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2017 ; 7
(1
): 4978
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Phosphatidylserine-mediated platelet clearance by endothelium decreases platelet
aggregates and procoagulant activity in sepsis
#MMPMID28694452
Ma R
; Xie R
; Yu C
; Si Y
; Wu X
; Zhao L
; Yao Z
; Fang S
; Chen H
; Novakovic V
; Gao C
; Kou J
; Bi Y
; Thatte HS
; Yu B
; Yang S
; Zhou J
; Shi J
Sci Rep
2017[Jul]; 7
(1
): 4978
PMID28694452
show ga
The mechanisms that eliminate activated platelets in inflammation-induced
disseminated intravascular coagulation (DIC) in micro-capillary circulation are
poorly understood. This study explored an alternate pathway for platelet disposal
mediated by endothelial cells (ECs) through phosphatidylserine (PS) and examined
the effect of platelet clearance on procoagulant activity (PCA) in sepsis.
Platelets in septic patients demonstrated increased levels of surface activation
markers and apoptotic vesicle formation, and also formed aggregates with
leukocytes. Activated platelets adhered were and ultimately digested by ECs in
vivo and in vitro. Blocking PS on platelets or ?v?3 integrin on ECs attenuated
platelet clearance resulting in increased platelet count in a mouse model of
sepsis. Furthermore, platelet removal by ECs resulted in a corresponding decrease
in platelet-leukocyte complex formation and markedly reduced generation of factor
Xa and thrombin on platelets. Pretreatment with lactadherin significantly
increased phagocytosis of platelets by approximately 2-fold, diminished PCA by
70%, prolonged coagulation time, and attenuated fibrin formation by 50%. Our
results suggest that PS-mediated clearance of activated platelets by the
endothelium results in an anti-inflammatory, anticoagulant, and antithrombotic
effect that contribute to maintaining platelet homeostasis during acute
inflammation. These results suggest a new therapeutic target for impeding the
development of DIC.