Significance of platelet-derived microparticles and activated platelets indiabetic nephropathy

We measured levels of platelet-derived microparticles (PMP), which have coa gulative activity and are produced by platelet activation or physical stimu lation, and CD62P/ CD63-positive platelets in patients with diabetes mellit us to determine their clinical significance and effects on complications of diabetes including diabetic nephropathy. We also compared these levels bef ore and after administration of the antiplatelet drug cilostazol. Plasma PM P and CD62P/CD63-positive platelet levels were significantly higher in pati ents with diabetes mellitus than normal controls. CD62P-positive platelet l evels were significantly higher in patients with nephropathy than in patien ts without complications. After administration of cilostazol, PMP and CD62P /CD63-positive platelet levels were significantly decreased. The increases in platelet activity and its related procoagulant activity appear to accoun t in part for the hypercoagulability observed in diabetes mellitus. Our fin dings suggest that activated platelets might play a role in the development of diabetic nephropathy. Furthermore, antiplatelet therapy with cilostazol for diabetic patients may be useful as antithrombin therapy including anti platelet therapy, since it suppresses the production of intrinsic coagulant s produced by platelet activation.