post-EVAR patients who developed type II endoleaks, yielding an area under the curve (AUC) value of 0.64. A risk stratification panel incorporating MPV, type II diabetes history, and administration of dual antiplatelet therapies yielded an AUC of 0.70 and predicted an endoleak-free survival rate with a hazard ratio of 2.94. A nomogram revealed that MPV had the highest scoring weight among all significant variables.

CONCLUSION

Patients with type II endoleaks following EVAR have elevated MPV indicative of different phenotypes of circulating platelets. MPV presents an attractive predictive criteria for assessing the occurrence of type II endoleaks in patients with AAA.

Mean Platelet Volume-to-Platelet Count Ratio (MPR) in Acute Exacerbations of Idiopathic Pulmonary Fibrosis: A Novel Biomarker for ICU Mortality

Background and Objectives: Acute exacerbation of idiopathic pulmonary fibrosis (IPF-AE) often results in severe respiratory distress requiring treatment in the intensive care unit and has a high mortality rate. Identifying prognostic markers and assessing disease severity are crucial for clinicians to gain detailed insights. The mean platelet volume-to-platelet count ratio (MPR) is an inflammatory marker commonly used in malignancies. This study aimed to evaluate MPR and other factors affecting mortality in patients with IPF-AE who were monitored in the intensive care unit (ICU). Materials and Methods: This retrospective study was conducted on patients monitored in the ICU for IPF-AE between 2017 and 2023. Demographic characteristics, vital signs, laboratory and imaging findings, and administered treatments were reviewed. MPR was calculated by dividing the mean platelet volume by the platelet count. The primary endpoint was defined as 1-month in-hospital mortality. Results: A total of 59 patients monitored in the ICU for IPF-AE were included in the study. The mean age of the patients was 62.75 years, and 81.4% of the participants were male. During the 30-day follow-up period, 62.7% of the patients died. The need for invasive mechanical ventilation (IMV) was significantly associated with increased mortality (p < 0.001). The optimal cutoff value for MPR was determined to be 0.033, with a sensitivity of 83.7% and specificity of 63.64%, indicating its predictive value for mortality (AUC: 0.764; 95% CI: 0.635-0.864; p < 0.001). Conclusions: In this study, the need for IMV emerged as a critical parameter in predicting mortality in patients with IPF-AE. Additionally, the use of the MPR as a prognostic biomarker may offer a novel approach in the management of IPF patients. These findings could contribute to the development of strategies aimed at early intervention in IPF patients. Further studies with larger sample sizes are needed to validate these results. This study has demonstrated that MPR is a significant prognostic biomarker for predicting mortality in patients with IPF-AE who are managed in the intensive care unit. The potential use of MPR as a biomarker in clinical decision-making may provide new approaches to the management of IPF patients. Additionally, the need for IMV in IPF-AE emerges as a critical parameter for predicting mortality. These findings may contribute to the development of early intervention strategies for IPF patients. Further studies with larger cohorts are needed to validate these results.

Platelet mass index, systemic immune-inflammation index, and neutrophil-lymphocyte ratio as practical markers in childhood brucellosis

OBJECTIVE

Brucellosis is a multisystem infectious disease and may cause an increase in acute phase reactants. This study aimed to examine the platelet mass index (PMI), the neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in children with brucellosis and to determine their roles in focal involvement.

METHODS

This retrospective observational study included 69 patients with brucellosis and a control group of 69 healthy children. Inflammation markers, PMI, NLR, and SII were compared in brucellosis patients and the control group and in brucellosis patients with and without focal involvement.

RESULTS

Hemoglobin and platelet values were significantly lower in brucellosis cases compared to the control group (p<0.001), and C-reactive protein and ferritin were significantly higher (p<0.001). SII and PMI were significantly lower in the brucellosis patient group compared to the control group (p<0.001). In the comparing cases with and without focal involvement, no statistically significant difference was detected in hematological parameters and inflammation markers.

CONCLUSIONS

This study showed that PMI, one of the new markers that can be calculated from complete blood count, may be useful in diagnosing childhood brucellosis. Similar results could not be reached for NLR and SII. New studies testing the diagnostic value of PMI, NLR, and SII in childhood brucellosis are needed.

Blood Cells Parameters in Second Trimester of Pregnancy and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis

OBJECTIVE

Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy. There is inconsistency between previous studies regarding the blood and inflammatory parameters levels among pregnant women and its association with GDM. This study aimed to investigate the relationship between blood parameters in relation to GDM.

METHODS

Systematic literature searches were carried out through databases like PubMed, Web of Science, Epistemonikos, Scopus, Scientific Information Database and Magiran till May 2024. The effect size of serum blood parameters levels was determined by using standard mean deviations (SMDs) and 95% confidence intervals (CIs).

RESULTS

Thirty articles were included in this study. Meta-analysis showed that compared with the control group, women with GDM had significantly higher levels of haemoglobin (0.343 [95% CI 0.134-0.553] p = 0.01, sensitivity analysis: 0.174 [95% CI 0.0343-0.315] p = 0.01), red blood cell (0.387 [95% CI 0.224-0.550] p < 0.001), mean platelet volume (0.498 [95% CI 0.165-0.831] p = 0.003), white blood cell count (0.351 [95% CI 0.0882-0.615] p = 0.009) and neutrophil-lymphocyte ratio (0.534 [95% CI 0.127-0.941] p = 0.01). However, women with GDM had lower levels of mean corpuscular haemoglobin concentration (-0.249 [95% CI -0.386--0.112] p < 0.001). Pooled results from MPV showed no association between adjusted MPV and GDM (adjusted OR 1.33 [95% CI 0.8-1.86] I2 = 57.2%).

CONCLUSIONS

Finding supports higher levels of blood parameters (Hb, RBC, WBC, NLR and MPV) among women with GDM in the second trimester of pregnancy. Future studies should investigate the potential role of these haematological markers as predictive tools for adverse pregnancy outcomes and evaluate therapeutic interventions targeting these parameters to enhance maternal and fetal health.

Hematological markers as prognostic indicators in multiple sclerosis progression

AIMS

To evaluate routine blood count parameters as diagnostic and prognostic markers in Multiple Sclerosis (MS) progression.

PATIENTS/METHODS

182 patients with Relapsing-Remitting MS (RRMS) and 60 with Secondary Progressive MS (SPMS) were analyzed for blood parameters.

RESULTS

In RRMS, the Expanded Disability Status Scale (EDSS) score correlated positively with Red Cell Distribution Width (RDW). In SPMS, the EDSS score correlated positively with White Blood Cell count (WBC) and Mean Platelet Volume (MPV). RDW predicted higher EDSS scores in RRMS, while MPV was a predictor in SPMS. Elevated MPV levels characterized the increased risk of transitioning from RRMS to SPMS.

CONCLUSIONS

Elevated MPV may serve as a significant indicator of disease progression from RRMS to SPMS, emphasizing its potential clinical relevance.

Platelet distribution width-a prognosis marker in patients with chronic heart failure

Background

Increased levels of platelet distribution width (PDW) can predict cardiac death and infarction recurrence in acute myocardial infarction. PDW appears to be a prognosis marker in acute heart failure (HF); however, its impact on chronic HF is still unknown. We investigated the impact of PDW on chronic HF.

Methods

We retrospectively analyzed outpatients with chronic HF with left ventricular systolic dysfunction (LVSD) from January 2012 to May 2018. Patients with no data on PDW levels or with preserved or recovered ejection fraction were excluded. The primary end point was all-cause mortality. Multivariable Cox regression analysis was used to evaluate the association between PDW and mortality. A multivariate model was built adjusting for age, sex, comorbidities, brain-type natriuretic peptide, New York Heart Association (NYHA) class, evidence-based therapy, and severity of LVSD.

Results

In our cohort of 766 patients, 65.7% were male, the mean age was 70 years, and 35.4% were in NYHA class I; 38.3% had diabetes mellitus, 51.4% had severe LVSD, and 3.9% had an inflammatory or autoimmune disease. The median (interquartile range) PDW was 13.5 (12.1-14.9) fL. During a median follow-up of 49 (30-79) months, 372 patients (48.6%) died. Patients with PDW ≥ 14.3 fL presented a multivariate-adjusted higher risk of all-cause death than those with lower values (hazard ratio: 1.32, 95% confidence interval [CI]: 1.05-1.64, P = .2).

Conclusions

Patients with PDW ≥14.3 fL (upper tercile for PDW) presented a multivariate-adjusted 32% (95% CI: 5-64%) higher risk of all-cause death than those with lower values. PDW can help clinicians stratify patients with chronic HF; it is a practical, inexpensive, and widely available parameter.

Mean platelet volume to lymphocyte ratio as an inflammatory marker associated with high-grade recurrence and progression of non-muscle-invasive bladder cancer treated with Bacillus Calmette-Guérin

Introduction

To assess the value of a novel inflammatory marker involving the ratio between mean platelet volume and lymphocyte counts (MPVL) in the prediction of high-grade recurrence-free survival (HG RFS) and progression-free survival (PFS) in patients with non-muscle-invasive bladder cancer (NMIBC) treated with adjuvant Bacillus Calmette-Guérin (BCG) therapy.

Material and methods

In this retrospective, single tertiary centre study the medical records of 216 consecutive patients with NMIBC, who received BCG between 2010 and 2019, were reviewed. Kaplan-Meier curves and Cox proportional hazard regression were used for survival analysis.

Results

We included 194 patients who underwent transurethral resection of a bladder tumour and received at least an induction course of BCG. The majority of patients presented with high-grade T1 tumours (n = 114, 59%). Within a median follow-up of 65 months (IQR: 27-93), 35 patients (18%) experienced progression, and 69 (34.5%) had a high-grade recurrence. Kaplan-Meier analyses revealed a significant association between higher MPVL and worse PFS and HG RFS (both p <0.05). Specifically, patients with higher MPVL demonstrated decreased 5-year PFS (75% vs 90%) and HG RFS (54.5% vs 75%) compared to lower MPVL counterparts. Multivariate analyses confirmed the independent prognostic value of MPVL for HG RFS (HR = 1.7, p = 0.047) and PFS (HR = 2.37, p = 0.026).

Conclusions

In patients with NMIBC treated with adjuvant BCG, an elevated inflammatory marker comprising mean platelet volume and lymphocyte count ratio may serve as a prognostic factor associated with worse PFS and HG RFS. The role of MPVL in clinical decision-making must be validated in further multicentre prospective studies.

Novel immunoinflammatory blood markers in Graves' orbitopathy: insights into activity and severity

OBJECTIVE

This prospective case-control study examined the novel immunoinflammatory markers obtained from blood counts of patients with Graves' orbitopathy (GO), Graves' disease (GD) and healthy subjects.

METHODS

Demographic data, white cell count parameters, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), platelet-to-neutrophil ratio (PNR), red cell distribution width (RDW), RDW-to-platelet ratio (RDW/PLT), MPV-to-lymphocyte ratio (MPV/ALC), eosinophil-to-lymphocyte ratio (ELR) and systemic immune-inflammatory index (SII) were evaluated. The European Group on Graves Orbitopathy scale and Clinical Activity Score were used for clinical activity and severity assessment.

RESULTS

The GO group showed significantly higher mean MPV (p˂0.001) and MPV/ALC (p=0.03) than the GD group. The PLR (p=0.02), MPV/ALC (p=0.04) and SII (p=0.04) were significantly higher in the GO than healthy group. A significantly higher absolute neutrophil count (p=0.005), NLR (p=0.001), MPV (p=0.001), MPV/ALC (p=0.003), MPV/PLT (p=0.04), RDW (p˂0.001), RDW/PLT (p=0.02) and SII (p=0.01) as well as lower ALC (p=0.01) and PNR (p˂0.001) was observed in the active than inactive GO. Moderate to severe GO group had a significantly higher NLR (p=0.006), PLR (p=0.04), ELR (p=0.006), MPV (p=0.03), MPV/ALC (p=0.002), RDW (p˂0.001), RDW/PLT (p=0.02) and SII (p=0.03) as well as a lower ALC (p=0.01) and PNR (p=0.01) than mild GO.

CONCLUSIONS

The MPV/ALC ratio and MPV levels may identify GD patients at risk of GO. The MPV, MPV/ALC, ALC, NLR, PLR, PNR, RDW, RDW/PLT, MPV/PLT and SII may help distinguish the GO activity and severity. However, the study's small sample size and single-centre design may limit the generalisability of the results. Furthermore, the lack of longitudinal follow-up precludes assessing marker evolution over time.

Evaluation of hematological inflammatory parameters in patients with palmoplantar pustulosis

BACKGROUND

Palmoplantar pustulosis (PPP) is a chronic inflammatory disease of ill-defined etiopathology. Recent studies have proposed complete blood count-based hematological parameters, such as neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), as biomarkers to monitor disease status in many inflammatory diseases. This study aimed to analyze for the first time the clinical significance of hematological parameters, including NLR, monocyte/lymphocyte ratio (MLR), PLR, mean platelet volume (MPV), plateletcrit (PCT), and pan-immune-inflammation value (PIV) in PPP patients.

METHODS

We retrospectively investigated the clinical and laboratory data of 237 patients with PPP and 250 sex-age-matched healthy controls (HCs). Hematological parameters were compared between patients with PPP and HCs. The correlations between these parameters and disease severity, as well as treatment response, were analyzed.

RESULTS

NLR, MLR, MPV, PCT, and PIV values were significantly higher in PPP patients than in HCs. But in receiver-operating characteristic analyses, only monocyte count (Youden Index = 0.53), PCT (Youden Index = 0.65), and PIV (Youden Index = 0.52) performed relatively accurate distinguishment between moderate-to-severe cases and mild cases. PCT and PIV values were significantly correlated with disease severity. After treatment, both PIV and PCT values decreased significantly in the responder group but not in the non-responder group.

CONCLUSIONS

Hematological parameters altered significantly in PPP patients. PCT and PIV can be used as simple and inexpensive biomarkers for systemic inflammation in PPP patients.

Association between mean platelet volume and adiponectin in patients with metabolic syndrome

BACKGROUND

Metabolic syndrome is a significant pro-inflammatory and pro-coagulant condition. The clinical association of adiponectin, a mainly antidiabetogenic molecule, and its interaction with platelets and platelet indices remains insufficiently investigated.

OBJECTIVE

The aim of our study was to investigate the association of adiponectin with platelets and platelet indices in patients with metabolic syndrome.

METHODS

The investigation was conducted as a cross-sectional study involving 113 subjects: 63 patients with the diagnosis of metabolic syndrome, and 50 healthy controls - with clear inclusion and exclusion criteria. The group of patients with metabolic syndrome was divided into two subgroups according to the platelet/high-density lipoprotein (HDL) ratio.

RESULTS

The subgroup with a higher platelet/HDL ratio was prediabetic. In the same subgroup of patients, a positive correlation between the adiponectin and mean platelet volume (MPV) was seen, while linear regression (95% CI) confirmed the association.

CONCLUSION

Considering that MPV is the index that indicates average platelet volume and activity, we believe this association with adiponectin can represent a protective compensatory response in patients with metabolic syndrome and prediabetes. Our results provide a basis for a more precise selection of patients in whom the future therapeutic application of recombinant adiponectin would be most effective.

A study of platelet function in patients with chronic immune thrombocytopenia treated with thrombopoietin receptor agonists

BACKGROUND

Thrombopoietin receptor agonists (TPO-RAs) are widely used in immune thrombocytopenia (ITP) and are associated with increased thrombotic risk. However, data regarding their impact on platelet function is scarce.

METHODS

Platelet function was evaluated in chronic ITP patients enrolled over one year, using light transmission aggregometry and platelet-derived microparticle (PMP) levels measurement with flow cytometry. Aggregation responses to various concentrations of ADP, collagen, ristocetin, and PMP levels were compared between TPO-RA-treated patients, patients treated with other agents and healthy individuals.

RESULTS

TPO-RA-treated patients (n = 24) displayed significantly reduced aggregation responses to 2.5 μM, 5 μM, and 10 μM of ADP and collagen compared to 15 healthy individuals (59.5 % vs. 87.6 %, p < .0001, 43.6 % vs. 79.9 %, p < .0001, 26.1 % vs. 75.2 %, p < .0001, 67.2 % vs. 86 %, p < .0001, respectively). Reduced responses to ADP and collagen were also recorded in patients treated with other agents (n = 16) compared to healthy controls but without difference between the two treatment groups. Aggregation response to ristocetin was normal in all three groups. None of the patients yielded enhanced platelet aggregation. In TPO-RA-treated patients, a strong positive correlation between platelet counts and aggregation response to ristocetin was observed (rs = 0.65, p = .0005). PMP levels were significantly elevated in TPO-RA-treated patients compared to patients treated with other agents (49.5 vs 4.5 events/uL, p < .0001) and healthy controls (5 events/uL, p < .0001).

CONCLUSIONS

These results suggest that TPO-RAs may not enhance platelet aggregation responses, whereas impaired responses may be a disease feature. Furthermore, TPO-RAs may increase PMP levels and thus be implicated in the modulation of platelet function in ITP patients.

Significant haematological alterations in clozapine-treated patients: prevalence and clinical correlation

OBJECTIVES

Clozapine is an atypical antipsychotic crucial for treatment-resistant schizophrenia, characterised by its multi-receptor targeting, including serotonin (5-HT2A, 5-HT2C) and dopamine (D1, D2, D3, D4) receptors, among others. This broad mechanism is effective against positive symptoms of schizophrenia with a lower incidence of extrapyramidal side effects. However, clozapine poses significant haematological risks, notably agranulocytosis, necessitating stringent blood monitoring protocols.

METHODS

This study examined haematological parameters in 157 patients on clozapine therapy, analysing the prevalence and clinical correlations of haematological abnormalities such as leucocytosis, thrombocytosis, and alterations in red blood cell distribution width (RDW) and mean platelet volume (MPV).

RESULTS

The findings revealed leucocytosis in 36.9% of patients, thrombocytosis in 8.9%, and elevated RDW in 23.6%. Notably, higher clozapine doses were associated with leucocytosis, though no significant correlations were found between clozapine dose, duration of use, and changes in RDW, mean corpuscular haemoglobin concentration, or MPV.

CONCLUSION

The study's results underscore the necessity of regular haematological monitoring to mitigate the risks of clozapine therapy while leveraging its therapeutic benefits. Additionally, the study suggests personalised dosing strategies to balance efficacy and safety, particularly in managing clozapine-induced haematological changes.

Development of a simplified model and nomogram for the prediction of pulmonary hemorrhage in respiratory distress syndrome in extremely preterm infants

BACKGROUND

Pulmonary hemorrhage (PH) in respiratory distress syndrome (RDS) in extremely preterm infants exhibits a high mortality rate and poor long-term outcomes. The aim of the present study was to develop a machine learning (ML) predictive model for RDS with PH in extremely preterm infants.

METHODS

We performed a retrospective analysis of extremely preterm infants with RDS at the Children's Hospital of Soochow University between January 2015 and January 2021. We applied three ML algorithms-logistic regression (LR), random forest (RF), and extreme gradient boosting (XGBoost)-to evaluate the performance of each model using the area under the curve (AUC), and developed a predictive model based on the optimal model. We calculated SHapley Additive exPlanations (SHAP) values to determine variables importance and show visualization results, and constructed a nomogram for individualized prediction.

RESULTS

A total of 309 patients with RDS were enrolled, including 48 (15.5%) with PH. A total of 29 variables were collected, including demographic and clinical characteristics, laboratory data, and image classification. According to the AUC values, the RF model performed best (AUC = 0.868). Based on the SHAP values, the top five important variables in the RF model were gestational age, PaO2/FiO2, birth weight, mean platelet volume, and Apgar score at 5 min.

CONCLUSIONS

Our study showed that the RF model could be used to predict the risk of PH in RDS in extremely preterm infants. The nomogram provides clinicians with an effective tool for early warning and timely management.

Involvement of platelet signaling pathways in colorectal cancer and new therapeutic targets

Colorectal cancer (CRC) is one of the most widespread tumor types, and it stands as the second leading cause of disease-related mortality globally. Due to its adverse effects, which lead to low patient adherence, new alternatives to conventional chemotherapy and radiotherapy treatments are being studied. Since, in most cases, platelets are positively involved in the persistence and progression of CRC, several elements of the platelet signaling pathway have been considered possible therapeutic targets. The present study assembles the main treatments for CRC and investigates the cellular mechanisms involved in the interaction between blood platelets and cancer cells. Additionally, this review cites other articles that propose possible therapeutic targets in the platelet activation pathways to be explored. Despite the reported benefits of antithrombotic therapy on CRC progression, some studies have warned about an increased bleeding risk and CRC incidence and highlight the importance of controlling this therapy through diagnostic tests. However, their high cost is still a significant obstacle to the population's access from low Human Development Index (HDI) countries. Many research groups have studied platelet signaling pathways in depth to develop a safer, more effective, and affordable therapy for the population.

Mean platelet volume/platelet count ratio can predict the recurrence-free survival rate of patients after complete resection of gastrointestinal stromal tumors

Purpose

The aim of this study is to compare mean platelet volume/platelet count ratio (PVPR) and other indicators' predictive abilities. Simultaneously, a new nomogram for predicting recurrence-free survival (RFS) after gastrointestinal stromal tumors (GISTs) R0 resection was developed.

Methods

From January 2010 to July 2019, 295 patients with GIST who were operated on at Harbin Medical University Cancer Hospital were retrospectively reviewed. With a 4-year RFS as the end point, using the Kaplan-Meier methods and log rank test, and then conducting Cox regression analysis, we compared and identified meaningful indicators for predicting prognosis. Finally, a nomogram was developed and validated using calibration curves.

Results

The receiver operating characteristic curve indicated that a cutoff point of 0.044 was the ideal threshold for PVPR, and patients were divided into a high-PVPR group (≤0.044) and a low-PVPR group (>0.044). Kaplan-Meier curves suggested that PVPR>0.044 had obvious associations with better RFS (p < 0.001). In accordance with multivariate analysis, PVPR (>0.044 vs. ≤0.044) (p = 0.005), National Institutes of Health (NIH) risk category (p < 0.001), and Ki-67 (p = 0.005) were the independent prognostic indicators of RFS. Tumor size, gastrointestinal bleeding, mitotic index, NIH risk category, CD34, and Ki-67 all exhibited an obvious correlation with PVPR (all p < 0.05). The nomogram's probability of concordance was 0.823, indicating that the nomogram predictions were well calibrated.

Conclusion

In GISTs, RFS can be independently predicted by PVPR. Patients with higher PVPR have better RFS. The nomogram including PVPR could be used to assist clinical treatment decision-making.

Peripheral Blood Mean Platelet Volume and the Ratio of Mean Platelet Volume to Platelet Count as Prognostic Biomarkers in Patients with Cutaneous Angiosarcoma of the Head and Neck: A Retrospective Cohort Study

Abstract is missing (Research letter)

Mean platelet volume might be an effective indicator of poor semen quality in varicocele patients

OBJECTIVE

To delve into the relationship between mean platelet volume (MPV) and semen quality in patients with varicocele.

MATERIALS AND METHODS

A total of 246 varicocele patients and 120 healthy adult males were enrolled. Physical examinations and the color Doppler ultrasonography were conducted on patients with varicocele to confirm the diagnosis. Venous blood samples and semen samples were collected from all participants for subsequent analysis. A series of statistical analyses were conducted to assess the relationship between their MPV levels and semen quality. A series of statistical analyses were performed to assess the relationship between MPV and semen quality.

RESULTS

No statistically significant differences were found between body mass index (BMI), sexual hormones, semen volume, platelet count, and right testicular volume in all three groups (health subjects, varicocele without symptoms, and varicocele with infertility). When conducting regression analysis on two groups with varicocele, the results indicated that a lower MPV is associated with a reduced risk of varicocele accompanied by infertility (OR = 0.557 95% CI: 0.432-0.719, P < 0.001). Further correlation analysis in varicocele patients revealed that high MPV had a statistically negative impact on the occurrence of poor semen quality, affecting sperm concentration, progressive motility, and morphology (all P < 0.001). More importantly, when predicting varicocele associated with infertility, MPV demonstrated high diagnostic sensitivity (AUC = 0.745, P < 0.001).

CONCLUSION

Our results indicate that MPV is higher in varicocele with infertility and is closely related to semen quality, which may suggest an accompanying decline in semen quality associated with varicocele. However, these conclusions require further experimental validation.

Study on Undercarboxylated Osteocalcin in Improving Cognitive Function of Rats with Type 2 Diabetes Mellitus by Regulating PI3K-AKT-GSK/3β Signaling Pathwaythrough medical images

This paper aims to clarify the effect of Undercarboxylated osteocalcin (ucOC) on cognitive function in rats with type 2 diabetes mellitus (T2DM). This research reviewed the cognitive function of 35 diabetic patients, 33 non-diabetic patients and the serum levels of Undercarboxylated osteocalcin (ucOC) in patients. What's more, we analyzed the correlation between serum ucOC levels and cognitive function. Diabetic rats were treated with high (30 μg·kg-1·d-1) and low (10 μg·kg-1·d-1) doses of ucOC to investigate its effects in regulating ucOC on blood lipid, blood glucose and cognitive function. We systematically detected the phosphorylation levels of cognitive level-related proteins (PI3K, AKT, and GSK/3β) in the hippocampus by Western Blot. Finally, PI3K-Akt pathway involved in regulating cognitive function in diabetic rats by ucOC was verified with AKT pathway inhibitor LY294002. MoCA score and serum ucOC levels were significantly reduced in patients with diabetes mellitus. ucOC could concentration-dose-dependently decrease the blood glucose and lipid levels, and improve glucose metabolism and weaken insulin resistance in diabetic rats (P < 0.001). In addition, escape latency in diabetic rats was significantly higher than that of normal rats in the Morris maze test, and ucOC dose-dependently shortened the escape latency in diabetic rats (all with P < 0.05). After using AKT pathway inhibitor, ucOC failed to shorten the escape latency in diabetic rats. In conclusion, this study explored the relevant mechanisms in inducing cognitive dysfunction of T2DM, suggesting the potential value of ucOC as a drug to improve cognitive dysfunction in patients with T2DM in clinical.

Mood disorders and 5-HTR2A genetic variants - the moderator effect of inflammation on expression of affective polarity phenotype

BACKGROUND

Although repeatedly confirmed, the molecular nature of gene-environment (GxE) interactions has rarely been investigated in the clinical context of mood disorders. This study assesses the relationship between HTR2A genetic variants and the modulatory effect of inflammation in a collective cohort of patients with major depressive disorder (MDD) and bipolar disorder (BD), as a unified group with two distinct phenotypes.

METHODS

The study included 138 patients with acute mood episodes (BD = 83; MDD = 55). HTR2A rs6313 and rs6314 genotyping was performed while measuring platelet-derived indicators of inflammation (platelet count (PLT), mean platelet volume (MPV), plateletcrit, and platelet distribution width) and the MPV/PLT ratio.

RESULTS

The HTR2A rs6313 variant is a significant predictor of the polarity phenotype in mood disorders, with the MPV/PLT ratio moderating this relationship, but only under low-inflammatory conditions. In more pronounced inflammatory states, genetic influences lose their predictive role.

CONCLUSIONS

To our knowledge, this is the first study to investigate the complex interplay between platelet-derived indicators of inflammation and HTR2A variants in the context of mood disorders. Without pro-inflammatory conditions, mood disorders seem to be more genetically determined. Under pro-inflammatory conditions, phenotypic presentation is less dependent on genetic factors. GxE interactions in mood disorders are multifaceted, context-dependent and relevant for assessing their clinical presentation and course.

Association Between Ratio of White Blood Cells to Mean Platelet Volume and Coronary Artery Ectasia

Coronary artery ectasia (CAE) is a rare vascular phenotype characterized by abnormal dilation of blood vessels and disruption of coronary artery blood flow, which may promote thrombosis and an inflammatory response. We performed a cross-sectional study to investigate the association of white blood cells to mean platelet volume ratio (WMR) with CAE. Consecutive eligible patients (n = 492) were divided into two groups: including 238 patients with CAE and 254 patients in the normal coronary artery (NCA) group. WMR, the systemic immune-inflammation index (SII), and neutrophil-to-lymphocyte ratio (NLR) were found to be significantly associated with CAE in both univariate and multivariate logistic regression analyses. In multivariate analysis, the presence of WMR was associated with CAE (the odds ratios (OR) = 1.002, 95% CI: 1.001-1.003, P < .001). In the ROC analysis, the statistics (Z-values) of WMR vs SII and WMR vs NLR were 2.427 and 2.670 and were statistically significant (P = .015 and P = .008), indicating that WMR was superior to SII and NLR in distinguishing WMR. The optimal cut-off value was calculated from the point of maximal sensitivity and specificity by using Youden's index, which was determined to be 635.50. WMR has the potential to be a cost-effective tool to monitor CAE.

Red cell distribution width and mean platelet volume detection in patients with endometrial cancer and endometrial hyperplasia

Background

Endometrial cancer is the most common malignancy in women in developed countries, and its incidence is increasing annually. Due to the availability and cost-effectiveness of serum markers of red cell distribution width (RDW), and mean platelet volume (MPV), we decided to investigate these two important markers in patients with endometrial cancer and assess their role in diagnosing the tumor and differentiate it from endometrial hyperplasia and other causes of bleeding.

Methods

This is a case-control study that examined the data of patients who were referred to Al-Zahra Hospital during 2022-2023 with complaints of abnormal bleeding and underwent diagnostic curettage. Based on the pathology findings, the patients were divided into 3 groups, including endometrial cancer, endometrial hyperplasia, and control. The clinical characteristics and results of MPV and RDW were compared in these three groups. The IBM SPSS Statistics for Windows, Version 21.0. was used for data analysis.

Results

In this study, 87 women were examined in three groups endometrial cancer, endometrial hyperplasia, and control with a mean age of 52.70 ± 11.63 years. The results showed that the endometrial cancer group, had higher gravida, underlying disease, history of radiation therapy, anticoagulant therapy, blood transfusion, surgery, and family history of cancer (p < 0.05). Meanwhile, the endometrial cancer group had lower menstrual age and history of using contraceptives than other groups (p < 0.05). In addition, in this study, the results indicated that the levels of MPV and RDW in the endometrial cancer group were significantly higher than in the endometrial hyperplasia and control groups (p < 0.05).

Conclusion

Since MPV and RDW are cheap and accessible and can be easily obtained from complete blood count panels, they can be used as suitable diagnostic markers for endometrial cancer. However, conducting comprehensive multicenter prospective studies with a larger sample size can be helpful.

Can serum M30 levels be utilized as an activation marker in patients with ulcerative colitis?

OBJECTIVE

Ascertainment of disease activation is an important component of therapeutic decisions in ulcerative colitis patients and may present certain clinical challenges. The objective of this study was to determine serum levels of the M30 fragment of cytokeratin 18 and its utility as an activation marker in patients with ulcerative colitis, who are known to have increased apoptosis.

METHODS

A total of 60 ulcerative colitis (30 active and 30 remission) patients aged over 18 years and 29 healthy individuals as controls were included in the study. M30, C-reactive protein, and mean platelet volume were evaluated in all participants and compared between ulcerative colitis patients and controls, as well as between those with active disease or remission.

RESULTS

Although ulcerative colitis patients with active disease had higher M30 levels than those in remission, the difference was not statistically significant (p=0.085). The mean M30 levels tended to increase with increasing extent of involvement, although the differences were not significant (p=0.065). The comparison of C-reactive protein and mean platelet volume according to the site of involvement, however, showed significant differences (p=0.02 and 0.004, respectively). M30 did not show significant correlations with C-reactive protein, mean platelet volume, and Mayo Score (p=0.0834, 0.768, and 0.401, respectively).

CONCLUSIONS

Our results suggest that, in contrast to C-reactive protein and mean platelet volume, M30 levels do not have a significant role as an activation marker in ulcerative colitis patients. Thus, we believe that M30 may not represent an appropriate marker to be used for this purpose.

The Role of Platelet Distribution Width in the Association Between Blood Glucose and Neurological Impairment Severity in Acute Ischemic Stroke: A Moderated Mediation Model

Objective

Fasting blood glucose (FBG) is a recognized risk factor for Ischemic Stroke, but little research has examined the interaction among FBG, Platelet Distribution Width (PDW) and the severity of neuronal damage. Thus, the present study constructs a moderated mediation model aimed to elucidate the relationships among FBG, PDW, and NIHSS scores in patients with acute ischemic stroke (AIS).

Methods

We conducted a cross-sectional study on 431 AIS patients. Upon hospital admission, we assessed the patients' NIHSS scores and collected blood samples to measure FBG and PDW levels. The relationship between FBG and NIHSS scores moderated by PDW was analyzed by linear curve fitting analysis, multiple linear regression analysis, and moderated mediation analysis respectively.

Results

In the tertile grouping based on FBG, both PDW and NIHSS scores of AIS patients demonstrated an increase corresponding with rising levels of FBG (p<0.001 for both). Multiple linear regression analysis revealed that, the β coefficients (95% CI) for the relationship between FBG and NIHSS scores were 1.49 (1.27-1.71, p<0.01) post-adjustment for potential confounders. The β coefficients (95% CI) for the relationship between FBG and PDW were 0.02 (0.01-0.04, p<0.01) post-adjustment. Likewise, for the relationship between PDW and NIHSS scores, the β coefficients (95% CI) were 4.33 (3.07-5.59, p<0.01) after adjustment. These positive association remained consistent in sensitivity analysis and hierarchical analysis. Smoothed plots suggested that there are linear relationships between FBG and PDW and NIHSS scores respectively. Further mediation analysis indicated that increased PDW significantly (p<0.01) mediated 5.91% of FBG-associated increased NIHSS scores.

Conclusion

This study suggested that FBG levels were associated with NIHSS scores, and the FBG-associated neurological impairment may be partially mediated by PDW. These findings underscore the importance of monitoring FBG and PDW levels in AIS patients, potentially guiding risk intervention strategies.

The clinical significance of inflammatory biomarkers, IL6 cytokine, and systemic immune inflammatory index in rabbit model of acute and chronic Methicillin-resistant Staphylococcus epidermidis-induced osteomyelitis

Infections are a major complication of open fractures and fracture fixation. In this study, an innovative bioactive medical device was used to experimentally treat MRSE-induced osteomyelitis in rabbit tibia. This paper investigates the clinical significance of inflammatory biomarkers (NLR, PLR, MLR and PMR), SII and IL-6 and assesses their role in the development of osteomyelitis. The main objective is to identify the utility of hematological reports derived from neutrophils, leukocytes, monocytes and platelets in the evolution of implant-related osteomyelitis and the estimation of treatment efficiency. In particular, this study compares the response of these inflammatory markers to different treatments in the presence or absence of bioactive materials and/or topical antibiotics over time. The analysis of the threads showed that NLR, PLR and SII had high values in the acute phase of the disease, so that after chronicization, they decrease. The animals treated with vancomycin nano-functionalized peptide-enriched silk fibroin-coated implants showed lower levels of inflammatory biomarkers compared to the other groups (empty implants and peptide-enriched silk fibroin-coated implants). NLR, PLR and SII, complemented by IL-6 can be used as fairly accurate biomarkers for the diagnosis of osteomyelitis.

The association of platelet count, high-density lipoprotein cholesterol, and platelet/high-density lipoprotein cholesterol ratio with serum soluble Klotho

BACKGROUND AND OBJECTIVE

Klotho is a protein that is closely related to human aging. Soluble Klotho (S-Klotho) is a circulating protein, and its level decreases in response to systemic inflammation. The relationship between the platelet/high-density lipoprotein cholesterol ratio (PHR), an emerging inflammatory index, and S-Klotho concentrations is still unclear. In addition, the mean platelet volume has been confirmed to have a significant negative association with S-Klotho concentrations, but the relationship between the platelet count (PC) and S-Klotho concentrations has not yet been reported.

METHODS

Data from individuals who participated in the National Health and Nutrition Examination Survey (NHANES) during the five cycles from 2007 to 2016 were retrieved for analysis. Linear regression, two-piecewise linear regression, and restricted cubic spline (RCS) methods were used to analyze the associations of the PHR index and its components with S-Klotho concentrations. In addition, subgroup analysis and effect modification tests were conducted.

RESULTS

A total of 11,123 participants (5463 men (48.17%)), with an average age of 56.2 years, were included. After full adjustment, the S-Klotho levels of participants in the highest quartile group of PHR (β: -51.19, 95% CI: -75.41 to -26.97, P < 0.001) and the highest quartile group of PC (β: -72.34, 95% CI: -93.32 to -51.37, P < 0.0001) were significantly lower than those in their respective lowest quartile groups, and a significant downward trend was presented among the four groups (P for trend < 0.05, respectively). However, high-density lipoprotein cholesterol (HDL-C) concentrations were not significantly associated with S-Klotho concentrations. RCS revealed that the PHR and PC were nonlinearly associated with S-Klotho concentrations; two-piecewise linear regression revealed that the inflection points were 175.269 and 152, respectively, and that these associations slightly weakened after the inflection point. According to the subgroup analysis, liver disease status enhanced the association between the PC and S-Klotho concentrations.

CONCLUSIONS

Both the PHR and PC were significantly negatively associated with S-Klotho concentrations, and these associations were nonlinear. There was no significant association between HDL-C and S-Klotho concentrations. Liver disease status enhances the negative association between the PC and S-Klotho concentrations, and the specific mechanism deserves further exploration.

Cogent integration of inflammatory biomarkers and perioperative complications of thyroid surgery in thyroidology

OBJECTIVE

Back to the sources, postoperative nausea and vomiting, hypo- and hypertension, heart rate alterations, and hypoxemia due to laryngospasm might be considered perioperative complications.

METHODS

This cross-sectional study was conducted at an Education and Research Hospital between January 2018 and June 2023. The study included a total of 437 cases of thyroid surgery. The demographic data such as age, sex, co-morbidities of the instances, hypotension, hypertension, bradycardia, hypoxemia, and postoperative nausea and vomiting, as well as laboratory data were obtained and analyzed.

RESULTS

Of 437 cases, 334 (76%) were females and 103 (24%) were males, with a mean age of 51.83±11.91 years and 55.32±11.87 years, respectively. No statistical significance was realized between the complications, co-morbid diseases, and age. Notably, no liaison between the complications after awakening from the anesthesia and preoperative laboratory parameters was discerned. However, a high but no significant relationship was revealed between the platelet-to-lymphocyte ratio (P/L) in cases with hypoxemia and hypotension. Finally, no significance between laboratory values, bradycardia, hypertension, and postoperative nausea and vomiting was distinguished.

CONCLUSION

We postulate that the so-called inflammatory biomarkers measured at the time of preoperative examination in the blood count concept selectively do not enrich for anticipating complications that arise in the perioperative echelon.

Relationship Between Hematologic Inflammatory Markers and Glycemic Control in Type 2 Diabetes Mellitus Patients in a Tertiary Hospital in Nigeria

INTRODUCTION

Hematologic inflammatory biomarkers derived from a full blood count (FBC) are elevated in Type 2 diabetes mellitus (DM). In low- and middle-income countries like Nigeria, a FBC is an affordable and easily available test, even in rural areas. Glycated hemoglobin (HbA1c), a measure of glycemic control, has been found to correlate with hematologic inflammatory markers. In Nigeria, where health care is expensive and patients essentially pay out of pocket, a more affordable and accessible alternative to HbA1c in determining glycemic control is needed. Therefore, this study aimed to determine the relationship between Hb A1c and hematologic inflammatory biomarkers, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV), in predicting glycemic control.

METHODS

This was a six-month study of 109 patients with Type 2 DM in a tertiary hospital in Lagos. The patients' HbA1c and FBC were measured. NLR, PLR, and MPV were derived from the FBC values. We categorized the patients based on glycemic control. Spearman correlation analysis was used to determine the relationship between HbA1c and the inflammatory biomarkers.

RESULTS

There was no significant difference in NLR, PLR, and MPV between optimal and suboptimal controlled diabetic patients. Spearman's correlation analysis showed no significant association between NLR, PLR, MPV, and HbA1c in the patients (NLR: r=0.027, P=0.680; PLR: r=-0.091, P=0.356; MPV: r=-0.032, P=0.744).

CONCLUSION

The inflammatory markers studied had no significant relationship with HbA1c and might not help monitor glycemic control in Type 2 DM patients.

Adverse Associations of Long-Term Exposure to PM2.5 and Its Components with Platelet Traits among Subway Shift-Workers without Air Purifier Use

Air purifier use, shift work, and long-term exposure to fine particulate matter (PM2.5) are linked to platelet abnormality. However, the role of air purifier use and shift work in the individual or joint associations of PM2.5 and its components with platelet indices are largely unknown. A total of 8772 participants were recruited from a population of subway workers in China. PM2.5 and its component data were obtained from the Tracking Air Pollution in China dataset. The role of air purifier use and shift work in the association between PM2.5 and its components and platelet indices were analyzed. Among shift workers without air purifier use, positive associations of PM2.5 and each component in PM2.5 with the mean platelet volume (MPV) or platelet counts (PLT) were observed, whereas negative associations of PM2.5 and each component in PM2.5 with the platelet distribution width (PDW) were observed. Furthermore, estimated changes (95%CIs) in PLT, MPV, and PDW in response to each 10th percentile increment in the mixture of PM2.5 and its components were 0.8657 (0.2496, 1.4819), 0.0192 (0.0054, 0.0329), and -0.0648 (-0.0945, -0.0351), respectively, and sulfate in PM2.5 was the major contributor to those associations. Long-term exposure to PM2.5 and its components was related to increased platelet disorders among shift workers without air purifier use, and those associations were mainly attributed to sulfate in PM2.5.

Mitochondrial Dysfunction of Peripheral Platelets as a Predictive Biomarker for Postoperative Delirium in Elderly Patients

OBJECTIVE

To determine the association between the preoperative Bioenergetic Health Index (BHI) of platelets and the occurrence of postoperative delirium (POD) in elderly patients.

METHODS

Elderly patients scheduled for major abdominal surgery under general anesthesia were included. The presence of POD was assessed within the 3 days after surgery. Seahorse XF analysis and transmission electron microscopy were utilized to evaluate the mitochondrial metabolism and morphology of platelets.

RESULTS

A total of 20 out of 162 participants developed POD. Participants with POD showed lower preoperative Mini-Mental State Examination scores and total protein levels, fewer educational years, longer surgery duration, higher mean platelet volume, and lower platelet BHI compared with those without POD. Damaged mitochondria with swollen appearance and distorted cristae was detected in platelets from participants with POD. Preoperative platelet BHI was independently associated with the occurrence of POD after adjusting for age, education, preoperative Mini-Mental State Examination score, preoperative mean platelet volume and total protein levels, surgical type and duration, and lymphocyte counts on the first postoperative day (OR 0.11, 95% CI 0.03-0.37, p < 0.001). The areas under the receiver operating curves for predicting POD were 0.83 (95% CI 0.76-0.88) for platelet BHI. It showed a sensitivity of 85.00% and specificity of 73.24%, with an optimal cutoff value of 1.61. Using a serial combination (mean platelet volume followed by BHI) yielded a sensitivity of 80.00% and specificity of 82.39%.

INTERPRETATION

Preoperative platelet BHI was independently associated with the occurrence of POD in elderly patients and has the potential as a screening biomarker for POD risk. ANN NEUROL 2024;96:74-86.

Exploring Mean Platelet Volume and Platelet Count Recovery in Dengue Patients: Findings From an Observational Retrospective Clinical Study

Introduction Mean platelet volume (MPV) measures platelet size in the blood, which is important because dengue fever often leads to low platelet counts, especially during the critical phase. However, predicting when a patient's platelet count will recover is challenging due to the lack of clinical data. MPV may offer a solution as it tends to rise when platelet counts fall, suggesting a possible link to bone marrow activity. This study aims to understand how MPV changes during the three phases of dengue fever and how it relates to platelet count recovery. Successful results could provide valuable markers for clinicians, helping improve patient care and management. Material The study was carried out in the Department of Medicine, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India. The patients who were admitted with dengue fever/dengue haemorrhagic fever in the month of July 2023 were analysed. Observations A total of 130 patients were analysed. The average (avg) MPV on day one was 10.85 ± 1.56, on day three was 10 ± 1.48, and on day five was 9.80 ± 1.30. The avg. total platelet on day one was 119476.92 ± 78,107.78, on day three was 119000 ± 59962.52, and on day five was 169200 ± 100839.84. The correlation between MPV and platelet on day one was r= -0.22, p=0.011, which was statistically significant; on day three was r= -0.32, p=0.0001, which was statistically significant, and on day five was r= -0.30, p= 0.0004, which was statistically significant. Conclusion These findings suggest that as dengue fever progresses, MPV tends to increase as platelet counts decline. This information can be beneficial in clinical practice as it highlights the potential utility of MPV as a predictive marker for platelet recovery, aiding healthcare providers in the timely management of dengue patients to mitigate bleeding risks.

Analysis of predictive factors of thrombosis in autogenous arteriovenous fistula

PURPOSE

To investigate the predictors of early diagnosis of thrombus of autogenous arteriovenous fistula (aAVF).

METHODS

The included patients were divided into the thrombus group with aAVF failure or thrombosis and the control group with good internal fistula function. The general data of the patients, including age, sex, diabetes mellitus, were collected. Platelets (PLT), platelet crit (P-LCR), platelet distribution width (PDW), mean platelet volume (MPV), homocysteine (HCY), and other biochemical data were collected. The predictors of thrombus of aAVF were obtained by the t test and logistic regression analysis, and receiver operating characteristic (ROC) curve analysis was used to compare the area under the ROC curve (AUC) between the combined predictors and the original indicators. The optimal critical value was determined when the Youden index reached its maximum value, and the sensitivity, specificity, accuracy, diagnostic index, and so on were calculated. Finally, prediction was performed by substituting each value in individually.

RESULTS

PLT, PDW, P-LCR, MPV, and HCY showed significant differences between two groups (p < 0.05). Logistic regression analysis showed that, for PLT (OR = 1.014, 95% CI 1.006-1.022, p = 0.01), PDW (OR = 1.295, 95% CI 1.009-1.661, p = 0.042), P-LCR (OR = 1.230, 95% CI 1.089-1.389, p = 0.001), MPV (OR = 1.696, 95% CI 1.101-2.613, p = 0.017), and HCY (OR = 1.332, 95% CI 1.182-1.502, p = 0.01), the difference was significant; PLT, PDW, P-LCR, MPV, and HCY were positively correlated with thrombogenesis (p < 0.05). By logistic regression, a group of the five predictors of PLT, PDW, P-LCR, MPV, and HCY was obtained, and the combined predictors were 0.014*PLT + 0.258*PDW + 0.207*P-LCR + 0.528*MPV + 0.287*HCY. The area under the curve of the combined predictor was 0.933, the sensitivity was 92.4%, the specificity was 81.2%, the maximum diagnostic index was 0.736, the diagnostic cutoff point was 21.790, and the accuracy rate was 87%.

CONCLUSION

PLT, PDW, P-LCR, MPV, and HCY are predictors of thrombus of aAVF. They can better predict thrombus of aAVF, and the combination of these five indicators is better than a single indicator.

Determinants of Variable Total Platelet Count in Healthy Plateletpheresis Donor

The platelet count in a healthy individual varies between 150 and 450 × 109/L. This study explores the factors affecting this variation in platelet count in healthy blood donors selected for platelet donation. This retrospective study comprises an analysis of platelet donor data between the year 2016-2022. The pre-recorded donor details such as age, gender, blood group, body mass index (BMI), and complete blood counts were collected and analyzed using the software 'R' (version 4.1.0). The statistical analysis consists of a test of normalcy followed by descriptive details and advanced statistics such as correlation and regression analysis to predict the variables affecting platelet count. The p-value of less than 0.05 was taken as significant. The median (IQR) of hemoglobin, platelet count, and total leucocyte count (TLC) was 142(135-150) g/L, 239(204-285) × 109/L, and 7.6(6.4-8.8) × 109/L, respectively. The platelet count was positively correlated with TLC (p = 0.000) and negatively with the age of the platelet donor (p = 0.001). The Kruskal-Wallis test detected significant differences in the platelet count among the ABO blood group (p = 0.008). Further, regression analysis confirms the independent positive association of total platelet count with the total leucocyte count (p = 0.000) and the negative association of platelet count with age (p = 0.004). This study concludes the strong dependency of total platelet count with total leucocyte count, age, and blood group.

The Potential Value of Mean Platelet Volume and Platelet Distribution Width as Inflammatory Indicators in Surgical Necrotizing Enterocolitis

Background

This study aims to investigate the potential significance of mean platelet volume (MPV) and platelet distribution width (PDW) in predicting surgical neonatal necrotizing enterocolitis (NEC) and establish the correlation between MPV/PDW levels and the severity/prognosis of NEC.

Methods

A retrospective study was conducted on a cohort of 372 patients diagnosed with NEC. The patients were categorized into two groups based on whether they underwent surgical therapy. Univariate /multivariate analysis were employed to compare the MPV and PDW between the two groups. Moreover, patients in surgical group were categorized into multiple subgroups based on intraoperative findings and postoperative prognosis, and the levels of MPV and PDW were compared among these subgroups.

Results

Of the 372 patients, the operative group exhibited significantly higher levels of MPV and PDW than the nonoperative group (P < 0.05). Logistic regression analysis revealed that MPV (OR = 4.895, P < 0.001) and PDW (OR = 1.476, P < 0.001) independently associated with surgical NEC. The analysis of the receiver operating characteristic (ROC) curve revealed that the area under the curve (AUC) was 0.706 for MPV alone, with a cut-off value of 11.8 fL. Similarly, the AUC was 0.728 for PDW alone, with a cut-off value of 16%. However, when MPV and PDW were combined, the AUC increased to 0.906 for predicting surgical NEC. In accordance with the intraoperative findings, the levels of MPV and PDW were found to be higher in the large area necrosis group than in the partial or mild necrosis group (P < 0.01). Furthermore, the MPV and PDW values in the death group were significantly greater than those in the survival group (P =0.040, P =0.008).

Conclusion

MPV and PDW may serve as potentially valuable indicators for determining the need for surgical intervention and predicting the prognosis of patients with NEC.

The effect of oscillation depolymerization on ethylenediaminetetraacetic acid-dependent platelet aggregation samples: A cross-over study

INTRODUCTION

Ethylenediaminetetraacetic acid (EDTA)-dependent platelet aggregation (PA) can cause medical errors. Currently, there is no reliable method for completely solving this problem. This study aims to solve this problem that has plagued clinical practice for many years by using oscillation method.

METHODS

Sixty-one EDTA-PA samples were collected, divided, and disaggregated using the oscillation method at various times and speeds. The samples were analyzed using routine blood tests and blood smears.

RESULTS

Platelet counts (PLT) were increased significantly after oscillation. PLT in the 3000 rpm for 0.5 min group was significantly higher than that in the 500 rpm for 0.5 min group (p < 0. 01). After 3000 rpm oscillation, the PLT gradually increased with time, while compared with the 10-min group, the PLT in the 13-min group showed no significant differences. The effective disaggregation rates in the EDTA-PA samples using the oscillation method and sodium citrate anticoagulant were 96.72% and 65.57%, respectively. There were no significant changes in white blood cell (WBC) or red blood cell (RBC) counts or morphology after the use of the oscillation method.

CONCLUSION

The oscillation method effectively depolymerized EDTA-PA without adverse effects on WBC and RBC. The implementation of this technique promises to resolve the issue of EDTA-PA.

Role of Platelets in Rheumatic Chronic Autoimmune Inflammatory Diseases

Platelets are essential in maintaining blood homeostasis and regulating several inflammatory processes. They constantly interact with immune cells, have immunoregulatory functions, and can affect, through immunologically active substances, endothelium, leukocytes, and other immune response components. In reverse, inflammatory and immune processes can activate platelets, which might be significant in autoimmune disease progression and arising complications. Thus, considering this interplay, targeting platelet activity may represent a new approach to treatment of autoimmune diseases. This review aims to highlight the role of platelets in the pathogenic mechanisms of the most frequent chronic autoimmune inflammatory diseases to identify gaps in current knowledge and to provide potential new targets for medical interventions.