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  1. Fulltext A transmission electron microscopy study of anticoagulant-induced platelet vesiculation
    Almhanawi BH, Khalid B, Ibrahim TA, Tohit ERM
    Porto Biomed J, 2016 12 27;2(1):23-27.
    PMID: 32258580 DOI: 10.1016/j.pbj.2016.11.002
    Highlights: EDTA induces platelet microparticles (PMPs) vesiculation.Sodium citrated tubes are better than EDTA tubes in PMPs analysis.Sodium citrate has a minor impact on platelet structure.

    Abstract: Platelet microparticles (PMPs) are small membrane fragments released from activated platelets in response to various stimuli. PMPs serve as biomarkers for several diseases and conditions and are useful tools for prognostic, diagnostic, and therapeutic purposes. The objective of our study was to compare the direct effects of ethylenediaminetetraacetic acid (EDTA) and sodium citrate anticoagulants on platelet structure and PMP vesiculation using transmission electron microscopy to visualize the morphologic changes in platelets. Micrographs revealed that platelets in the EDTA-anticoagulated tube manifested with significant morphologic changes and induced PMP vesiculation. On the other hand, the sodium citrate-anticoagulated tube showed a normal platelet structure and minor modifications in some cases, with poor indication of PMP vesiculation. In conclusion, EDTA induced platelet activation and PMP vesiculation and represents a major source of artifacts during the pre-analysis steps of PMP vesiculation.

  2. Fulltext Platelet-related cytokines among normal body mass index, overweight, and obese Malaysians
    Riyahi N, Tohit ERM, Thambiah SC, Ibrahim Z
    Asia Pac J Clin Nutr, 2017 12 10;27(1):182-188.
    PMID: 29222897 DOI: 10.6133/apjcn.032017.01
    BACKGROUND AND OBJECTIVES: Recent studies have reported that obesity is associated with platelet activation and systemic inflammation. Malaysia has the highest prevalence of obesity, hence, this research is performed to evaluate the development of low-grade inflammation and platelet activation, measured using soluble CD40 ligand (sCD40L) and soluble P-selectin (sP-sel), and to determine their association with obesity. In addition, we assessed the mean platelet volume (MPV) and platelet count (PLT), which are novel parameters consistently associated with obesity.

    METHODS AND STUDY DESIGN: A cross-sectional study was conducted on 112 healthy men and women from 3 main ethnic group (Malay, Chinese, and Indian) who were aged 18-60 years. The participants were categorized into normal body mass index (BMI), overweight and obese groups according to WHO criteria for BMI in Asian populations (18.5 kg/m2

  3. Shifting Paradigms and Arising Concerns in Severe Hemophilia A Treatment
    Chandran R, Tohit ERM, Stanslas J, Salim N, Mahmood TMT, Rajagopal M
    Semin Thromb Hemost, 2024 Jan 15.
    PMID: 38224699 DOI: 10.1055/s-0043-1778103
    The management of hemophilia A has undergone a remarkable revolution, in line with technological advancement. In the recent past, the primary concern associated with Factor VIII (FVIII) concentrates was the risk of infections, which is now almost resolved by advanced blood screening and viral inactivation methods. Improving patients' compliance with prophylaxis has become a key focus, as it can lead to improved health outcomes and reduced health care costs in the long term. Recent bioengineering research is directed toward prolonging the recombinant FVIII (rFVIII) coagulant activity and synthesising higher FVIII yields. As an outcome, B-domain deleted, polyethylene glycolated, single-chain, Fc-fused rFVIII, and rFVIIIFc-von Willebrand Factor-XTEN are available for patients. Moreover, emicizumab, a bispecific antibody, is commercially available, whereas fitusiran and tissue factor pathway inhibitor are in clinical trial stages as alternative strategies for patients with inhibitors. With these advancements, noninfectious complications, such as inhibitor development, allergic reactions, and thrombosis, are emerging concerns requiring careful management. In addition, the recent approval of gene therapy is a major milestone toward a permanent cure for hemophilia A. The vast array of treatment options at our disposal today empowers patients and providers alike, to tailor therapeutic regimens to the unique needs of each individual. Despite significant progress in modern treatment options, these highly effective therapies are markedly more expensive than conventional replacement therapy, limiting their access for patients in developing countries.
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