Summary
Thrombin exosite-1 mediates the specific binding of thrombin with fibrinogen and protease-activated
receptor (PAR) 1. Exosite-1 inhibitors have been shown to effectively decrease the
clotting activity of thrombin, while their antiplatelet effects are relatively weak.
In the present study, the inhibitory effects of two exosite-1 inhibitors, hirugen
and HD1, but not the exosite-2 inhibitor HD22, on thrombin-induced platelet aggregation
and P-selectin expression were dramatically enhanced by a PAR4 antagonist, YD-3. In
contrast, the PAR1 antagonist SCH-79797 did not affect the antiplatelet effects of
exosite-1 inhibitors. The exosite-1 inhibitors and YD-3 prevented the Ca2+ spike and the prolonged Ca2+ response in thrombin-stimulated platelets, respectively; and combination of these
two classes of agents led to abolishment of Ca2+ signal. Unlike exosite-1 inhibitors, the antiplatelet effects of the active site
inhibitor PPACK and the bivalent inhibitor bivalirudin were not significantly enhanced
by YD-3. In addition, the platelet-stimulating activity of γ-thrombin, an autolytic
product of α-thrombin which lacks exosite-1, was inhibited by YD-3. These results
suggest that the synergistic antiplatelet effects of exosite-1 inhibitor and PAR4
antagonist are resulted from combined blockade of PAR1 and PAR4 in platelets. In fibrinogen
or plasma clotting assay, YD-3 neither prolonged the clotting time on its own nor
enhanced the anticoagulant activity of exosite-1 inhibitors. Therefore, the combined
blockade of exosite-1 and PAR4 may offer a potential strategy for improving the balance
of benefits and risks of antithrombotic therapy.
Keywords
Platelet activation - thrombin - exosite - protease-activated receptors