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Abstract
Platelets - blood cells continuously produced from megakaryocytes mainly in the bone marrow - are implicated not only in haemostasis and arterial thrombosis, but also in other physiological and pathophysiological processes. This Review describes current evidence for the heterogeneity in platelet structure, age, and activation properties, with consequences for a diversity of platelet functions. Signalling processes of platelet populations involved in thrombus formation with ongoing coagulation are well understood. Genetic approaches have provided information on multiple genes related to normal haemostasis, such as those encoding receptors and signalling or secretory proteins, that determine platelet count and/or responsiveness. As highly responsive and secretory cells, platelets can alter the environment through the release of growth factors, chemokines, coagulant factors, RNA species, and extracellular vesicles. Conversely, platelets will also adapt to their environment. In disease states, platelets can be positively primed to reach a pre-activated condition. At the inflamed vessel wall, platelets interact with leukocytes and the coagulation system, interactions mediating thromboinflammation. With current antiplatelet therapies invariably causing bleeding as an undesired adverse effect, novel therapies can be more beneficial if directed against specific platelet responses, populations, interactions, or priming conditions. On the basis of these novel concepts and processes, we discuss several initiatives to target platelets therapeutically.
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152
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Karel MFA, Hechler B, Kuijpers MJE, Cosemans JMEM. Atherosclerotic plaque injury-mediated murine thrombosis models: advantages and limitations. Platelets 2020; 31:439-446. [DOI: 10.1080/09537104.2019.1708884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- MFA Karel
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - B. Hechler
- Université de Strasbourg, INSERM, Etablissement Français du Sang (EFS)-Grand Est, BPPS UMR_S 1255, Fédération de Médecine Translationnelle de Strasbourg (FMTS)
| | - MJE Kuijpers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
| | - JMEM Cosemans
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands
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153
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Lin YC, Ko YC, Hung SC, Lin YT, Lee JH, Tsai JY, Kung PH, Tsai MC, Chen YF, Wu CC. Selective Inhibition of PAR4 (Protease-Activated Receptor 4)-Mediated Platelet Activation by a Synthetic Nonanticoagulant Heparin Analog. Arterioscler Thromb Vasc Biol 2020; 39:694-703. [PMID: 30727756 DOI: 10.1161/atvbaha.118.311758] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective- PAR4 (protease-activated receptor 4), one of the thrombin receptors in human platelets, has emerged as a promising target for the treatment of arterial thrombotic disease. Previous studies implied that thrombin exosite II, known as a binding site for heparin, may be involved in thrombin-induced PAR4 activation. In the present study, a heparin octasaccharide analog containing the thrombin exosite II-binding domain of heparin was chemically synthesized and investigated for anti-PAR4 effect. Approach and Results- PAR4-mediated platelet aggregation was examined using either thrombin in the presence of a PAR1 antagonist or γ-thrombin, which selectively activates PAR4. SCH-28 specifically inhibits PAR4-mediated platelet aggregation, as well as the signaling events downstream of PAR4 in response to thrombin. Moreover, SCH-28 prevents thrombin-induced β-arrestin recruitment to PAR4 but not PAR1 in Chinese Hamster Ovary-K1 cells using a commercial enzymatic complementation assay. Compared with heparin, SCH-28 is more potent in inhibiting PAR4-mediated platelet aggregation but has no significant anticoagulant activity. In an in vitro thrombosis model, SCH-28 reduces thrombus formation under whole blood arterial flow conditions. Conclusions- SCH-28, a synthetic small-molecular and nonanticoagulant heparin analog, inhibits thrombin-induced PAR4 activation by interfering with thrombin exosite II, a mechanism of action distinct from other PAR4 inhibitors that target the receptor. The characteristics of SCH-28 provide a new strategy for targeting PAR4 with the potential for the treatment of arterial thrombosis.
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Affiliation(s)
- Yu-Chuan Lin
- From the Graduate Institute of Natural Products (Y.-C.L., J.-H.L., J.-Y.T., P.-H.K., M.-C.T., Y.-F.C., C.-C.W.), Kaohsiung Medical University, Taiwan
| | - Yen-Chun Ko
- Genomics Research Center, Academia Sinica, Taipei, Taiwan (Y.-C.K., S.-C.H.)
| | - Shang-Cheng Hung
- Genomics Research Center, Academia Sinica, Taipei, Taiwan (Y.-C.K., S.-C.H.)
| | - Ying-Ting Lin
- Department of Biotechnology, College of Life Science (Y.-T.L., J.-H.L.), Kaohsiung Medical University, Taiwan
| | - Jia-Hau Lee
- From the Graduate Institute of Natural Products (Y.-C.L., J.-H.L., J.-Y.T., P.-H.K., M.-C.T., Y.-F.C., C.-C.W.), Kaohsiung Medical University, Taiwan.,Department of Biotechnology, College of Life Science (Y.-T.L., J.-H.L.), Kaohsiung Medical University, Taiwan
| | - Ju-Ying Tsai
- From the Graduate Institute of Natural Products (Y.-C.L., J.-H.L., J.-Y.T., P.-H.K., M.-C.T., Y.-F.C., C.-C.W.), Kaohsiung Medical University, Taiwan
| | - Po-Hsiung Kung
- From the Graduate Institute of Natural Products (Y.-C.L., J.-H.L., J.-Y.T., P.-H.K., M.-C.T., Y.-F.C., C.-C.W.), Kaohsiung Medical University, Taiwan
| | - Meng-Chun Tsai
- From the Graduate Institute of Natural Products (Y.-C.L., J.-H.L., J.-Y.T., P.-H.K., M.-C.T., Y.-F.C., C.-C.W.), Kaohsiung Medical University, Taiwan
| | - Yih-Fung Chen
- From the Graduate Institute of Natural Products (Y.-C.L., J.-H.L., J.-Y.T., P.-H.K., M.-C.T., Y.-F.C., C.-C.W.), Kaohsiung Medical University, Taiwan
| | - Chin-Chung Wu
- From the Graduate Institute of Natural Products (Y.-C.L., J.-H.L., J.-Y.T., P.-H.K., M.-C.T., Y.-F.C., C.-C.W.), Kaohsiung Medical University, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan (C.-C.W.).,Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan (C.-C.W.)
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154
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Correia C, Tavares E, Lopes C, Silva JG, Duarte A, Geraldes V, Rodrigues MA, Melo EP. Stability of Protein Formulations at Subzero Temperatures by Isochoric Cooling. J Pharm Sci 2020; 109:316-322. [DOI: 10.1016/j.xphs.2019.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/28/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
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155
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Olie RH, van der Meijden PEJ, Spronk HMH, Ten Cate H. Antithrombotic Therapy: Prevention and Treatment of Atherosclerosis and Atherothrombosis. Handb Exp Pharmacol 2020; 270:103-130. [PMID: 32776281 DOI: 10.1007/164_2020_357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Atherosclerosis is a multifactorial vascular disease that develops in the course of a lifetime. Numerous risk factors for atherosclerosis have been identified, mostly inflicting pro-inflammatory effects. Vessel injury, such as occurring during erosion or rupture of atherosclerotic lesions triggers blood coagulation, in attempt to maintain hemostasis (protect against bleeding). However, thrombo-inflammatory mechanisms may drive blood coagulation such that thrombosis develops, the key process underlying myocardial infarction and ischemic stroke (not due to embolization from the heart). In the blood coagulation system, platelets and coagulation proteins are both essential elements. Hyperreactivity of blood coagulation aggravates atherosclerosis in preclinical models. Pharmacologic inhibition of blood coagulation, either with platelet inhibitors, or better documented with anticoagulants, or both, limits the risk of thrombosis and may potentially reverse atherosclerosis burden, although the latter evidence is still based on animal experimentation.Patients at risk of atherothrombotic complications should receive a single antiplatelet agent (acetylsalicylic acid, ASA, or clopidogrel); those who survived an atherothrombotic event will be prescribed temporary dual antiplatelet therapy (ASA plus a P2Y12 inhibitor) in case of myocardial infarction (6-12 months), or stroke (<6 weeks), followed by a single antiplatelet agent indefinitely. High risk for thrombosis patients (such as those with peripheral artery disease) benefit from a combination of an anticoagulant and ASA. The price of gained efficacy is always increased risk of (major) bleeding; while tailoring therapy to individual needs may limit the risks to some extent, new generations of agents that target less critical elements of hemostasis and coagulation mechanisms are needed to maintain efficacy while reducing bleeding risks.
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Affiliation(s)
- R H Olie
- Internal Medicine and CARIM School for Cardiovascular Research, Maastricht University Medical Center, Maastricht, The Netherlands.,Thrombosis Expertise Center, Heart+ Cardiovascular Center, and Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - P E J van der Meijden
- Thrombosis Expertise Center, Heart+ Cardiovascular Center, and Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - H M H Spronk
- Thrombosis Expertise Center, Heart+ Cardiovascular Center, and Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands
| | - H Ten Cate
- Internal Medicine and CARIM School for Cardiovascular Research, Maastricht University Medical Center, Maastricht, The Netherlands. .,Thrombosis Expertise Center, Heart+ Cardiovascular Center, and Department of Biochemistry, Maastricht University Medical Center, Maastricht, The Netherlands.
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156
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Ngo T, Kim K, Bian Y, Nam G, Park HJ, Lee K, Cho GS, Ryu JM, Lim KM, Chung JH. Antithrombotic effect of SP-8008, a benzoic acid derivative, through the selective inhibition of shear stress-induced platelet aggregation. Br J Pharmacol 2019; 177:929-944. [PMID: 31648364 PMCID: PMC7024737 DOI: 10.1111/bph.14894] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/30/2019] [Accepted: 09/05/2019] [Indexed: 01/23/2023] Open
Abstract
Background and Purpose Bleeding is one of the most critical adverse effects of antithrombotic drugs, and many efforts have been made to discover novel antiplatelet agents without bleeding complications. Shear stress‐induced platelet aggregation (SIPA), where the interaction of von Willebrand factor (vWF) and platelet glycoprotein (GP) Ib constitutes the initial step, is a promising target to overcome bleeding problems, as SIPA occurs only in pathological conditions. Here, we describe SP‐8008, a novel modulator of vWF–GP Ib interactions and evaluated its antiplatelet/antithrombotic effects. Experimental Approach Newly synthesized compounds were screened for antiplatelet effects in vitro, using human platelets exposed to high shear stress. Aggregation, intracellular calcium level, granule secretion, and integrin activation were assessed. Molecular modelling using virtual docking and flow cytometry were used to evaluate effects on vWF–GP Ib interactions. Antithrombotic effects in vivo were determined in rats, using arterial thrombosis and shear stress‐specific thrombosis. Transection tail bleeding time was used to evaluate adverse effects. Key Results SP‐8008 was a potent inhibitor of SIPA, with IC50 of 1.44 ± 0.09 μM. SP‐8008 effectively and broadly blocked shear stress‐induced platelet activation events, without any significant toxicity. Importantly, SP‐8008 was highly selective against SIPA, effectively interfering with vWF–GP Ib engagement. Most importantly, SP‐8008 exerted significant antithrombotic effects in vivo in both shear stress‐specific and arterial thrombosis, without prolonging bleeding time. Conclusions and Implications Our results demonstrated that SP‐8008 can be a novel selective antiplatelet agent with improved safety profile.
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Affiliation(s)
- Thien Ngo
- College of Pharmacy, Seoul National University, Seoul, Korea
| | - Keunyoung Kim
- College of Pharmacy, Seoul National University, Seoul, Korea
| | - Yiying Bian
- College of Pharmacy, Seoul National University, Seoul, Korea
| | - Gibeom Nam
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Hyun-Ju Park
- School of Pharmacy, Sungkyunkwan University, Suwon, Korea
| | - Kiho Lee
- College of Pharmacy, Korea University, Sejong, Korea
| | - Geum-Sil Cho
- Research Headquarters, Shin Poong Pharm. Co. Ltd., Ansan, Korea
| | - Jei-Man Ryu
- Research Headquarters, Shin Poong Pharm. Co. Ltd., Ansan, Korea
| | - Kyung-Min Lim
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | - Jin-Ho Chung
- College of Pharmacy, Seoul National University, Seoul, Korea
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157
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Molica F, Meens MJ, Pelli G, Hautefort A, Emre Y, Imhof BA, Fontana P, Scemes E, Morel S, Kwak BR. Selective inhibition of Panx1 channels decreases hemostasis and thrombosis in vivo. Thromb Res 2019; 183:56-62. [PMID: 31669824 DOI: 10.1016/j.thromres.2019.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/30/2019] [Accepted: 09/16/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Hemostasis is a tightly regulated physiological process to rapidly induce hemostatic plugs at sites of vascular injury. Inappropriate activation of this process may lead to thrombosis, i.e. pathological blood clot formation in uninjured vessels or on atherosclerotic lesions. ATP release through Pannexin1 (Panx1) membrane channels contributes to collagen-induced platelet aggregation in vitro. OBJECTIVE To investigate the effects of genetic and pharmacological inhibition of Panx1 on hemostasis and thrombosis in vivo. RESULTS Bleeding time after tail clipping was increased by 2.5-fold in Panx1-/- mice compared to wild-type controls, suggesting that Panx1 deficiency impairs primary hemostasis. Wire myography on mesenteric arteries revealed diminished vasoconstriction in response to phenylephrine or U446619 in Panx1-/- mice. Mice with platelet-specific deletion of Panx1 (Panx1PDel) displayed 2-fold longer tail bleeding times than Panx1fl/fl controls. Moreover, venous thromboembolism (VTE) after injection of collagen/epinephrine in the jugular vein was reduced in Panx1-/- and Panx1PDel mice. Panx1PDel mice also showed reduced FeCl3-induced thrombosis in mesenteric arteries. BrilliantBlue-FCF, a Panx1 channel inhibitor, decreased collagen-induced platelet aggregation in vitro, increased tail bleeding time and reduced VTE in wild-type mice. Furthermore, we developed a specific Panx1 blocking antibody targeting a Panx1 extracellular loop, which reduced ATP release from platelets in vitro. Treating wild-type mice with this antibody increased tail bleeding time and decreased VTE compared to control antibody. CONCLUSIONS Panx1 channel deletion or inhibition diminishes clot formation during hemostasis and thrombosis in vivo. Blocking Panx1 channels may be an attractive strategy for modulating platelet aggregation in thrombotic disease.
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Affiliation(s)
- Filippo Molica
- Dept of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Merlijn J Meens
- Dept of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Graziano Pelli
- Dept of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Aurélie Hautefort
- Dept of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Yalin Emre
- Dept of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Beat A Imhof
- Dept of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Pierre Fontana
- Division of Angiology and Haemostasis, Geneva University Hospitals and Geneva Platelet Group, University of Geneva, Geneva, Switzerland
| | - Eliana Scemes
- Dept of Cell Biology and Anatomy, New York Medical College, Valhalla, NY, USA
| | - Sandrine Morel
- Dept of Pathology and Immunology, University of Geneva, Geneva, Switzerland
| | - Brenda R Kwak
- Dept of Pathology and Immunology, University of Geneva, Geneva, Switzerland; Dept of Medical Specializations - Cardiology, University of Geneva, Geneva, Switzerland.
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158
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Ngo T, Kim K, Bian Y, Noh H, Lim KM, Chung JH, Bae ON. Antithrombotic Effects of Paeoniflorin from Paeonia suffruticosa by Selective Inhibition on Shear Stress-Induced Platelet Aggregation. Int J Mol Sci 2019; 20:ijms20205040. [PMID: 31614534 PMCID: PMC6834133 DOI: 10.3390/ijms20205040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/30/2019] [Accepted: 10/09/2019] [Indexed: 12/16/2022] Open
Abstract
Antiplatelet agents are important in the pharmacotherapeutic regime for many cardiovascular diseases, including thrombotic disorders. However, bleeding, the most serious adverse effect associated with current antiplatelet therapy, has led to many efforts to discover novel anti-platelet drugs without bleeding issues. Of note, shear stress-induced platelet aggregation (SIPA) is a promising target to overcome bleeding since SIPA happens only in pathological conditions. Accordingly, this study was carried out to discover antiplatelet agents selectively targeting SIPA. By screening various herbal extracts, Paeonia suffruticosa and its major bioactive constituent, paeoniflorin, were identified to have significant inhibitory effects against shear-induced aggregation in human platelets. The effects of paeoniflorin on intraplatelet calcium levels, platelet degranulation, and integrin activation in high shear stress conditions were evaluated by a range of in vitro experiments using human platelets. The inhibitory effect of paeoniflorin was determined to be highly selective against SIPA, through modulating von Willebrand Factor (vWF)-platelet glycoprotein Ib (GP Ib) interaction. The effects of paeoniflorin on platelet functions under high shear stress were confirmed in the ex vivo SIPA models in rats, showing the good accordance with the anti-SIPA effects on human platelets. Treatment with paeoniflorin significantly prevented arterial thrombosis in vivo from the dose of 10 mg/kg without prolonging bleeding time or blood clotting time in rats. Collectively, our results demonstrated that paeoniflorin can be a novel anti-platelet agent selectively targeting SIPA with an improved safety profile.
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Affiliation(s)
- Thien Ngo
- College of Pharmacy, Seoul National University, Seoul 08826, Korea.
- Faculty of Pharmacy, Thai Binh University of Medicine and Pharmacy, Thai Binh city 410000, Vietnam.
| | - Keunyoung Kim
- College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Yiying Bian
- College of Pharmacy, Seoul National University, Seoul 08826, Korea.
- School of Public Health, China Medical University, Shenyang 110122, China.
| | - Hakjun Noh
- College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Kyung-Min Lim
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea.
| | - Jin-Ho Chung
- College of Pharmacy, Seoul National University, Seoul 08826, Korea.
| | - Ok-Nam Bae
- College of Pharmacy, Hanyang University, Ansan 15588, Korea.
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159
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Affiliation(s)
- Dermot Cox
- Molecular & Cellular Therapeutics Royal College of Surgeons in Ireland Dublin Ireland
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160
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Chemical constituents from heartwoods of Caesalpinia sappan with antiplatelet aggregation activities. CHINESE HERBAL MEDICINES 2019. [DOI: 10.1016/j.chmed.2019.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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161
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McFadyen JD, Fernando H, Peter K. Off-target drug effects on platelet function: Protecting an Achilles heel of drug development. CURRENT OPINION IN TOXICOLOGY 2019. [DOI: 10.1016/j.cotox.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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162
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Ngo T, Kim K, Bian Y, An GJ, Bae ON, Lim KM, Chung JH. Cyclocurcumin from Curcuma longa selectively inhibits shear stress-induced platelet aggregation. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.103462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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163
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Palasubramaniam J, Wang X, Peter K. Myocardial Infarction-From Atherosclerosis to Thrombosis. Arterioscler Thromb Vasc Biol 2019; 39:e176-e185. [PMID: 31339782 DOI: 10.1161/atvbaha.119.312578] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Jathushan Palasubramaniam
- From the Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (J.P., X.W., K.P.).,Department of Medicine, Monash University, Melbourne, Australia (J.P., X.W., K.P.).,Department of Cardiology, Alfred Hospital, Melbourne, Australia (J.P., K.P.)
| | - Xiaowei Wang
- From the Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (J.P., X.W., K.P.).,Department of Medicine, Monash University, Melbourne, Australia (J.P., X.W., K.P.)
| | - Karlheinz Peter
- From the Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (J.P., X.W., K.P.).,Department of Medicine, Monash University, Melbourne, Australia (J.P., X.W., K.P.).,Department of Cardiology, Alfred Hospital, Melbourne, Australia (J.P., K.P.)
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164
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Nurden AT. Clinical significance of altered collagen-receptor functioning in platelets with emphasis on glycoprotein VI. Blood Rev 2019; 38:100592. [PMID: 31351674 DOI: 10.1016/j.blre.2019.100592] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 07/05/2019] [Accepted: 07/19/2019] [Indexed: 01/01/2023]
Abstract
Much interest surrounds the receptors α2β1 and glycoprotein VI (GPVI) whose synchronized action mediates the attachment and activation of platelets on collagen, essential for preventing blood loss but also the most thrombogenic component of the vessel wall. Subject to density variations on platelets through natural polymorphisms, the absence of α2β1 or GPVI uniquely leads to a substantial block of hemostasis without causing major bleeding. Specific to the megakaryocyte lineage, GPVI and its signaling pathways are most promising targets for anti-thrombotic therapy. This review looks at the clinical consequences of the loss of collagen receptor function with emphasis on both the inherited and acquired loss of GPVI with brief mention of mouse models when necessary. A detailed survey of rare case reports of patients with inherited disease-causing variants of the GP6 gene is followed by an assessment of the causes and clinical consequences of acquired GPVI deficiency, a more frequent finding most often due to antibody-induced platelet GPVI shedding. Release of soluble GPVI is brought about by platelet metalloproteinases; a process induced by ligand or antibody binding to GPVI or even high shear forces. Also included is an assessment of the clinical importance of GPVI-mediated platelet interactions with fibrin and of the promise shown by the pharmacological inhibition of GPVI in a cardiovascular context. The role for GPVI in platelet function in inflammation and in the evolution and treatment of major illnesses such as rheumatoid arthritis, cancer and sepsis is also discussed.
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Affiliation(s)
- Alan T Nurden
- Institut de Rhythmologie et de Modélisation Cardiaque, PTIB, Hôpital Xavier Arnozan, 33600 Pessac, France.
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165
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Wang M, Hao H, Leeper NJ, Zhu L. Thrombotic Regulation From the Endothelial Cell Perspectives. Arterioscler Thromb Vasc Biol 2019; 38:e90-e95. [PMID: 29793992 DOI: 10.1161/atvbaha.118.310367] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Miao Wang
- From the State Key Laboratory of Cardiovascular Disease (M.W., H.H., L.Z.) .,Clinical Pharmacology Center (M.W.), Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Huifeng Hao
- From the State Key Laboratory of Cardiovascular Disease (M.W., H.H., L.Z.)
| | | | - Liyuan Zhu
- From the State Key Laboratory of Cardiovascular Disease (M.W., H.H., L.Z.)
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166
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Sonia D'Souza C, Li Z, Luke Maxwell D, Trusler O, Murphy M, Crewther S, Peter K, Orian JM. Platelets Drive Inflammation and Target Gray Matter and the Retina in Autoimmune-Mediated Encephalomyelitis. J Neuropathol Exp Neurol 2019; 77:567-576. [PMID: 29757405 DOI: 10.1093/jnen/nly032] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Despite growing evidence for platelets as active players in infection and immunity, it remains unresolved whether platelets contribute to, or are key elements in the development of neuroinflammation. Using the experimental autoimmune encephalomyelitis (EAE) model of multiple sclerosis, we identified platelet accumulation in the circulation by 7-day postinduction (dpi), ahead of clinical onset which occurs at 13-14 dpi. By inducing platelet depletion between 7 and 16 dpi, we demonstrate an association between platelet accumulation in the spinal cord and disease development. Additionally, we provide evidence for platelet infiltration in the white and gray matter parenchyma, but with different outcomes. Thus, while in white matter platelets are clearly associated with lesions, in gray matter large-scale platelet infiltration and expression of the platelet-specific molecule PF4 are detectable prior to T cell entry. In the retina, platelet accumulation also precedes clinical onset and is associated with significant increase in retinal thickness in experimental relative to control animals. Platelet accumulation increases over the disease course in this tissue, but without subsequent T cell infiltration. These findings provide definitive confirmation that platelet accumulation is key to EAE pathophysiology. Furthermore, they suggest an undescribed and, most importantly, therapeutically targetable mechanism of neuronal damage.
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Affiliation(s)
| | - Zenjiang Li
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science
| | - Dain Luke Maxwell
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science
| | - Oliver Trusler
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science
| | - Melanie Murphy
- Department of Psychology and Counselling, La Trobe University, Melbourne, Victoria, Australia
| | - Sheila Crewther
- Department of Psychology and Counselling, La Trobe University, Melbourne, Victoria, Australia
| | - Karlheinz Peter
- Atherothrombosis and Vascular Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
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167
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Greco A, Capranzano P, Barbanti M, Tamburino C, Capodanno D. Antithrombotic pharmacotherapy after transcatheter aortic valve implantation: an update. Expert Rev Cardiovasc Ther 2019; 17:479-496. [PMID: 31198065 DOI: 10.1080/14779072.2019.1632189] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: Transcatheter aortic valve implantation (TAVI) is the treatment of choice for a large proportion of patients with severe aortic stenosis. Despite numerous technological and clinical advances, TAVI remains associated with thrombotic complications requiring antithrombotic pharmacotherapy, which exposes to the risk of bleeding, especially in elderly individuals. The optimal antithrombotic regimen following TAVI is uncertain and several investigations are ongoing. Areas covered: Clinical guidelines are mostly driven by observational trials and experts' opinions, thus resulting into low-grade level of evidence. The aim of the current review is to critically explore the epidemiology, pathophysiology and prognostic value of thrombotic and bleeding events after TAVI, and to review the current literature on antithrombotic strategies following the procedure. Expert opinion: Thrombotic and bleeding events remain major complications occurring in the frail population that is currently offered TAVI. Waiting for upcoming evidence from ongoing randomized clinical trials, tailoring antithrombotic therapies based on patients' characteristics, values and circumstances is a preferable approach.
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Affiliation(s)
- Antonio Greco
- a Division of Cardiology , A.O.U. "Policlinico-Vittorio Emanuele", University of Catania , Catania , Italy
| | - Piera Capranzano
- a Division of Cardiology , A.O.U. "Policlinico-Vittorio Emanuele", University of Catania , Catania , Italy
| | - Marco Barbanti
- a Division of Cardiology , A.O.U. "Policlinico-Vittorio Emanuele", University of Catania , Catania , Italy
| | - Corrado Tamburino
- a Division of Cardiology , A.O.U. "Policlinico-Vittorio Emanuele", University of Catania , Catania , Italy
| | - Davide Capodanno
- a Division of Cardiology , A.O.U. "Policlinico-Vittorio Emanuele", University of Catania , Catania , Italy
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168
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GPVI inhibitor as antitumor gateway drug. Blood 2019; 133:2633-2634. [PMID: 31221792 DOI: 10.1182/blood.2019000811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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169
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Abstract
ST-segment elevation myocardial infarction (STEMI) is the most acute manifestation of coronary artery disease and is associated with great morbidity and mortality. A complete thrombotic occlusion developing from an atherosclerotic plaque in an epicardial coronary vessel is the cause of STEMI in the majority of cases. Early diagnosis and immediate reperfusion are the most effective ways to limit myocardial ischaemia and infarct size and thereby reduce the risk of post-STEMI complications and heart failure. Primary percutaneous coronary intervention (PCI) has become the preferred reperfusion strategy in patients with STEMI; if PCI cannot be performed within 120 minutes of STEMI diagnosis, fibrinolysis therapy should be administered to dissolve the occluding thrombus. The initiation of networks to provide around-the-clock cardiac catheterization availability and the generation of standard operating procedures within hospital systems have helped to reduce the time to reperfusion therapy. Together with new advances in antithrombotic therapy and preventive measures, these developments have resulted in a decrease in mortality from STEMI. However, a substantial amount of patients still experience recurrent cardiovascular events after STEMI. New insights have been gained regarding the pathophysiology of STEMI and feed into the development of new treatment strategies.
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170
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Ziegler M, Wang X, Peter K. Platelets in cardiac ischaemia/reperfusion injury: a promising therapeutic target. Cardiovasc Res 2019; 115:1178-1188. [PMID: 30906948 PMCID: PMC6529900 DOI: 10.1093/cvr/cvz070] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/01/2019] [Accepted: 03/21/2019] [Indexed: 12/21/2022] Open
Abstract
Acute myocardial infarction (AMI) is the single leading cause of mortality and morbidity worldwide. A key component of AMI therapy is the timely reopening of occluded vessels to prevent further ischaemic damage to the myocardium. However, reperfusion of the ischaemic myocardium can itself trigger reperfusion injury causing up to 50% of the overall infarct size. In recent years, considerable research has been devoted to understanding the pathogenesis of ischaemia/reperfusion (I/R) injury and platelets have emerged as a major contributing factor. This review summarizes the role of platelets in the pathogenesis of I/R injury and highlights the potential of platelet-directed therapeutics to minimize cardiac I/R injury. Activated platelets infiltrate specifically into the ischaemic/reperfused myocardium and contribute to I/R injury by the formation of microthrombi, enhanced platelet-leucocyte aggregation, and the release of potent vasoconstrictor and pro-inflammatory molecules. This review demonstrates the benefits of platelet inhibition beyond their well-described anti-thrombotic effect and highlights the direct cardioprotective role of anti-platelet drugs. In particular, the inhibition of COX, the P2Y12 receptor and the GPIIb/IIIa receptor has demonstrated the potential to attenuate I/R injury. Moreover, targeting of drug candidates or regenerative cells to the activated platelets accumulated within the ischaemic/reperfused myocardium shows remarkable potential to protect the myocardium from I/R injury. Overall, activated platelets play a key role in the pathogenesis of I/R injury. Their direct inhibition as well as their use as epitopes for site-directed therapy is a unique and promising therapeutic approach for the prevention of I/R injury and ultimately the preservation of cardiac function.
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Affiliation(s)
- Melanie Ziegler
- Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Commercial Road 75, Melbourne, Australia
| | - Xiaowei Wang
- Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Commercial Road 75, Melbourne, Australia
| | - Karlheinz Peter
- Atherothrombosis and Vascular Biology Laboratory, Baker Heart and Diabetes Institute, Commercial Road 75, Melbourne, Australia
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171
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Voors-Pette C, Lebozec K, Dogterom P, Jullien L, Billiald P, Ferlan P, Renaud L, Favre-Bulle O, Avenard G, Machacek M, Plétan Y, Jandrot-Perrus M. Safety and Tolerability, Pharmacokinetics, and Pharmacodynamics of ACT017, an Antiplatelet GPVI (Glycoprotein VI) Fab. Arterioscler Thromb Vasc Biol 2019; 39:956-964. [DOI: 10.1161/atvbaha.118.312314] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective—
ACT017 is a novel, first in class, therapeutic antibody to platelet GPVI (glycoprotein VI) with potent and selective antiplatelet effects. This first-in-human, randomized, placebo-controlled phase 1 study was conducted to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of ACT017 in healthy subjects.
Approach and Results—
Six cohorts of 8 healthy male and female subjects each received ascending single doses of ACT017 (n=6) or placebo (n=2) as a 6-hour intravenous infusion, with ¼ of the total dose administered within 15 minutes and the rest of the dose (¾ of the total dose) administered within 5 hours and 45 minutes. The 6 investigated doses ranged from 62.5 to 2000 mg. All doses of ACT017 were well tolerated, and no serious adverse events occurred during the study. None of the subjects reported an infusion site reaction. Template bleeding time was not affected in a clinically significant manner by any of the ACT017 doses. Plasma concentrations, determined by liquid chromatography-tandem mass spectrometry, increased linearly with the dose received as were the established pharmacokinetics values. There was no change in the platelet count, platelet GPVI expression assessed by flow cytometry, or plasma levels of soluble GPVI assessed by ELISA. In contrast, administration of ACT017 inhibited collagen-induced platelet aggregation measured by light transmission aggregometry on platelet-rich plasma, and the extent and duration of the effect were dose-dependent.
Conclusions—
The novel antiplatelet agent ACT017 has consistent pharmacokinetic/pharmacodynamic properties and favorable safety and tolerability profiles warranting further clinical development.
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Affiliation(s)
| | - Kristell Lebozec
- Acticor-Biotech, Paris, France (K.L., L.J., P.B., P.F., O.F-B., G.A., Y.P., M.J-P.)
- University Paris Sud, School of Pharmacy, Inserm-S 1193, Châtenay Malabry, France (K.L., P.B.)
| | - Peter Dogterom
- From the QPS Holdings LLC, Groningen, the Netherlands (C.V.-P., P.D.)
| | - Laurie Jullien
- Acticor-Biotech, Paris, France (K.L., L.J., P.B., P.F., O.F-B., G.A., Y.P., M.J-P.)
| | - Philippe Billiald
- Acticor-Biotech, Paris, France (K.L., L.J., P.B., P.F., O.F-B., G.A., Y.P., M.J-P.)
- University Paris Sud, School of Pharmacy, Inserm-S 1193, Châtenay Malabry, France (K.L., P.B.)
| | - Pauline Ferlan
- Acticor-Biotech, Paris, France (K.L., L.J., P.B., P.F., O.F-B., G.A., Y.P., M.J-P.)
| | | | - Olivier Favre-Bulle
- Acticor-Biotech, Paris, France (K.L., L.J., P.B., P.F., O.F-B., G.A., Y.P., M.J-P.)
- 3Biotech, Paris, France (O.F-B.)
| | - Gilles Avenard
- Acticor-Biotech, Paris, France (K.L., L.J., P.B., P.F., O.F-B., G.A., Y.P., M.J-P.)
| | | | - Yannick Plétan
- Acticor-Biotech, Paris, France (K.L., L.J., P.B., P.F., O.F-B., G.A., Y.P., M.J-P.)
- ULTRACE, Orsay, France (Y.P.)
| | - Martine Jandrot-Perrus
- Acticor-Biotech, Paris, France (K.L., L.J., P.B., P.F., O.F-B., G.A., Y.P., M.J-P.)
- Inserm, Université Paris Sorbonne Cité, UMR_S1148, Paris, France (M.J-P.)
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172
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Majithia A, Bhatt DL. Novel Antiplatelet Therapies for Atherothrombotic Diseases. Arterioscler Thromb Vasc Biol 2019; 39:546-557. [PMID: 30760019 PMCID: PMC6445601 DOI: 10.1161/atvbaha.118.310955] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 01/20/2019] [Indexed: 01/03/2023]
Abstract
Antiplatelet therapies are an essential tool to reduce the risk of developing clinically apparent atherothrombotic disease and are a mainstay in the therapy of patients who have established cardiovascular, cerebrovascular, and peripheral artery disease. Strategies to intensify antiplatelet regimens are limited by concomitant increases in clinically significant bleeding. The development of novel antiplatelet therapies targeting additional receptor and signaling pathways, with a focus on maintaining antiplatelet efficacy while preserving hemostasis, holds tremendous potential to improve outcomes among patients with atherothrombotic diseases.
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Affiliation(s)
- Arjun Majithia
- From the Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA
| | - Deepak L. Bhatt
- From the Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA
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173
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Contractile forces in platelet aggregates under microfluidic shear gradients reflect platelet inhibition and bleeding risk. Nat Commun 2019; 10:1204. [PMID: 30867419 PMCID: PMC6416331 DOI: 10.1038/s41467-019-09150-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 02/13/2019] [Indexed: 12/21/2022] Open
Abstract
Platelets contract forcefully after their activation, contributing to the strength and stability of platelet aggregates and fibrin clots during blood coagulation. Viscoelastic approaches can be used to assess platelet-induced clot strengthening, but they require thrombin and fibrin generation and are unable to measure platelet forces directly. Here, we report a rapid, microfluidic approach for measuring the contractile force of platelet aggregates for the detection of platelet dysfunction. We find that platelet forces are significantly reduced when blood samples are treated with inhibitors of myosin, GPIb-IX-V, integrin αIIbβ3, P2Y12, or thromboxane generation. Clinically, we find that platelet forces are measurably lower in cardiology patients taking aspirin. We also find that measuring platelet forces can identify Emergency Department trauma patients who subsequently require blood transfusions. Together, these findings indicate that microfluidic quantification of platelet forces may be a rapid and useful approach for monitoring both antiplatelet therapy and traumatic bleeding risk. Platelet aggregates generate contractile forces that contribute to their cohesion and adhesion. Here, Ting et al. develop a microfluidic device to measure contractile forces generated by platelet aggregates, and find it can detect the response of platelets to pharmacological agents and predict bleeding risk in trauma patients.
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174
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Kong D, Xue T, Guo B, Cheng J, Liu S, Wei J, Lu Z, Liu H, Gong G, Lan T, Hu W, Yang Y. Optimization of P2Y12 Antagonist Ethyl 6-(4-((Benzylsulfonyl)carbamoyl)piperidin-1-yl)-5-cyano-2-methylnicotinate (AZD1283) Led to the Discovery of an Oral Antiplatelet Agent with Improved Druglike Properties. J Med Chem 2019; 62:3088-3106. [DOI: 10.1021/acs.jmedchem.8b01971] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Deyu Kong
- Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai 200062, P. R. China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, P. R. China
| | - Tao Xue
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, P. R. China
| | - Bin Guo
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, P. R. China
| | - Jianjun Cheng
- iHuman Institute, ShanghaiTech University, Shanghai 201210, P. R. China
| | - Shunyin Liu
- Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai 200062, P. R. China
| | - Jianhai Wei
- Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai 200062, P. R. China
| | - Zhengyu Lu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, P. R. China
| | - Haoran Liu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, P. R. China
| | - Guoqing Gong
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province 210009, P. R. China
| | - Tian Lan
- Department of Pharmacology, School of Pharmacy, China Pharmaceutical University, Nanjing, Jiangsu Province 210009, P. R. China
| | - Wenhao Hu
- Shanghai Engineering Research Center of Molecular Therapeutics and New Drug Development, School of Chemistry and Molecular Engineering, East China Normal University, Shanghai 200062, P. R. China
- School of Pharmaceutical Sciences, Sun Yat-Sen University, Guangzhou 510006, P. R. China
| | - Yushe Yang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, P. R. China
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175
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Ranasinghe MP, Peter K, McFadyen JD. Thromboembolic and Bleeding Complications in Transcatheter Aortic Valve Implantation: Insights on Mechanisms, Prophylaxis and Therapy. J Clin Med 2019; 8:jcm8020280. [PMID: 30823621 PMCID: PMC6406714 DOI: 10.3390/jcm8020280] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 01/09/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) has emerged as an important alternative to surgical aortic valve repair (SAVR) for patients with severe aortic stenosis. This rapidly advancing field has produced new-generation devices being delivered with small delivery sheaths, embolic protection devices and improved retrieval features. Despite efforts to reduce the rate of thrombotic complications associated with TAVI, valve thrombosis and cerebral ischaemic events post-TAVI continue to be a significant issue. However, the antithrombotic treatments utilised to prevent these dreaded complications are based on weak evidence and are associated with high rates of bleeding, which in itself is associated with adverse clinical outcomes. Recently, experimental data has shed light on the unique mechanisms, particularly the complex haemodynamic changes at sites of TAVI, that underpin the development of post-TAVI thrombosis. These new insights regarding the drivers of TAVI-associated thrombosis, coupled with the ongoing development of novel antithrombotics which do not cause bleeding, hold the potential to deliver newer, safer therapeutic paradigms to prevent post-TAVI thrombotic and bleeding complications. This review highlights the major challenge of post-TAVI thrombosis and bleeding, and the significant issues surrounding current antithrombotic approaches. Moreover, a detailed discussion regarding the mechanisms of post-TAVI thrombosis is provided, in addition to an appraisal of current antithrombotic guidelines, past and ongoing clinical trials, and how novel therapeutics offer the hope of optimizing antithrombotic strategies and ultimately improving patient outcomes.
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Affiliation(s)
- Mark P Ranasinghe
- Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, 75 Commercial Road, PO Box 6492, Melbourne, Victoria 3004, Australia.
- Department of Medicine, Monash University, Melbourne, Victoria 3800, Australia.
| | - Karlheinz Peter
- Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, 75 Commercial Road, PO Box 6492, Melbourne, Victoria 3004, Australia.
- Department of Medicine, Monash University, Melbourne, Victoria 3800, Australia.
- Heart Centre, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia.
| | - James D McFadyen
- Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, 75 Commercial Road, PO Box 6492, Melbourne, Victoria 3004, Australia.
- Department of Medicine, Monash University, Melbourne, Victoria 3800, Australia.
- Department of Clinical Haematology, The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia.
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176
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Yap ML, McFadyen JD, Wang X, Ziegler M, Chen YC, Willcox A, Nowell CJ, Scott AM, Sloan EK, Hogarth PM, Pietersz GA, Peter K. Activated platelets in the tumor microenvironment for targeting of antibody-drug conjugates to tumors and metastases. Theranostics 2019; 9:1154-1169. [PMID: 30867822 PMCID: PMC6401411 DOI: 10.7150/thno.29146] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/12/2019] [Indexed: 12/16/2022] Open
Abstract
Rationale: Platelets are increasingly recognized as mediators of tumor growth and metastasis. Hypothesizing that activated platelets in the tumor microenvironment provide a targeting epitope for tumor-directed chemotherapy, we developed an antibody-drug conjugate (ADC), comprised of a single-chain antibody (scFv) against the platelet integrin GPIIb/IIIa (scFvGPIIb/IIIa) linked to the potent chemotherapeutic microtubule inhibitor, monomethyl auristatin E (MMAE). Methods: We developed an ADC comprised of three components: 1) A scFv which specifically binds to the high affinity, activated integrin GPIIb/IIIa on activated platelets. 2) A highly potent microtubule inhibitor, monomethyl auristatin E. 3) A drug activation/release mechanism using a linker cleavable by cathepsin B, which we demonstrate to be abundant in the tumor microenvironment. The scFvGPIIb/IIIa-MMAE was first conjugated with Cyanine7 for in vivo imaging. The therapeutic efficacy of the scFvGPIIb/IIIa-MMAE was then tested in a mouse metastasis model of triple negative breast cancer. Results: In vitro studies confirmed that this ADC specifically binds to activated GPIIb/IIIa, and cathepsin B-mediated drug release/activation resulted in tumor cytotoxicity. In vivo fluorescence imaging demonstrated that the newly generated ADC localized to primary tumors and metastases in a mouse xenograft model of triple negative breast cancer, a difficult to treat tumor for which a selective tumor-targeting therapy remains to be clinically established. Importantly, we demonstrated that the scFvGPIIb/IIIa-MMAE displays marked efficacy as an anti-cancer agent, reducing tumor growth and preventing metastatic disease, without any discernible toxic effects. Conclusion: Here, we demonstrate the utility of a novel ADC that targets a potent cytotoxic drug to activated platelets and specifically releases the cytotoxic agent within the confines of the tumor. This unique targeting mechanism, specific to the tumor microenvironment, holds promise as a novel therapeutic approach for the treatment of a broad range of primary tumors and metastatic disease, particularly for tumors that lack specific molecular epitopes for drug targeting.
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Affiliation(s)
- May Lin Yap
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, 3010, Australia
| | - James D McFadyen
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
- Department of Medicine, Monash University, Melbourne, 3800, Australia
- Department of Hematology, The Alfred Hospital, Melbourne, 3004, Australia
| | - Xiaowei Wang
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
- Department of Medicine, Monash University, Melbourne, 3800, Australia
| | - Melanie Ziegler
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
| | - Yung-Chih Chen
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
| | - Abbey Willcox
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
- Department of Medicine, Monash University, Melbourne, 3800, Australia
- Department of Hematology, The Alfred Hospital, Melbourne, 3004, Australia
| | - Cameron J Nowell
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052, Australia
| | - Andrew M Scott
- Olivia Newton-John Cancer Research Institute, and School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia
- Department of Molecular Imaging and Therapy, Austin Health, and University of Melbourne, Melbourne, Victoria, Australia
| | - Erica K Sloan
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria 3052, Australia
| | - P Mark Hogarth
- Department of Clinical Pathology, The University of Melbourne, Melbourne, 3010, Australia
- Burnet Institute, Melbourne, 3004, Australia
- Department of Immunology, Monash University, Melbourne, 3800, Australia
| | - Geoffrey A Pietersz
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, 3010, Australia
- Burnet Institute, Melbourne, 3004, Australia
- Department of Immunology, Monash University, Melbourne, 3800, Australia
- College of Health and Biomedicine, Victoria University, Melbourne, 3021, Australia
| | - Karlheinz Peter
- Baker Heart and Diabetes Institute, Melbourne, 3004, Australia
- Department of Medicine, Monash University, Melbourne, 3800, Australia
- Department of Immunology, Monash University, Melbourne, 3800, Australia
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177
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Kocovski P, Jiang X, D'Souza CS, Li Z, Dang PT, Wang X, Chen W, Peter K, Hale MW, Orian JM. Platelet Depletion is Effective in Ameliorating Anxiety-Like Behavior and Reducing the Pro-Inflammatory Environment in the Hippocampus in Murine Experimental Autoimmune Encephalomyelitis. J Clin Med 2019; 8:jcm8020162. [PMID: 30717130 PMCID: PMC6406682 DOI: 10.3390/jcm8020162] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 01/21/2019] [Accepted: 01/27/2019] [Indexed: 01/16/2023] Open
Abstract
The neuropsychiatric symptoms of multiple sclerosis (MS), such as anxiety and depression, can result from disease activity itself as well as psychological reaction to an unfavorable diagnosis. Accordingly, the literature reports evidence of increased anxiety-like behavior in experimental autoimmune encephalomyelitis (EAE), an accepted MS model. Due to the recently described critical role of platelets in inflammation and autoimmune disease, we examined the relationship between platelets, inflammation, and anxiety-like behavior in EAE. In the elevated plus maze, EAE-induced C57BL/6J mice showed decreased time spent in the open arms relative to vehicle-only controls, demonstrating an increase in anxiety-like behavior. This effect occurred in the presence of platelet–neuron association, but absence of lymphocytic infiltration, in the hippocampal parenchyma. Platelet depletion at the pre-clinical disease stage, using antibody-mediated lysis prevented the EAE-induced increase in anxiety-like behavior, while no significant difference in distance moved was recorded. Furthermore, platelet depletion was also associated with reduction of the pro-inflammatory environment to control levels in the hippocampus and prevention of EAE disease symptomology. These studies demonstrate the high efficacy of a platelet-targeting approach in preventing anxiety-like symptoms and clinical manifestations of EAE and have implications for the treatment of neuropsychiatric symptoms in MS.
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Affiliation(s)
- Pece Kocovski
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia.
| | - Xiangrui Jiang
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Bundoora, VIC 3086, Australia.
| | - Claretta S D'Souza
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Bundoora, VIC 3086, Australia.
| | - Zhenjiang Li
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Bundoora, VIC 3086, Australia.
| | - Phuc T Dang
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Bundoora, VIC 3086, Australia.
| | - Xiaowei Wang
- Atherothrombosis and Vascular Biology, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
- Department of Medicine, Monash University, Melbourne, VIC 3800, Australia.
| | - Weisan Chen
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Bundoora, VIC 3086, Australia.
| | - Karlheinz Peter
- Atherothrombosis and Vascular Biology, Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia.
- Department of Medicine, Monash University, Melbourne, VIC 3800, Australia.
| | - Matthew W Hale
- Department of Psychology and Counselling, School of Psychology and Public Health, La Trobe University, Bundoora, VIC 3086, Australia.
| | - Jacqueline M Orian
- Department of Biochemistry and Genetics, La Trobe Institute for Molecular Science (LIMS), La Trobe University, Bundoora, VIC 3086, Australia.
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178
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Vara D, Cifuentes-Pagano E, Pagano PJ, Pula G. A novel combinatorial technique for simultaneous quantification of oxygen radicals and aggregation reveals unexpected redox patterns in the activation of platelets by different physiopathological stimuli. Haematologica 2019; 104:1879-1891. [PMID: 30679320 PMCID: PMC6717585 DOI: 10.3324/haematol.2018.208819] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/18/2019] [Indexed: 01/12/2023] Open
Abstract
The regulation of platelets by oxidants is critical for vascular health and may explain thrombotic complications in diseases such as diabetes and dementia, but remains poorly understood. Here, we describe a novel technique combining electron paramagnetic resonance spectroscopy and turbidimetry, which has been utilized to monitor simultaneously platelet activation and oxygen radical generation. This technique has been used to investigate the redox-dependence of human and mouse platelets. Using selective peptide inhibitors of NADPH oxidases (NOXs) on human platelets and genetically modified mouse platelets (NOX1−/− or NOX2−/−), we discovered that: 1) intracellular but not extracellular superoxide anion generated by NOX is critical for platelet activation by collagen; 2) superoxide dismutation to hydrogen peroxide is required for thrombin-dependent activation; 3) NOX1 is the main source of oxygen radicals in response to collagen, while NOX2 is critical for activation by thrombin; 4) two platelet modulators, namely oxidized low density lipoproteins (oxLDL) and amyloid peptide β (Aβ), require activation of both NOX1 and NOX2 to pre-activate platelets. This study provides new insights into the redox dependence of platelet activation. It suggests the possibility of selectively inhibiting platelet agonists by targeting either NOX1 (for collagen) or NOX2 (for thrombin). Selective inhibition of either NOX1 or NOX2 impairs the potentiatory effect of tested platelet modulators (oxLDL and Aβ), but does not completely abolish platelet hemostatic function. This information offers new opportunities for the development of disease-specific antiplatelet drugs with limited bleeding side effects by selectively targeting one NOX isoenzyme.
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Affiliation(s)
- Dina Vara
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Eugenia Cifuentes-Pagano
- Department of Pharmacology and Chemical Biology and Vascular Medicine Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Patrick J Pagano
- Department of Pharmacology and Chemical Biology and Vascular Medicine Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Giordano Pula
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
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179
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Dong L, Liu X, Wang T, Fang B, Chen J, Li C, Miao X, Wei C, Yu F, Xin H, Hong K, Ding X, Wang X. Localized Light-Au-Hyperthermia Treatment for Precise, Rapid, and Drug-Free Blood Clot Lysis. ACS APPLIED MATERIALS & INTERFACES 2019; 11:1951-1956. [PMID: 30571091 DOI: 10.1021/acsami.8b20616] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Thrombus diseases, induced by blood stasis or vascular embolization normally, frequently occur with high disability and mortalities worldwide. At present, drug thrombolysis, a primary clinical therapy for blood clot lysis, could increase the lethal risk for hemorrhage when thrombolysis agents are overused in the whole body. Therefore, a novel and advanced therapy for blood clot lysis, based on remote physical signals, is helpful for assisting clinical therapy. Here, we used the localized light-Au-hyperthermia (LAH) treatment, induced by gold nanorods (Au NRs) irradiated with near-infrared light (808 nm), for precise, rapid, and drug-free blood clot lysis. The LAH technology was first introduced in the murine hematoma model and the murine myocardial infarction model for blood clot lysis. Compared with traditional therapy, LAH was assured to shorten the time of detumescence in the murine hematoma model owing to their precise and localized hyperthermia. Meanwhile, we also discovered that LAH was a benefit to vascular recanalization in the murine myocardial infarction model. In addition, the Au NRs used in LAH present ideal biocompatibility in the murine model, which endows it to be suitable for blood clot lysis in vivo.
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Affiliation(s)
- Lina Dong
- Institute of Translational Medicine , Nanchang University , Nanchang , Jiangxi 330088 , China
| | - Xiao Liu
- Jiangxi Key Laboratory of Molecular Medicine , Nanchang , Jiangxi 330006 , China
| | - Tian Wang
- Institute of Translational Medicine , Nanchang University , Nanchang , Jiangxi 330088 , China
| | - Bixing Fang
- Department of Otolaryngology Head & Neck Surgery , The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou , Guangdong 510630 , China
| | - Jinghuang Chen
- Institute of Translational Medicine , Nanchang University , Nanchang , Jiangxi 330088 , China
| | | | | | - Chaochao Wei
- Institute of Translational Medicine , Nanchang University , Nanchang , Jiangxi 330088 , China
| | - Fen Yu
- Institute of Translational Medicine , Nanchang University , Nanchang , Jiangxi 330088 , China
| | - Hongbo Xin
- Institute of Translational Medicine , Nanchang University , Nanchang , Jiangxi 330088 , China
| | - Kui Hong
- Jiangxi Key Laboratory of Molecular Medicine , Nanchang , Jiangxi 330006 , China
| | - Xingwei Ding
- Institute of Translational Medicine , Nanchang University , Nanchang , Jiangxi 330088 , China
| | - Xiaolei Wang
- Institute of Translational Medicine , Nanchang University , Nanchang , Jiangxi 330088 , China
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180
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Wang ZY, Ruan CG. [The progresses in research and treatment of inherited platelet disorders]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2018; 39:877-880. [PMID: 30369214 PMCID: PMC7348291 DOI: 10.3760/cma.j.issn.0253-2727.2018.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Indexed: 11/05/2022]
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181
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Baqi Y, Müller CE. Antithrombotic P2Y 12 receptor antagonists: recent developments in drug discovery. Drug Discov Today 2018; 24:325-333. [PMID: 30291899 DOI: 10.1016/j.drudis.2018.09.021] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 08/31/2018] [Accepted: 09/27/2018] [Indexed: 12/16/2022]
Abstract
The P2Y12 receptor is one of eight known P2Y receptor subtypes, and belongs to the G-protein-coupled receptor (GPCR) family. The P2Y12 receptor is highly expressed on blood platelets and in the brain. Potent, selective, peripherally acting antagonists for the P2Y12 receptor are used clinically as antithrombotic drugs. Several different scaffolds have been identified as P2Y12 receptor antagonists, including irreversibly acting thienotetrahydropyridines (prodrugs), and reversible competitive antagonists, including adenine nucleotide analogs, piperazinyl-glutamate-quinolines, -pyridines, and -pyrimidines, and anthraquinone derivatives. Here, we provide an overview of the different scaffolds that have been developed as P2Y12 receptor antagonists, some of which have become important therapeutics.
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Affiliation(s)
- Younis Baqi
- Department of Chemistry, Faculty of Science, Sultan Qaboos University, PO Box 36, Postal Code 123, Muscat, Oman.
| | - Christa E Müller
- Pharma-Center Bonn, Pharmaceutical Institute, Pharmaceutical Chemistry I, An der Immenburg 4, D-53121 Bonn, Germany
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182
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Martins Lima A, Bragina ME, Burri O, Bortoli Chapalay J, Costa-Fraga FP, Chambon M, Fraga-Silva RA, Stergiopulos N. An optimized and validated 384-well plate assay to test platelet function in a high-throughput screening format. Platelets 2018; 30:563-571. [PMID: 30183501 DOI: 10.1080/09537104.2018.1514106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Despite significant advances in the treatment of cardiovascular diseases, antiplatelet therapies are still associated with a high risk of hemorrhage. In order to develop new drugs, methods to measure platelet function must be adapted for the high-throughput screening (HTS) format. Currently, all assays capable of assessing platelet function are either expensive, complex, or not validated, which makes them unsuitable for drug discovery. Here, we propose a simple, low-cost, and high-throughput-compatible platelet function assay, validated for the 384-well plate. In the proposed assay, agonist-induced platelet activity was assessed by three different methods: (i) measurement of light absorbance, which decreases with platelet aggregation; (ii) luminescence measurement, based on ATP release from activated platelets and luciferin-luciferase reaction; and (iii) automated bright-field microscopy of the wells and further quantification of platelet image area, described here for the first time. Brightfield imaging results were validated by demonstrating the similarity of dose-response curves obtained with absorbance and luminescence measurements after stimulating platelets, pre-incubated with prostaglandin E1 or tirofiban, and demonstrating the similarity of dose-response curves obtained with agonists. Assay quality was confirmed using the Z'-factor, a statistical parameter used to validate the robustness and suitability of an HTS assay. The results showed that, under high rotations per minute (1200 RPM), an acceptable Z'-factor score is reached for absorbance measurements (Z'-factor - 0.58) and automated brightfield imaging (Z'-factor - 0.52), without the need of replicates, while triplicates must be used to achieve an acceptable Z'-factor score (0.54) for luminescence measurements. Using low platelet concentration (4 × 104/μl - 10 μl), the brightfield imaging test was further validated using washed platelets. Furthermore, drug screening was performed with compounds selected by structure-based virtual screening. Taken together, this study presents an optimized and validated assay for HTS to be used as a tool for antiplatelet drug discovery.
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Affiliation(s)
- Augusto Martins Lima
- a Institute of Bioengineering , École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Maiia E Bragina
- a Institute of Bioengineering , École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Olivier Burri
- b BioImaging and Optics Core Facility , École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Julien Bortoli Chapalay
- c Biomolecular Screening Facility , École Polytechnique Federale de Lausanne , Lausanne , Switzerland
| | - Fabiana P Costa-Fraga
- a Institute of Bioengineering , École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Marc Chambon
- c Biomolecular Screening Facility , École Polytechnique Federale de Lausanne , Lausanne , Switzerland
| | - Rodrigo A Fraga-Silva
- a Institute of Bioengineering , École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
| | - Nikolaos Stergiopulos
- a Institute of Bioengineering , École Polytechnique Fédérale de Lausanne , Lausanne , Switzerland
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183
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Rizzi M, Albisetti M. Treatment of arterial thrombosis in children: Methods and mechanisms. Thromb Res 2018; 169:113-119. [DOI: 10.1016/j.thromres.2018.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 07/05/2018] [Indexed: 12/17/2022]
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184
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Hanjaya-Putra D, Haller C, Wang X, Dai E, Lim B, Liu L, Jaminet P, Yao J, Searle A, Bonnard T, Hagemeyer CE, Peter K, Chaikof EL. Platelet-targeted dual pathway antithrombotic inhibits thrombosis with preserved hemostasis. JCI Insight 2018; 3:99329. [PMID: 30089712 PMCID: PMC6129120 DOI: 10.1172/jci.insight.99329] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 06/28/2018] [Indexed: 12/22/2022] Open
Abstract
Despite advances in antithrombotic therapy, the risk of recurrent coronary/cerebrovascular ischemia or venous thromboembolism remains high. Dual pathway antithrombotic blockade, using both antiplatelet and anticoagulant therapy, offers the promise of improved thrombotic protection; however, widespread adoption remains tempered by substantial risk of major bleeding. Here, we report a dual pathway therapeutic capable of site-specific targeting to activated platelets and therapeutic enrichment at the site of thrombus growth to allow reduced dosing without compromised antithrombotic efficacy. We engineered a recombinant fusion protein, SCE5-TAP, which consists of a single-chain antibody (SCE5) that targets and blocks the activated GPIIb/IIIa complex, and tick anticoagulant peptide (TAP), a potent direct inhibitor of activated factor X (FXa). SCE5-TAP demonstrated selective platelet targeting and inhibition of thrombosis in murine models of both carotid artery and inferior vena cava thrombosis, without a significant impact on hemostasis. Selective targeting to activated platelets provides an attractive strategy to achieve high antithrombotic efficacy with reduced risk of bleeding complications.
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Affiliation(s)
- Donny Hanjaya-Putra
- Department of Surgery, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Carolyn Haller
- Department of Surgery, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Xiaowei Wang
- Baker Heart and Diabetes Research Institute, Melbourne, VIC 8008, Australia
| | - Erbin Dai
- Department of Surgery, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
| | - Bock Lim
- Baker Heart and Diabetes Research Institute, Melbourne, VIC 8008, Australia
| | - Liying Liu
- Department of Surgery, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts, USA
| | | | - Joy Yao
- Baker Heart and Diabetes Research Institute, Melbourne, VIC 8008, Australia
| | - Amy Searle
- Baker Heart and Diabetes Research Institute, Melbourne, VIC 8008, Australia
| | - Thomas Bonnard
- Baker Heart and Diabetes Research Institute, Melbourne, VIC 8008, Australia
| | | | - Karlheinz Peter
- Baker Heart and Diabetes Research Institute, Melbourne, VIC 8008, Australia
| | - Elliot L. Chaikof
- Department of Surgery, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School, Boston, Massachusetts, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, USA
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185
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Knowles RB, Warner TD. Anti-platelet drugs and their necessary interaction with endothelial mediators and platelet cyclic nucleotides for therapeutic efficacy. Pharmacol Ther 2018; 193:83-90. [PMID: 30081048 PMCID: PMC6325790 DOI: 10.1016/j.pharmthera.2018.08.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
For many millions of patients at secondary risk of coronary thrombosis pharmaceutical protection is supplied by dual anti-platelet therapy. Despite substantial therapeutic developments over the last decade recurrent thrombotic events occur, highlighting the need for further optimisation of therapies. Importantly, but often ignored, anti-platelet drugs interact with cyclic nucleotide systems in platelets and these are the same systems that mediate key endogenous pathways of platelet regulation, notably those dependent upon the vascular endothelium. The aim of this review is to highlight interactions between the anti-platelet drugs, aspirin and P2Y12 receptor antagonists and endogenous pathways of platelet regulation at the level of cyclic nucleotides. These considerations are key to concepts such as anti-platelet drug resistance and individualized anti-platelet therapy which cannot be understood by study of platelets in isolation from the circulatory environment. We also explore novel and emerging therapies that focus on preserving haemostasis and how the concepts outlined in this review could be exploited therapeutically to improve anti-thrombotic efficacy whilst reducing bleeding risk.
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Affiliation(s)
- Rebecca B Knowles
- The Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Timothy D Warner
- The Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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186
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Capodanno D, Mehran R, Valgimigli M, Baber U, Windecker S, Vranckx P, Dangas G, Rollini F, Kimura T, Collet JP, Gibson CM, Steg PG, Lopes RD, Gwon HC, Storey RF, Franchi F, Bhatt DL, Serruys PW, Angiolillo DJ. Aspirin-free strategies in cardiovascular disease and cardioembolic stroke prevention. Nat Rev Cardiol 2018; 15:480-496. [DOI: 10.1038/s41569-018-0049-1] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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187
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Luu S, Gardiner EE, Andrews RK. Bone Marrow Defects and Platelet Function: A Focus on MDS and CLL. Cancers (Basel) 2018; 10:E147. [PMID: 29783667 PMCID: PMC5977120 DOI: 10.3390/cancers10050147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/11/2018] [Accepted: 05/16/2018] [Indexed: 12/16/2022] Open
Abstract
The bloodstream typically contains >500 billion anucleate circulating platelets, derived from megakaryocytes in the bone marrow. This review will focus on two interesting aspects of bone marrow dysfunction and how this impacts on the quality of circulating platelets. In this regard, although megakaryocytes are from the myeloid lineage leading to granulocytes (including neutrophils), erythrocytes, and megakaryocytes/platelets, recent evidence has shown that defects in the lymphoid lineage leading to B cells, T cells, and natural killer (NK) cells also result in abnormal circulating platelets. Current evidence is limited regarding whether this latter phenomenon might potentially arise from (a) some form of as-yet-undetected defect common to both lineages; (b) adverse interactions occurring between cells of different lineages within the bone marrow environment; and/or (c) unknown disease-related factor(s) affecting circulating platelet receptor expression/function after their release from megakaryocytes. Understanding the mechanisms underlying how both myeloid and lymphoid lineage bone marrow defects lead to dysfunction of circulating platelets is significant because of the potential diagnostic and predictive value of peripheral platelet analysis for bone marrow disease progression, the additional potential effects of new anti-cancer drugs on platelet function, and the critical role platelets play in regulation of bleeding risk, inflammation, and innate immunity.
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Affiliation(s)
- Sarah Luu
- Australian Centre for Blood Diseases, Monash University, Melbourne, VIC 3004, Australia.
| | - Elizabeth E Gardiner
- ACRF Department of Cancer Biology and Therapeutics, The John Curtin School of Medical Research, The Australian National University, Canberra, ACT 2600, Australia.
| | - Robert K Andrews
- Australian Centre for Blood Diseases, Monash University, Melbourne, VIC 3004, Australia.
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188
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Lu W, Gómez NM, Lim JC, Guha S, O'Brien-Jenkins A, Coffey EE, Campagno KE, McCaughey SA, Laties AM, Carlsson LG, Mitchell CH. The P2Y 12 Receptor Antagonist Ticagrelor Reduces Lysosomal pH and Autofluorescence in Retinal Pigmented Epithelial Cells From the ABCA4 -/- Mouse Model of Retinal Degeneration. Front Pharmacol 2018; 9:242. [PMID: 29725296 PMCID: PMC5917064 DOI: 10.3389/fphar.2018.00242] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/05/2018] [Indexed: 11/13/2022] Open
Abstract
The accumulation of partially degraded lipid waste in lysosomal-related organelles may contribute to pathology in many aging diseases. The presence of these lipofuscin granules is particularly evident in the autofluorescent lysosome-associated organelles of the retinal pigmented epithelial (RPE) cells, and may be related to early stages of age-related macular degeneration. While lysosomal enzymes degrade material optimally at acidic pH levels, lysosomal pH is elevated in RPE cells from the ABCA4-/- mouse model of Stargardt's disease, an early onset retinal degeneration. Lowering lysosomal pH through cAMP-dependent pathways decreases accumulation of autofluorescent material in RPE cells in vitro, but identification of an appropriate receptor is crucial for manipulating this pathway in vivo. As the P2Y12 receptor for ADP is coupled to the inhibitory Gi protein, we asked whether blocking the P2Y12 receptor with ticagrelor could restore lysosomal acidity and reduce autofluorescence in compromised RPE cells from ABCA4-/- mice. Oral delivery of ticagrelor giving rise to clinically relevant exposure lowered lysosomal pH in these RPE cells. Ticagrelor also partially reduced autofluorescence in the RPE cells of ABCA4-/- mice. In vitro studies in ARPE-19 cells using more specific antagonists AR-C69931 and AR-C66096 confirmed the importance of the P2Y12 receptor for lowering lysosomal pH and reducing autofluorescence. These observations identify P2Y12 receptor blockade as a potential target to lower lysosomal pH and clear lysosomal waste in RPE cells.
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Affiliation(s)
- Wennan Lu
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States
| | - Néstor M Gómez
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States
| | - Jason C Lim
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States
| | - Sonia Guha
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States.,Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Ann O'Brien-Jenkins
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States
| | - Erin E Coffey
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States
| | - Keith E Campagno
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States
| | - Stuart A McCaughey
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States
| | - Alan M Laties
- Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Leif G Carlsson
- Department of Bioscience Heart Failure, Cardiovascular, Renal and Metabolic Diseases, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Claire H Mitchell
- Department of Anatomy and Cell Biology, University of Pennsylvania, Philadelphia, PA, United States.,Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, United States.,Department of Physiology, University of Pennsylvania, Philadelphia, PA, United States
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