Recombinant GPVI-Fc added to single or dual antiplatelet therapy in vitro prevents plaque-induced platelet thrombus formation

Ann-Katrin Mojica Munoz, Janina Jamasbi, Kerstin Uhland, Heidrun Degen, Goetz Muench, Martin Ungerer, Richard Brandl, Remco Megens, Christian Weber, Reinhard Lorenz, Wolfgang Siess*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Web of Science)

Abstract

The efficiency of current dual antiplatelet therapy might be further improved by its combination with a glycoprotein (GP) VI-targeting strategy without increasing bleeding. GPVI-Fc, a recombinant dimeric fusion protein binding to plaque collagen and concealing binding sites for platelet GPVI, acts as a lesion-focused antiplatelet drug, and does not increase bleeding in vivo. We investigated, whether GPVI-Fc added in vitro on top of acetylsalicylic acid (ASA), the P2Y(12) antagonist ticagrelor, and the fibrinogen receptor antagonist abciximab alone or in combination would increase inhibition of platelet activation by atherosclerotic plaque. Under static conditions, GPVI-Fc inhibited plaque-induced platelet aggregation by 53%, and increased platelet inhibition by ASA (51%) and ticagrelor (64%) to 66% and 80%, respectively. Under arterial flow, GPVI-Fc inhibited plaque-induced platelet aggregation by 57%, and significantly increased platelet inhibition by ASA (28%) and ticagrelor (47%) to about 81% each. The triple combination of GPVI-Fc, ASA and ticagrelor achieved almost complete inhibition of plaque-induced platelet aggregation (93%). GPVI-Fc alone or in combination with ASA or ticagrelor did not increase closure time measured by the platelet function analyzer (PFA)-200. GPVI-Fc added on top of abciximab, a clinically used anti fibrinogen receptor antibody which blocks platelet aggregation, strongly inhibited total (81%) and stable (89%) platelet adhesion. We conclude that GPVI-Fc added on top of single or dual antiplatelet therapy with ASA and/or a P2Y12 antagonist is likely to improve anti-atherothrombotic protection without increasing bleeding risk. In contrast, the strong inhibition of platelet adhesion by GPVI-Fc in combination with GPIIb/Illa inhibitors could be harmful.

Original languageEnglish
Pages (from-to)1651-1659
Number of pages9
JournalThrombosis and Haemostasis
Volume117
Issue number8
DOIs
Publication statusPublished - Aug 2017

Keywords

  • Antiplatelet agents
  • Atherothrombosis
  • GP VI
  • GP IIb/IIIa
  • Ischaemic heart disease
  • MULTIPLE ELECTRODE AGGREGOMETRY
  • GLYCOPROTEIN-VI
  • ATHEROSCLEROTIC PLAQUES
  • RECEPTOR ANTAGONISTS
  • FLOWING BLOOD
  • WHOLE-BLOOD
  • COLLAGEN
  • AGGREGATION
  • FUTURE
  • INHIBITION

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