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Thromb Haemost 2021; 121(10): 1337-1344
DOI: 10.1055/a-1420-7630
Cellular Haemostasis and Platelets

High-Dose Epinephrine Enhances Platelet Aggregation at the Expense of Procoagulant Activity

Alessandro Aliotta 
1   Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
,
Debora Bertaggia Calderara 
1   Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
,
Maxime G. Zermatten 
1   Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
,
Lorenzo Alberio 
1   Hemostasis and Platelet Research Laboratory, Division of Hematology and Central Hematology Laboratory, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
› Author Affiliations Funding The study was supported by grants from Dr. Henri Dubois-Ferrière Dinu Lipatti Foundation, Novartis Foundation for Medical-Biological Research (Grant #18B074), Swiss Heart Foundation (Grant FF19117), and the Swiss National Science Foundation (SNSF grant 320030-197392).
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Comment on:

COAT Platelets Under AlarmThromb Haemost 2021; 121(10): 1267-1267
DOI: 10.1055/s-0041-1735190

Abstract

Platelet activation is characterized by shape change, granule secretion, activation of fibrinogen receptor (glycoprotein IIb/IIIa) sustaining platelet aggregation, and externalization of negatively charged aminophospholipids contributing to platelet procoagulant activity. Epinephrine (EPI) alone is a weak platelet activator. However, it is able to potentiate platelet activation initiated by other agonists. In this work, we investigated the role of EPI in the generation of procoagulant platelets. Human platelets were activated with convulxin (CVX), thrombin (THR) or protease-activated receptor (PAR) agonists, EPI, and combination thereof. Platelet aggregation was assessed by light transmission aggregometry or with PAC-1 binding by flow cytometry. Procoagulant collagen-and-THR (COAT) platelets, induced by combined activation with CVX-and-THR, were visualized by flow cytometry as Annexin-V-positive and PAC-1-negative platelets. Cytosolic calcium fluxes were monitored by flow cytometry using Fluo-3 indicator. EPI increased platelet aggregation induced by all agonist combinations tested. On the other hand, EPI dose-dependently reduced the formation of procoagulant COAT platelets generated by combined CVX-and-THR activation. We observed a decreased Annexin-V-positivity and increased binding of PAC-1 with the triple activation (CVX + THR + EPI) compared with CVX + THR. Calcium mobilization with triple activation was decreased with the higher EPI dose (1,000 µM) compared with CVX + THR calcium kinetics. In conclusion, when platelets are activated with CVX-and-THR, the addition of increasing concentrations of EPI (triple stimulation) modulates platelet response reducing cytosolic calcium mobilization, decreasing procoagulant activity, and enhancing platelet aggregation.

Keywords

platelets - procoagulant platelets - epinephrine - aggregation

Author Contributions

A.A. designed and implemented the research, performed the experiments, analyzed the results, prepared the figures, wrote and edited the manuscript; D.B.C. and M.G.Z. critically revised and edited the manuscript; L.A. supervised the research, wrote and edited the manuscript.


Supplementary Material



Publication History

Received: 18 December 2020

Accepted: 08 March 2021

Accepted Manuscript online:
09 March 2021

Article published online:
13 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
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