Platelets play an important part in normal haemostasis, and are likely to be involved in the thromboembolism seen in the primary antiphospholipid syndrome (PAPS). Evidence exists for platelet activation in this disorder, and new flow cytometric techniques have made it possible to detect low levels of activation. We have previously studied the expression of the platelet activation markers CD62p and CD63, percentage of reticulated platelets, and levels of soluble P-selectin in a group of PAPS patients. Median platelet CD63 expression and plasma soluble P-selectin levels were significantly increased in PAPS patients compared to a group of controls; there was no difference in reticulated platelet percentages between the two groups. Additional assays of platelet activation (PAC-1 expression, Annexin V binding, platelet microparticles and complexes) are being developed and assessed with respect to disease activity, thrombosis risk and effects of antithrombotic therapy.
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