Platelet response heterogeneity in thrombus formation

Imke C. A. Munnix; Judith M. E. M. Cosemans; Jocelyn M. Auger; Johan W. M. Heemskerk

doi:10.1160/TH09-05-0289

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2009; 102(06): 1149-1156
DOI: 10.1160/TH09-05-0289

Review Article

Schattauer GmbH

Platelet response heterogeneity in thrombus formation

Authors

Imke C. A. Munnix^*

¹Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
Judith M. E. M. Cosemans^*

¹Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands
Jocelyn M. Auger

²Centre for Cardiovascular Sciences Institute of Biomedical Research, University of Birmingham, Birmingham, United Kingdom
Johan W. M. Heemskerk

¹Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands

Abstract

Summary

Vascular injury leads to formation of a structured thrombus as a consequence of platelet activation and aggregation, thrombin and fibrin formation, and trapping of leukocytes and red cells. This review summarises current evidence for heterogeneity of platelet responses and functions in the thrombus-forming process. Environmental factors contribute to response heterogeneity, as the platelets in a thrombus adhere to different substrates, and sense specific (ant)agonists and rheological conditions. Contraction of platelets and interaction with fibrin and other blood cells cause further response variation. On the other hand, response heterogeneity can also be due to intrinsic differences between platelets in age and in receptor and signalling proteins. As a result, at least three subpopulations of platelets are formed in a thrombus: aggregating platelets with (reversible) integrin activation, procoagulant (coated) platelets exposing phosphatidylserine and binding coagulation factors, and contracting platelets with cell-cell contacts. This recognition of thrombus heterogeneity has implications for the use and development of antiplatelet medication.

Keywords

Aggregation - coagulation - heterogeneity - platelets - thrombus formation

Volltext

Referenzen

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