Effect of insulin on platelet aggregation in coronary artery bypass grafting

2021 Fiscal Year Final Research Report

• Project/Area Number: 17K10771
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular surgery
• Research Institution: Kyushu University of Health and Welfare
• Principal Investigator: Yamamoto Ryuichi 九州保健福祉大学, 薬学部, 教授 (10094111)
• Co-Investigator(Kenkyū-buntansha): 蒲生 修治 九州保健福祉大学, 薬学部, 教授 (20273930)
• Project Period (FY): 2017-04-01 – 2022-03-31
• Keywords: 冠動脈バイパス手術 / 糖尿病 / 血小板 / インスリン / 伏在静脈 / スパズム / セロトニン（5-HT）

Outline of Final Research Achievements

It is likely that the increased contractile response to serotonin (5-HT) found in the blood vessels of diabetic patients may be due to the relative increase in the number of 5-HT2A receptors in the vascular smooth muscle cell membrane by the deficiency of insulin. The inhibitory effect of insulin on platelet aggregation induced by 5-HT was confirmed in rabbit platelets. However, in human platelets, the inhibitory effect of insulin on platelet aggregation induced by 5-HT was not confirmed. Platelet aggregation by 5-HT stimulation was observed after collagen stimulation, and its action was confirmed to be much smaller than that of ADP, which is another platelet-derived substance. Therefore, it is likely that the enhanced vasoconstrictor responsiveness to 5-HT observed in the blood vessels of diabetic patients is limited to vasoconstrictor muscle cells, and the contribution of 5-HT alone stimulation to platelets is small.

Free Research Field

薬理学

Academic Significance and Societal Importance of the Research Achievements

我々はこれまで、糖尿病におけるグラフト血管れん縮の増大には、インスリンによる細胞膜からの5-HT2A受容体インターナリゼーション作用の減弱が関連することを明らかにしてきた。しかし、この反応が血小板でも同様に起こるかは分かっていない。現在、周術期の血管れん縮抑制にはCa拮抗薬やアンジオテンシンⅡ受容体拮抗薬等が使用され、治療成績は改善されつつあるが、より有効で安全な予防法の確立が必要とされている。食生活の変化や高齢化社会の進展などにより、糖尿病患者に対する冠動脈バイパス手術施行回数が年々増加する中で、本研究の社会的意義は大きいと思われる。