Effect of DDAVP on Platelet Activation and Platelet-Derived Microparticle Generation

Abstract

Background The way by which 1-deamino-8-D-arginine vasopressin (DDAVP) acts on platelets remains unclear. Data from the literature tend to show that there is no definite effect on platelet activation, but recent work has suggested that a subtype of platelets, activated by the combined action of collagen and thrombin, was triggered by DDAVP. Moreover, platelet microparticles (PMPs), which have been shown to be procoagulant, have rarely been studied in this context. The goal of this study was to analyze the effects of DDAVP on PMPs' release through platelet activation. Methods Fifteen out of 18 consecutive patients undergoing a therapeutic test with DDAVP were included. They were suffering from factor VIII deficiency or from von Willebrand disease. The expression of P-selectin and PAC-1 binding on platelets and the numbers of circulating PMPs were evaluated ex vivo before and after DDAVP infusion. Peripheral blood was collected on CTAD to limit artifactual platelet activation. Results DDAVP induced a significant decrease of platelet counts and volume. Only small changes of P-selectin expression and PAC-1 binding were observed. Considering PMPs, two populations of patients could be defined, respectively, with (120%, n = 6) or without (21%, n = 7) an increase of PMPs after DDAVP. The decrease in platelet counts and volume remained significant in the group of responders. Conclusion This study shows that DDAVP induces the generation/release of PMPs in some patients with factor VIII deficiency and von Willebrand disease 1 hour after DDAVP infusion.

Haemostaseological pearls

“…So far, no consistent data are available on the interaction of DDAVP with platelets, although DDAVP may be an efficacious treatment option for some platelet disorders, too. The effects of DDAVP on the release of platelet microparticles through platelet activation were studied in 18 patients by Persyn et al 4 Results of this study were quite heterogeneous showing a clear increase in platelet microparticles after DDAVP in some patients and no increase in others.…”

Desmopressin as a Treatment in Patients With Von Willebrand Disease: A Systematic Review

“…In the study by Persyn et al [ 15 ], it was found that when DDAVP was given, the levels of VWF and FVIII went up. This was noticed in a group of nine people with VWD and eight people with hemophilia A.…”

“…This was noticed in a group of nine people with VWD and eight people with hemophilia A. These factors increased by an average of 3.3% and 3.1%, respectively, in people with VWD and hemophilia A [ 15 ]. The aim of the study was to determine whether platelet microparticles (PMPs) started to form after DDAVP was injected into living organisms.…”

“…In the study, it was found that the 13 patients who were tested released an average of 37% more PMPs than they did before. This rise was noticed exactly 1 hour after the DDAVP was given [ 15 ]. DDAVP seems to speed up the growth of coat platelets, which are triggered when collagen and thrombin work together.…”

“…DDAVP seems to speed up the growth of coat platelets, which are triggered when collagen and thrombin work together. Platelets are covered with proteins that help blood clot and molecules that hold cells together [ 15 ]. Also, the results given here back up what Horstman et al found in their study about PMPs, where they saw a rise in the number of PMPs released in about 27% of the people they looked at in a period of 60 minutes [ 21 ].…”