Abstract Number: PB0999
Meeting: ISTH 2021 Congress
Background: Migraine is a complex, debilitating, multifactorial neurovascular disorder. Association with patent foramen ovale (PFO) has been reported with symptom regression after PFO closure. Increased platelet aggregation as well as changes in reduced/oxidized gluthatione (GSH/GSSG) ratio, as marker of oxidative stress, have been documented in patients with migraine.
No data are available on migraineurs with PFO.
Aims: 1) To assess the oxidative stress status in PFO patients with migraine on 100 mg/die aspirin before and after PFO closure and
2) to investigate whether oxidative stress influences platelet activation using an in vitro approach.
Methods: Platelet activation markers (Pselectin, activated glycoprotein IIbIIIa [aGPIIbIIIa] and Tissue Factor [TF]) were evaluated by whole blood (WB) flow cytometry in 62 patients before (T0) and six-months after (T1) PFO closure. Oxidative stress was assessed by mass spectrometry as GSH/GSSG ratio. Eight healthy subjects (HS) treated with aspirin for 15 days were enrolled as controls. The in vitro effect of GSSG on Pselectin and TF expression was assessed on WB from HS pre-incubated with aspirin.
Results: Pselectin and aGPIIbIIIa expression was comparable in PFO patients before and after PFO closure and in HS. Conversely, TF expression was significantly higher in PFO patients at T0, returning to HS levels only after PFO closure (3.3%±1.9 vs 1.7%±1, respectively; p<0.0001). The GSH/GSSG ratio was significantly lower at T0, returning to HS levels only after PFO closure. In in vitro studies, GSSG concentration-dependently induced platelet-associated TF and Pselectin expression; pre-incubation with aspirin blunted Pselectin expression, while TF expression remained unchanged, thus recapitulating what observed in vivo.
Conclusions: PFO patients are characterized by an oxidative stress status that leads to platelet-associated TF expression, which is not fully controlled by aspirin. After PFO correction, the oxidative imbalance reverted to physiological levels, leading also to the reduction of platelet TF expression.
To cite this abstract in AMA style:Canzano P, Trabattoni D, Brambilla M, Porro B, Becchetti A, Fiorelli S, Tremoli E, Camera M. An Oxidative Stress-induced Platelet-associated Tissue Factor Expression Characterizes Patients with Migraine and Patent Foramen Ovale [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/an-oxidative-stress-induced-platelet-associated-tissue-factor-expression-characterizes-patients-with-migraine-and-patent-foramen-ovale/. Accessed December 7, 2021.
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