Platelet biology and functions: new concepts and clinical perspectives

Paola E. J. van der Meijden*, Johan W. M. Heemskerk*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

259 Citations (Web of Science)
196 Downloads (Pure)

Abstract

Platelets-blood cells continuously produced from megakaryocytes mainly in the bone marrow-are implicated not only in haemostasis and arterial thrombosis, but also in other physiological and pathophysiological processes. This Review describes current evidence for the heterogeneity in platelet structure, age, and activation properties, with consequences for a diversity of platelet functions. Signalling processes of platelet populations involved in thrombus formation with ongoing coagulation are well understood. Genetic approaches have provided information on multiple genes related to normal haemostasis, such as those encoding receptors and signalling or secretory proteins, that determine platelet count and/or responsiveness. As highly responsive and secretory cells, platelets can alter the environment through the release of growth factors, chemokines, coagulant factors, RNA species, and extracellular vesicles. Conversely, platelets will also adapt to their environment. In disease states, platelets can be positively primed to reach a pre-activated condition. At the inflamed vessel wall, platelets interact with leukocytes and the coagulation system, interactions mediating thrombo-inflammation. With current antiplatelet therapies invariably causing bleeding as an undesired adverse effect, novel therapies can be more beneficial if directed against specific platelet responses, populations, interactions, or priming conditions. On the basis of these novel concepts and processes, we discuss several initiatives to target platelets therapeutically.

Original languageEnglish
Pages (from-to)166-179
Number of pages14
JournalNature Reviews Cardiology
Volume16
Issue number3
DOIs
Publication statusPublished - Mar 2019

Keywords

  • DENSE-GRANULE SECRETION
  • THROMBUS FORMATION
  • ENDOTHELIAL-CELLS
  • GLYCOPROTEIN-VI
  • STENT THROMBOSIS
  • ALPHA-GRANULES
  • ACTIVATION
  • RELEASE
  • INFLAMMATION
  • COAGULATION

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