Exposure to fine airborne particulate matter (PM(2.5)) is associated with cardiovascular events and mortality in older and cardiac patients. Potential physiologic effects of in-vehicle, roadside, and ambient PM(2.5) were investigated in young, healthy, nonsmoking, male North Carolina Highway Patrol troopers. Nine troopers (age 23 to 30) were monitored on 4 successive days while working a 3 P.M. to midnight shift. Each patrol car was equipped with air-quality monitors. Blood was drawn 14 hours after each shift, and ambulatory monitors recorded the electrocardiogram throughout the shift and until the next morning. Data were analyzed using mixed models. In-vehicle PM(2.5) (average of 24 microg/m(3)) was associated with decreased lymphocytes (-11% per 10 microg/m(3)) and increased red blood cell indices (1% mean corpuscular volume), neutrophils (6%), C-reactive protein (32%), von Willebrand factor (12%), next-morning heart beat cycle length (6%), next-morning heart rate variability parameters, and ectopic beats throughout the recording (20%). Controlling for potential confounders had little impact on the effect estimates. The associations of these health endpoints with ambient and roadside PM(2.5) were smaller and less significant. The observations in these healthy young men suggest that in-vehicle exposure to PM(2.5) may cause pathophysiologic changes that involve inflammation, coagulation, and cardiac rhythm.

Currently, therapeutic platelet concentrates can be stored for only 5 days. We have developed a procedure that permits long-term storage of fixed and lyophilized platelets that retain hemostatic properties after rehydration. These rehydrated lyophilized platelets (RL platelets) restore hemostasis in thrombocytopenic rats and become incorporated in the hemostatic plug of bleeding time wounds of normal dogs as well as von Willebrand disease dogs with partially replenished plasma von Willebrand factor. Ultrastructurally, these platelets are well preserved and are comparable to control normal washed platelets. Flow cytometry analysis shows that RL platelets react with antibodies to the major surface receptors, glycoprotein (GP)Ib and GPIIb/IIIa. These receptors are involved in platelet agglutination, aggregation, and adhesion. In vitro functional tests document the ability of RL platelets to adhere to denuded subendothelium and to spread on a foreign surface. Circulating RL platelets participated in carotid arterial thrombus formation induced in normal canine subjects. The participation of RL platelets in these vital hemostatic properties suggests that with further development they could become a stable platelet product for transfusion.To promote effective hemostasis, platelets must respond quickly to changes in normal blood flow or vessel injury (1, 2). After vascular injury, platelets adhere to exposed subendothelium, aggregate, and form a primary platelet plug. Platelet activation and initiation of coagulation follow with stabilization of the platelet plug by the formation of fibrin. The initiation of a thrombus at a site of vascular injury is mediated through platelet membrane glycoprotein (GP) receptors (3, 4). Platelet adhesion to a damaged vessel wall and its extracellular matrix at high shear is primarily mediated through the specific interaction of the platelet membrane GPIb-IX complex and bound von Willebrand factor (vWF) (5-7), which is synthesized and released into plasma and the vessel wall by endothelial cells (1). Platelet adhesion at low shear rates is mediated by several interactions, including collagen with the a2131 integrin (7). Platelet adhesion stimulates a spreading of the platelet (8).Although the mechanism of platelet spreading has not been completely characterized, recent in vitro studies have shown that platelets will spread on surfaces coated with fibrinogen (9) or polymerized fibrin (10). The activation of the GPIIb/IIIa receptor by agents such as ADP results in a conformational change in the receptor (11-13). The activated receptor binds fibrinogen, which forms a "bridge" between the platelets, and causes aggregation (1,14,15). Activated platelets provide the phospholipid surface for the assembly of blood clotting enzyme complexes, and the concentration and localization of activated coagulant proteins at sites of vessel wall injury may be facilitated by adherent platelets (16). Internal storage granules in platelets release clot-promoting contents in response to activation of bi...

People driving in a vehicle might receive an enhanced dose of mobile source pollutants that are considered a potential risk for cardiovascular diseases. The exposure to components of air pollution in highway patrol vehicles, at an ambient, and a roadside location was determined during 25 work shifts (3 p.m. to midnight) in the autumn of 2001, each day with two cars. A global positioning system and a diary provided location and activity information. Average pollutant levels inside the cars were low compared to ambient air quality standards: carbon monoxide 2.7 ppm, nitrogen dioxide 41.7 microg/m3, ozone 11.7 ppb, particulate matter smaller 2.5 microm (PM2.5) 24 microg/m3. Volatile organic compounds inside the cars were in the ppb-range and showed the fingerprint of gasoline. PM2.5 was 24% lower than ambient and roadside levels, probably due to depositions associated with the recirculating air conditioning. Levels of carbon monoxide, aldehydes, hydrocarbons, and some metals (Al, Ca, Ti, V, Cr, Mn, Fe, Cu, and Sr) were highest in the cars, and roadside levels were higher than ambient levels. Elevated pollutant levels were related to locations with high traffic volumes. Our results point to combustion engine emissions from other vehicles as important sources of air pollutants inside the car.

The procoagulant protein F.VIII:C is noncovalently bound to von Willebrand factor (vWF) to give the factor VIII macromolecular complex. New highly purified preparations of isolated human F.VIII:C, devoid of vWF and about 500,000-fold purified, were administered to hemophilia A and von Willebrand disease (vWD) dogs to determine their hemostatic effectiveness and survival in the circulation. Two preparations of F.VIII:C were used: peak 1, with active components of Mr 185,000-280,000, and peak 2, with a single component of Mr 170,000. In hemophilic dogs, with no plasma F.VIII:C but normal vWF, both preparations immediately elevated plasma F.VIII:C to expected levels, promptly stopped induced and spontaneous hemorrhages, and gave sustained plasma levels of F.VIII:C. The isolated F.VIII:C immediately complexed with endogenous vWF in hemophilic plasma and was eliminated exponentially, with a half-life (t1/2) of about 9 hr. Survival of peak 2 F.VIII:C was longer than that of peak 1 material. In contrast, F.VIII:C complexed to vWF in a therapeutic concentrate administered to hemophilic dogs was eliminated biexponentially with first-phase t1/2 of 3.2 hr and second-phase t1/2 of 9 hr. In vWD dogs with no vWF and reduced F.VIII:C levels, the isolated F.VIII:C produced supernormal levels of F.VIII:C without effect on induced bleeding. It was rapidly eliminated from plasma with a t1/2 of about 1 hr, as was the complexed F.VIII:C in the concentrate. These data indicate that isolated F.VIII:C promptly complexes with vWF and in this form is highly effective in controlling hemophilic hemorrhages with good survival in plasma. Without endogenous vWF with which to complex, the F.VIII:C is promptly eliminated.