Effects of Dipyridamole and Aspirin on Platelet camp Levels and Prostaglandin Biosynthesis in vivo in Patients with Diabetes Mellitus
Platelets from diabetics with microvascular complications were shown to have lowered aggregation thresholds to ADP, epinephrine and collagen. They also produced more malonyl dialdehyde (MDA) than normal controls. In eight diabetic subjects, administration of dipyridamole (100mg tds)raised platelet aggregation thresholds and increased cyclic AMP levels, presumably as a result of inhibition of phosphodiesterase activity. It also caused a slight reduction of MDA production. This latter effect could be due to the rise in cyclic AMP, although we have found an apparently direct inhibitory effect to dipyridamole on MDA and thromboxane B2 production by intact platelets and platelet microsomes in vitro. On withdrawal of the drug, platelet cyclic AMP and MDA levels and aggregation thresholds returned toward pre-treatment levels. The administration of aspirin (120) plus dipyridamole markedly inhibited platelet aggregation, particularly in response to arachidonic acid and collagen and strongly inhibited MDA production. However, the rise in platelet cyclic AMP levels produced by dipyridamole alone was not present when aspirin and dipyridamole were given together, Aspirin may influence platelet cyclic AMP metabolism directly or by inhibiting prostacyclin formation. Thus, under appropriate conditions, basal platelet cyclic AMP may provide an index of PGI2 production in vivo.