Skip to main content
The Egyptian Journal of Bronchology
Download PDF
  • Original article
  • Open access
  • Published:

Role of mean platelet volume in patients with chronic obstructive pulmonary disease

Egyptian Journal of Bronchology volume 10, pages 251–260 (2016)Cite this article

Abstract

Background and objective

Stable chronic obstructive pulmonary disease (COPD) is associated with low-grade systemic inflammation as demonstrated by an increase in blood leukocytes, acute-phase proteins such as C-reactive protein, and inflammatory cytokines. Mean platelet volume (MPV) is one of the platelet (PLT) function indexes. It reflects the PLT production rate and stimulation. The changes in MPV during an exacerbation of COPD versus stable COPD have not been clearly examined. The aim of the present study was to evaluate MPV in participants during their stable phase and during an exacerbation of COPD.

Patients and methods

This study included a total of 80 COPD patients: group A included 40 patients in the stable state and group B included the remaining 40 who were admitted for exacerbation of COPD, who were followed-up for 6 weeks after recovery, and were matched with 40 healthy, nonsmoking controls. All patients underwent spirometry, laboratory investigations with respect to complete blood count, PLT count and MPV, and echocardiography.

Results

MPV revealed a highly significant decrease within the exacerbated patient group than stable ones who had lower levels of MPV than the control volunteers. There was a highly significant increase in MPV during the stable follow-up visit than during exacerbation for the same included group of patients. There was a significant positive correlation between MPV and grade of severity of COPD; 60% of the stable COPD patients were found to have pulmonary arterial hypertension by echocardiography. There was a significantly higher MPV among patients with pulmonary hypertension (PH) than those without PH. Although PLT count increased with increased severity of PH, it did not reach significance, and there was a significant increase in MPV with increased severity of PH.

Conclusion

MPV is a quick and reliable tool for the assessment of inflammatory response. PLT activation is an important prothrombotic manifestation of COPD, which may be a useful therapeutic target.

References

  1. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). Definition: Chapter 1. 2010. pp. 1–7.

    Google Scholar 

  2. Vernooy H, Küçükaycan M, Jacobs A. Local and systemic inflammation in patients with chronic obstructive pulmonary disease: soluble tumor necrosis factor receptors are increased in sputum. Am J Respir Crit Care Med 2002; 166:1218–1224.

    PubMed  Google Scholar 

  3. Islam M, Amin R. Total count of white blood cells in adult male smokers. J Bangladesh Soc Physiol 2007; 2:49–53.

    Google Scholar 

  4. Kume A, Kume T, Masuda K. Dose-dependent effect of cigarette smoke on blood biomarkers in healthy volunteers: observations from smoking and non-smoking. J Health Sci 2009; 55:259–264.

    CAS  Google Scholar 

  5. Green R, Rodgman A. The tobacco chemists’ research conference: a half century forum for advances in analytical methodology of tobacco and its products. Recent Adv Tob Sci 1996; 22:131–304.

    Google Scholar 

  6. Sin D, Wu L, Man S. The relationship between reduced lung function and cardiovascular mortality: a population-based study and a systematic review of the literature. Chest 2005; 127:1952–1959.

    PubMed  Google Scholar 

  7. Torre G, Kikkert R, Aarden A. Effects of smoking on the ex vivo cytokine production. J Periodont Res 2009; 44:28–34.

    Google Scholar 

  8. Alersandri C, Basilli S, Violi F. Hypercoagulability state in patients with chronic obstructive pulmonary disease. Thromb Hemost 1994; 72:343–346.

    Google Scholar 

  9. Rostango C, Prisco D, Boddi S. Evidence for local platelet activation in pulmonary vessels in patients with pulmonary hypertension secondary to chronic obstructive pulmonary disease. Eur Respir J 1991; 4:147–151.

    Google Scholar 

  10. Guzman A, Nieto N, Torres Y. Increased platelet and erythrocyte arginase activity in chronic obstructive pulmonary disease associated with tobacco or wood smoke exposure. J Investig Med 2011; 59:587–592.

    Google Scholar 

  11. Ferroni P, Basili S, Martini F. Soluble P-selectin as a marker of platelet hyperactivity in patients with chronic obstructive pulmonary disease. J Investig Med 2000; 48:21–27.

    CAS  PubMed  Google Scholar 

  12. Hurst J, Donaldson G, Perera R. Utility of plasma biomarkers at exacerbation of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2006; 174:867–874.

    CAS  PubMed  Google Scholar 

  13. Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Hematology 2002; 13:301–306.

    CAS  Google Scholar 

  14. Gasparyan A, Sandoo A, Stavropoulos S. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-alpha therapy. Rheumatol Int 2010; 30:1125–1129.

    CAS  PubMed  Google Scholar 

  15. Chu S, Becker R, Berger P. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and metaanalysis. J Thromb Haemost 2010; 8:148–156.

    CAS  PubMed  Google Scholar 

  16. Braekkan K, Mathiesen B, Njolstad I. Mean platelet volume is a risk factor for venous thromboembolism: the Tromso Study, Tromso, Norway. J Thromb Haemost 2010; 8:157–162.

    CAS  PubMed  Google Scholar 

  17. Shen D, Wang Y. Effects of hypoxia on platelet activation in pilots. Aviat Space Environ Med 1994; 11:191–196.

    Google Scholar 

  18. Briggs C. Quality counts: new parameters in blood cell counting. Int J Lab Hematol 2009; 31:277–297.

    CAS  PubMed  Google Scholar 

  19. Sandhaus L, Meyer P. How useful are CBC and reticulocyte reports to clinicians? Am J Clin Pathol 2002; 118:787–793.

    PubMed  Google Scholar 

  20. Celli B, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004; 23:932–946.

    CAS  PubMed  Google Scholar 

  21. Rodriguez R. Toward a consensus definition for COPD exacerbations. Chest 2000; 117:398S–401S.

    Google Scholar 

  22. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD). Manage exacerbations: Chapter 5 (Component 4). 2010. pp. 64–90.

    Google Scholar 

  23. Miller M, Hankinson J, Brusasco V. ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J 2005; 26:319–338.

    CAS  PubMed  Google Scholar 

  24. Quanjer P, Tammeling J, Cotes J. Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J 1993; 6:5–40.

    PubMed  Google Scholar 

  25. Chemla V, Castelain M, Humbert J. New formula for predicting mean pulmonary artery pressure using systolic pulmonary artery pressure. Chest 2004; 126:1313–1317.

    PubMed  Google Scholar 

  26. Gonzalez M, Ares J, Ayuela L. Combined use of pulsed and color M-mode Doppler echocardiography for the estimation of pulmonary capillary wedge pressure: an empirical approach based on an analytical relation. J Am Coll Cardiol 1999; 34:515–523.

    Google Scholar 

  27. Quiñones M, Otto M, Stoddard A. Doppler Quantification Task Force of the Nomenclature and Standards Committee of the American Society of Echocardiography. Recommendations for quantification of Doppler echocardiography. J Am Soc Echocardiogr 2002; 34:167–184.

    Google Scholar 

  28. Agustí G, Noguera A, Sauleda J. Systemic effects of chronic obstructive pulmonary disease. Eur Respir J 2003; 21:347–360.

    PubMed  Google Scholar 

  29. Gan W, Man S, Senthilselvan A. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta analysis. Thorax 2004; 59:574–580.

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Wouters F, Groenewegen H, Dentener M. Systemic inflammation in chronic obstructive pulmonary disease: the role of exacerbations. Proc Am Thorac Soc 2007; 4:626–634.

    CAS  PubMed  Google Scholar 

  31. Christie D, Kottke-Marchant K, Gorman T. Hypersensitivity of platelets to adenosine diphosphate in patients with stable cardiovascular disease predicts major adverse events despite antiplatelet therapy. Platelets 2008; 19:104–110.

    CAS  PubMed  Google Scholar 

  32. Dentener M, Creutzberg E, Schols A. Systemic anti-inflammatory mediators in COPD: increase in soluble interleukin 1 receptor II during treatment of exacerbations. Thorax 2001; 56:721–726.

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Bath P, Butterworth R. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996; 7:157–161

    CAS  PubMed  Google Scholar 

  34. Gasparyan A, Ayvazyan L, Mikhailidis D. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011; 17:47–58.

    CAS  PubMed  Google Scholar 

  35. Thompson C, Eaton K, Princiotta S. Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity and function. Br J Haematol 1982; 50:509–519

    CAS  PubMed  Google Scholar 

  36. Freedman D, Flanders W, Gates L. Cigarette smoking and leukocyte subpopulation in men. Ann Epidemol 1996; 6:299–306.

    CAS  Google Scholar 

  37. Muhammad A, Sajjad K, Zubaida U. Effect of cigarette smoking based on hematological parameters: comparison between male smokers and nonsmokers. Turk J Biochem 2013; 38:75–80

    Google Scholar 

  38. Calapai G, Caputi A, Mannucci C. Cardiovascular biomarkers in groups of established smokers after a decade of smoking. Basic Clin Pharmacol Toxicol 2009; 104:322–328.

    CAS  PubMed  Google Scholar 

  39. Loimaala A, Rontu R, Vuori I. Blood leukocyte count is a risk factor for intima-media thickening and subclinical carotid atherosclerosis in middleaged men. Atherosclerosis 2006; 188:363–369.

    CAS  PubMed  Google Scholar 

  40. Ravala M, Paula A. Cerebral venous thrombosis and venous infarction: case report of a rare initial presentation of smoker’s polycythemia. Case Rep Neurol 2010; 2:150–156.

    Google Scholar 

  41. Butkiewicz A, Kemona-Chetnik I, Dymicka-Piekarska V Does smoking affect thrombocytopoiesis and platelet activation in women and men? Adv Med Sci 2006; 51:123–126.

    CAS  PubMed  Google Scholar 

  42. Arslan E, Yakar T, Yavasoglu I. The effect of smoking on mean platelet volume and lipid profile in young male subjects. Anadolu Kardiyol Derg 2008; 8:422–425.

    PubMed  Google Scholar 

  43. Varol E, Icli A, Kocyigit S. Effect of smoking cessation on mean platelet volume. Clin Appl Thromb Hemost 2013; 19:315–319.

    PubMed  Google Scholar 

  44. Caponnetto P, Russo C, Di Maria A. Circulating endothelial coagulative activation markers after smoking cessation: a 12-month observational study. Eur J Clin Invest 2011; 4:616–626.

    Google Scholar 

  45. Bansal R, Gupta H, Goel A. Association of increased platelet volume in patients of chronic obstructive pulmonary disease: clinical implications. J Indian Acad Clin Med 2002; 3:169–172.

    Google Scholar 

  46. Onder I, Topcu S, Dokmetas HS. Platelet aggregation size and volume in chronic obstructive pulmonary disease. Mater Med Pol 1997; 29:11–13.

    CAS  PubMed  Google Scholar 

  47. Biljak V, Pancirov D, Cepelak I. Platelet count, mean platelet volume and smoking status in stable chronic obstructive pulmonary disease. Platelets 2011; 22:466–470.

    CAS  PubMed  Google Scholar 

  48. Ulasli SS, Ozyurek BA, Yilmaz EB, Ulubay G. Mean platelet volume as an inflammatory marker in acute exacerbation of chronic obstructive pulmonary disease. Pol Arch Med Wewn 2012; 122:122–126.

    Google Scholar 

  49. John D, David A, Shonna J. Increased platelet activation in patients with stable and acute exacerbation of COPD. Thorax 2011; 10:210–215

    Google Scholar 

  50. Barbera JA, Blanco I. Pulmonary hypertension in patients with chronic obstructive pulmonary disease: advances in pathophysiology and management. Drugs 2009; 69:1153–1171.

    CAS  PubMed  Google Scholar 

  51. Fazli M, Nadeem K, Muhammad A. Echocardiographic findings in chronic obstructive pulmonary disease (COPD) patients. Cardiol Clin 2004; 22:383–399.

    Google Scholar 

  52. Chaouat A, Naeije R, Weitzenblum E. Pulmonary hypertension in COPD. Eur Respir J 2008; 32:1371–1385.

    CAS  PubMed  Google Scholar 

  53. Chatila W, Thomashow B, Minai O. Comorbidities in chronic obstructive pulmonary disease. Proc Am Thorac soc. 2008; 5:549–555.

    PubMed  PubMed Central  Google Scholar 

  54. Naeiji R. Pulmonary hypertension and corpulmonale in COPD patients. Proc Am thorac soc 2005; 2:20–22.

    Google Scholar 

  55. Sertogullarindan B, Gumrukcuoglu A, Sezgi C. Frequency of pulmonary hypertension in patients with COPD due to bio-mass smoke and tobacco smoke. Int J Med Sci 2012; 9:406–412.

    PubMed  PubMed Central  Google Scholar 

  56. Andersen K, Iversen M, Kjaergaard J. Prevalence, predictors and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease. J Heart Lung Transplant 2012; 31:373–380.

    PubMed  Google Scholar 

  57. Gajanan k. Retrospective study of frequency of pulmonary hypertension in chronic obstructive pulmonary disease (COPD). Med Sci 2014; 12:2249–2255.

    Google Scholar 

  58. Simonneau G, Robbins I, Beghetti M. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2009; 54:S43–S54.

    PubMed  Google Scholar 

  59. Berger G, Azzam Z, Hoffmann R. Coagulation and anticoagulation in pulmonary arterial hypertension. Isr Med Assoc J 2009; 11:376–379.

    PubMed  Google Scholar 

  60. Chaouat A, Weitzenblum E, Higenbottam T. The role of thrombosis in severe pulmonary hypertension. Eur Respir J 1996; 9:356–363.

    CAS  PubMed  Google Scholar 

  61. Tolga S, Hatice B, Sami I. Comparison of meanplatelet volume values among different causes of pulmonary hypertension. Cardiol J 2012; 19:180–187.

    Google Scholar 

  62. Can M, Tanboga H, Demircan C. Enhanced hemostatic indices in patients with pulmonary arterial hypertension: an observational study. Thromb Res 2010; 126:280–282.

    CAS  PubMed  Google Scholar 

  63. Perros F, Montani D, Dorfmüller P. Platelet-derived growth factor expression and function in idiopathic pulmonary arterial hypertension. Am J Respir Crit Care Med 2008; 178:81–88.

    CAS  PubMed  Google Scholar 

  64. Mustafa S, Onder O, Mehmet F. Platelet indices in patients with pulmonary arterial hypertension. Clin Appl Thromb Hemost 2011; 17:171–174.

    Google Scholar 

  65. Derya A, Osman G, Fatma K. Platelet distribution width and mean platelet volume in children with pulmonary arterial hypertension secondary to congenital heart disease with left-to-right shunt: new indices of severity? Pediatr Cardiol 2013; 34:1013–1016.

    Google Scholar 

  66. Peinado V, Pizarro S, Barberà J. Pulmonary vascular involvement in COPD. Chest 2008; 134:808–814.

    CAS  PubMed  Google Scholar 

  67. Alper A, Akyol A, Hasdemir H. Effect of cardiac resynchronization therapy on mean platelet volume. Acta Cardiol 2008; 63:735–739.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Chest Diseases, Faculty of Medicine, Ain Shams University, 4, Abo-Elhol St, Cairo, El-Korba, Heliopolis, Egypt

    Eman R. Ali PhD (MD)

Authors
  1. Eman R. Ali PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eman R. Ali PhD.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ali, E.R. Role of mean platelet volume in patients with chronic obstructive pulmonary disease. Egypt J Bronchol 10, 251–260 (2016). https://doi.org/10.4103/1687-8426.193635

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1687-8426.193635

Keywords