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Wang M, Li L, Tang S, Liu J, Liu S, Ye J, Ding G, Sun G. Qilong capsule prevents myocardial ischemia/reperfusion injury by inhibiting platelet activation via the platelet CD36 signaling pathway. JOURNAL OF ETHNOPHARMACOLOGY 2024; 330:118211. [PMID: 38636580 DOI: 10.1016/j.jep.2024.118211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Qilong capsule (QC) is developed from the traditional Chinese medicine formula Buyang Huanwu Decoction, which has been clinically used to invigorate Qi and promote blood circulation to eliminate blood stasis. Myocardial ischemia‒reperfusion injury (MIRI) can be attributed to Qi deficiency and blood stasis. However, the effects of QC on MIRI remain unclear. AIM OF THE STUDY This study aimed to investigate the protective effect and possible mechanism of QC on platelet function in MIRI rats. MATERIALS AND METHODS The left anterior descending artery of adult Sprague‒Dawley rats was ligated for 30 min and then reperfused for 120 min with or without QC treatment. Then, the whole blood viscosity, plasma viscosity, coagulation, platelet adhesion rate, platelet aggregation, and platelet release factors were evaluated. Platelet CD36 and its downstream signaling pathway-related proteins were detected by western blotting. Furthermore, the active components of QC and the molecular mechanism by which QC regulates platelet function were assessed via molecular docking, platelet aggregation tests in vitro and BLI analysis. RESULTS We found that QC significantly reduced the whole blood viscosity, plasma viscosity, platelet adhesion rate, and platelet aggregation induced by ADP or AA in rats with MIRI. The inhibition of platelet activation by QC was associated with reduced levels of β-TG, PF-4, P-selectin and PAF. Mechanistically, QC effectively attenuated the expression of platelet CD36 and thus inhibited the activation of Src, ERK5, and p38. The active components of QC apparently suppressed platelet aggregation in vitro and regulated the CD36 signaling pathway. CONCLUSIONS QC improves MIRI-induced hemorheological disorders, which might be partly attributed to the inhibition of platelet activation via CD36-mediated platelet signaling pathways.
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Affiliation(s)
- Min Wang
- Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China.
| | - Lingxu Li
- Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China.
| | - Shuang Tang
- Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China.
| | - Jianxun Liu
- Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing, 100091, China.
| | - Shusen Liu
- Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China; School of Pharmacy, Harbin University of Commerce, Harbin, 150076, China.
| | - Jingxue Ye
- Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China.
| | - Gang Ding
- Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China.
| | - Guibo Sun
- Institute of Medicinal Plant Development, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100193, China.
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Mostafa MR, Eid MM, Awad AK, Takla A, Hassan AR, Katamesh BE, AlBarakat MM, Ziada AR, Mohamed S, Al-Azizi KM, Goldsweig AM. Safety and Efficacy of Cangrelor in Acute Coronary Syndromes: A Systematic Review and Network Meta-Analysis. Am J Cardiovasc Drugs 2024; 24:71-81. [PMID: 37995040 DOI: 10.1007/s40256-023-00616-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Cangrelor is a potent intravenous non-thienopyridine P2Y12 inhibitor. We conducted a network meta-analysis to study the efficacy and safety of cangrelor as compared with the oral P2Y12 inhibition, clopidogrel, or placebo in acute coronary syndromes. METHODS This meta-analysis followed the Cochrane collaboration guidelines and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocols. Outcomes of interest included all-cause mortality, myocardial infarction, stent thrombosis, target vessel revascularization, major bleeding, minor bleeding, and the need for blood transfusion. RESULTS The analysis was comprised of 6 studies including 26,444 patients treated with cangrelor, clopidogrel, or placebo. There were no statistically significant differences in the incidence of all-cause mortality, myocardial infarction, stent thrombosis, target vessel revascularization, or major bleeding. Cangrelor was associated with a higher risk of minor bleeding than clopidogrel or placebo, with no difference in requiring blood transfusion. CONCLUSION Cangrelor has comparable outcomes to clopidogrel in patients with acute coronary syndromes and can be used as a reliable alternative in this population.
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Affiliation(s)
| | | | - Ahmed K Awad
- Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Andrew Takla
- Department of Medicine, Rochester General Hospital, Rochester, NY, USA
| | | | | | - Majd M AlBarakat
- Faculty of Medicine, Jordan University of Science and Technology, Amman, Jordan
| | | | | | - Karim M Al-Azizi
- Baylor Scott and White Health-The Heart Hospital, Plano, TX, USA
| | - Andrew M Goldsweig
- Department of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA, USA
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Premji AM, Blegen MB, Corley AM, Ulloa J, Booth MS, Begashaw M, Larkin J, Shekelle P, Girgis MD, Maggard-Gibbons M. Dual antiplatelet management in the perioperative period: updated and expanded systematic review. Syst Rev 2023; 12:197. [PMID: 37838696 PMCID: PMC10576385 DOI: 10.1186/s13643-023-02360-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/25/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Antiplatelet agents are central in the management of vascular disease. The use of dual antiplatelet therapy (DAPT) for the management of thromboembolic complications must be weighed against bleeding risk in the perioperative setting. This balance is critical in patients undergoing cardiac or non-cardiac surgery. The management of patients on DAPT for any indication (including stents) is not clear and there is limited evidence to guide decision-making. This review summarizes current evidence since 2015 regarding the occurrence of major adverse events associated with continuing, suspending, or varying DAPT in the perioperative period. METHODS A research librarian searched PubMed and Cochrane from November 30, 2015 to May 17, 2022, for relevant terms regarding adult patients on DAPT for any reason undergoing surgery, with a perioperative variation in DAPT strategy. Outcomes of interest included the occurrence of major adverse cardiac events, major adverse limb events, all-cause death, major bleeding, and reoperation. We considered withdrawal or discontinuation of DAPT as stopping either aspirin or a P2Y12 inhibitor or both agents; continuation of DAPT indicates that both drugs were given in the specified timeframe. RESULTS Eighteen observational studies met the inclusion criteria. No RCTs were identified, and no studies were judged to be at low risk of bias. Twelve studies reported on CABG. Withholding DAPT therapy for more than 2 days was associated with less blood loss and a slight trend favoring less transfusion and surgical re-exploration. Among five observational CABG studies, there were no statistically significant differences in patient death across DAPT management strategies. Few studies reported cardiac outcomes. The remaining studies, which were about procedures other than exclusively CABG, demonstrated mixed findings with respect to DAPT strategy, bleeding, and ischemic outcomes. CONCLUSION The evidence base on the benefits and risks of different perioperative DAPT strategies for patients with stents is extremely limited. The strongest signal, which was still judged as low certainty evidence, is that suspension of DAPT for greater than 2 days prior to CABG surgery is associated with less bleeding, transfusions, and re-explorations. Different DAPT strategies' association with other outcomes of interest, such as MACE, remains uncertain. SYSTEMATIC REVIEW REGISTRATION A preregistered protocol for this review can be found on the PROSPERO International Prospective Register of systematic reviews ( http://www.crd.york.ac.uk/PROSPERO/ ; registration number: CRD42022371032).
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Affiliation(s)
- Alykhan M Premji
- Veterans Health Administration, Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073, USA.
| | - Mariah B Blegen
- Veterans Health Administration, Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073, USA
- National Clinician Scholars Program, University of California, Los Angeles, 1100 Glendon Ave., Suite 900, Los Angeles, CA, 90024, USA
| | - Alyssa M Corley
- Duke University School of Medicine, DUMC Box 104002, Durham, NC, 27710, USA
| | - Jesus Ulloa
- Veterans Health Administration, Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073, USA
- David Geffen School of Medicine at University of California, Los Angeles, 885 Tiverton Dr., Los Angeles, CA, 90095, USA
| | - Marika S Booth
- Southern California Evidence-Based Practice Center, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA
| | - Meron Begashaw
- Veterans Health Administration, Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073, USA
| | - Jody Larkin
- Southern California Evidence-Based Practice Center, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90401, USA
| | - Paul Shekelle
- Veterans Health Administration, Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073, USA
| | - Mark D Girgis
- Veterans Health Administration, Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073, USA
- David Geffen School of Medicine at University of California, Los Angeles, 885 Tiverton Dr., Los Angeles, CA, 90095, USA
| | - Melinda Maggard-Gibbons
- Veterans Health Administration, Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA, 90073, USA
- David Geffen School of Medicine at University of California, Los Angeles, 885 Tiverton Dr., Los Angeles, CA, 90095, USA
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Liu D, Zhang P, Zhang K, Bi C, Li L, Xu Y, Zhang T, Zhang J. Role of GPR56 in Platelet Activation and Arterial Thrombosis. Thromb Haemost 2023; 123:295-306. [PMID: 36402131 DOI: 10.1055/a-1983-0457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The adhesion G protein-coupled receptor GPR56 mediates cell-cell and cell-extracellular matrix interactions. To examine the function of GPR56 in platelet activation and arterial thrombosis, we generated GPR56-knockout mice and evaluated GPR56 expression in human and mouse platelets. The results revealed that the levels of the GPR56 N-terminal fragment were significantly higher on the first day after myocardial infarction than on the seventh day in the plasma of patients with ST-segment-elevation myocardial infarction. Next, we investigated the effects of GPR56 on platelet function in vitro and in vivo. We observed that collagen-induced aggregation and adenosine triphosphate release were reduced in Gpr56 -/- platelets. Furthermore, P-selectin expression on the Gpr56 -/- platelet surface was also reduced, and the spreading area on immobilized collagen was decreased in Gpr56 -/- platelets. Furthermore, collagen-induced platelet activation in human platelets was inhibited by an anti-GPR56 antibody. Gpr56 -/- mice showed an extended time to the first occlusion in models with cremaster arteriole laser injury and FeCl3-induced carotid artery injury. GPR56 activated the G protein 13 signaling pathway following collagen stimulation, which promoted platelet adhesion and thrombus formation at the site of vascular injury. Thus, our study confirmed that GPR56 regulated the formation of arterial thrombosis. Inhibition of the initial response of GPR56 to collagen could significantly inhibit platelet activation and thrombus formation. Our results provide new insights for research into antiplatelet drugs.
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Affiliation(s)
- Dongsheng Liu
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peng Zhang
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kandi Zhang
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Changlong Bi
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Li
- Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Yanyan Xu
- Department of Biochemistry and Molecular Cell Biology, Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tiantian Zhang
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Junfeng Zhang
- Department of Cardiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Elsonbaty A, Hassan WS, Eissa MS, Abdulwahab S. Micelle-Incorporated Liquid Chromatography in the Light of Green Chemistry: An Application for the Quality Control Analysis of Anti-Platelet Fixed-Dose Combinations. J AOAC Int 2022; 105:1228-1233. [DOI: 10.1093/jaoacint/qsac046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/04/2022] [Accepted: 04/01/2022] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Oral anti-platelet agents are the cornerstone of the treatment of multiple cardiovascular diseases and in the long-term prevention of their recurrence.
Objective
In the present work, we report a method based on micellar liquid chromatography coupled with ultraviolet detection (MLC/UV), for the simultaneous quantification of combined anti-platelet therapy namely, clopidogrel bisulfate (CPS), aspirin (ASP), together with salicylic acid (SA), in their pharmaceutical dosage form.
Methods
The incorporation of 0.1M polyoxyethylene 23 lauryl ether (Brij-35) as a surfactant into the mobile phase improved solute–mobile phase interaction allowing for minimal organic solvent utilization, enhanced resolution, and rapid analysis (7 min). Furthermore, we performed a comprehensive evaluation of the environmental impact caused by our procedures versus previously reported analytical procedures applied in the determination of CPS and ASP. The evaluation was made using the Eco-scale tool.
Results
The results of the developed method indicated the superiority of our procedures in terms of greenness without compromising the quality of performance characteristics. The method was linear in the range of 1–100 µg/mL with limits of detection of 0.28, 0.32, and 0.29 µg/mL for CPS, ASP, and SA, respectively. The developed method can also be utilized to test the purity and the stability of ASP in pharmaceutical formulations through monitoring SA as its main degradation product.
Conclusion
The MLC/UV method was successfully applied to the quantitative analysis of CPS, ASP together with SA—as a main degradation product of ASP—in their pharmaceutical dosage form
Highlights
The developed method was successfully applied for the determination of clopidogrel bisulfate (CPS), aspirin (ASP), together with salicylic acid (SA), in their pharmaceutical dosage form.
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Affiliation(s)
- Ahmed Elsonbaty
- Egyptian Russian University, Faculty of Pharmacy, Department of Analytical Chemistry , Cairo, Egypt
| | - Wafaa S Hassan
- Zagazig University, Faculty of Pharmacy, Department of Analytical Chemistry , Zagazig, Egypt
| | - Maya S Eissa
- Egyptian Russian University, Faculty of Pharmacy, Department of Analytical Chemistry , Cairo, Egypt
| | - Sara Abdulwahab
- Zagazig University, Faculty of Pharmacy, Department of Analytical Chemistry , Zagazig, Egypt
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Fernández-Rojas M, Rodríguez L, Trostchansky A, Fuentes E. Regulation of platelet function by natural bioactive compounds. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2022.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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7
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Kopeikina E, Ponomarev ED. The Role of Platelets in the Stimulation of Neuronal Synaptic Plasticity, Electric Activity, and Oxidative Phosphorylation: Possibilities for New Therapy of Neurodegenerative Diseases. Front Cell Neurosci 2021; 15:680126. [PMID: 34335186 PMCID: PMC8318360 DOI: 10.3389/fncel.2021.680126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/23/2021] [Indexed: 12/04/2022] Open
Abstract
The central nervous system (CNS) is highly vascularized where neuronal cells are located in proximity to endothelial cells, astroglial limitans, and neuronal processes constituting integrated neurovascular units. In contrast to many other organs, the CNS has a blood-brain barrier (BBB), which becomes compromised due to infection, neuroinflammation, neurodegeneration, traumatic brain injury, and other reasons. BBB disruption is presumably involved in neuronal injury during epilepsy and psychiatric disorders. Therefore, many types of neuropsychological disorders are accompanied by an increase in BBB permeability leading to direct contact of circulating blood cells in the capillaries with neuronal cells in the CNS. The second most abundant type of blood cells are platelets, which come after erythrocytes and outnumber ~100-fold circulating leukocytes. When BBB becomes compromised, platelets swiftly respond to the vascular injury and become engaged in thrombosis and hemostasis. However, more recent studies demonstrated that platelets could also enter CNS parenchyma and directly interact with neuronal cells. Within CNS, platelets become activated by recognizing major brain gangliosides on the surface of astrocytes and neurons and releasing a milieu of pro-inflammatory mediators, neurotrophic factors, and neurotransmitters. Platelet-derived factors directly stimulate neuronal electric and synaptic activity and promote the formation of new synapses and axonal regrowth near the site of damage. Despite such active involvement in response to CNS damage, the role of platelets in neurological disorders was not extensively studied, which will be the focus of this review.
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Affiliation(s)
- Ekaterina Kopeikina
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Eugene D Ponomarev
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
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Cao D, Chandiramani R, Chiarito M, Claessen BE, Mehran R. Evolution of antithrombotic therapy in patients undergoing percutaneous coronary intervention: a 40-year journey. Eur Heart J 2021; 42:339-351. [PMID: 33367641 DOI: 10.1093/eurheartj/ehaa824] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/02/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
Since its introduction in 1977, percutaneous coronary intervention has become one of the most commonly performed therapeutic procedures worldwide. Such widespread diffusion, however, would have not been possible without a concomitant evolution of the pharmacotherapies associated with this intervention. Antithrombotic agents are fundamental throughout the management of patients undergoing coronary stent implantation, starting from the procedure itself to the long-term prevention of cardiovascular events. The last 40 years of interventional cardiology have seen remarkable improvements in both drug therapies and device technologies, which largely reflected a progressive understanding of the pathophysiological mechanisms of coronary artery disease, as well as procedure- and device-related adverse events. The purpose of this article is to provide an overview of the important milestones in antithrombotic pharmacology that have shaped clinical practice of today while also providing insights into knowledge gaps and future directions.
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Affiliation(s)
- Davide Cao
- Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA
| | - Rishi Chandiramani
- Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA
| | - Mauro Chiarito
- Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy.,Cardio Center, Humanitas Clinical and Research Hospital IRCCS, Via Alessandro Manzoni 56, 20090 Rozzano, Milan, Italy
| | - Bimmer E Claessen
- Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA
| | - Roxana Mehran
- Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA
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Papanagiotou P, Gory B. The Challenge of an Acute Antithrombotic Regimen for Treatment of Tandem Lesions Stroke. AJNR Am J Neuroradiol 2021; 42:926. [PMID: 33832954 DOI: 10.3174/ajnr.a7122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- P Papanagiotou
- Department of RadiologyAreteion University Hospital, National and Kapodistrian University of AthensAthens, GreeceDepartment of Diagnostic and Interventional NeuroradiologyHospital Bremen-MitteBremen, Germany
| | - B Gory
- Department of Diagnostic and Therapeutic NeuroradiologyUniversité de LorraineNancy, France
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Coronary Stents and Metal Allergy. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Mehmood A, Usman M, Patil P, Zhao L, Wang C. A review on management of cardiovascular diseases by olive polyphenols. Food Sci Nutr 2020; 8:4639-4655. [PMID: 32994927 PMCID: PMC7500788 DOI: 10.1002/fsn3.1668] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 05/07/2020] [Indexed: 12/21/2022] Open
Abstract
Noncommunicable diseases have increasingly grown the cause of morbidities and mortalities worldwide. Among them, cardiovascular diseases (CVDs) continue to be the major contributor to deaths. CVDs are common in the urban community population due to the substandard living conditions, which have a significant impact on the healthcare system, and over 23 million human beings are anticipated to suffer from the CVDs before 2030. At the moment, CVD physicians are immediately advancing both primary and secondary prevention modalities in high-risk populations. The cornerstone of CVD prevention is a healthy lifestyle that is more cost-effective than the treatments after disease onset. In fact, in the present scenario, comprehensive research conducted on food plant components is potentially efficacious in reducing some highly prevalent CVD risk factors, such as hypercholesterolemia, hypertension, and atherosclerosis. Polyphenols of olive oil (OO), virgin olive oil (VOO), and extra virgin olive oil contribute an essential role for the management of CVDs. Olive oil induces cardioprotective effects due to the presence of a plethora of polyphenolic compounds, for example, oleuropein (OL), tyrosol, and hydroxytyrosol. The present study examines the bioavailability and absorption of major olive bioactive compounds, for instance, oleacein, oleocanthal, OL, and tyrosol. This review also elucidates the snobbish connection of olive polyphenols (OP) and the potential mechanism involved in combating various CVD results taken up from the in vitro and in vivo studies, such as animal and human model studies.
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Affiliation(s)
- Arshad Mehmood
- Beijing Advance Innovation Center for Food Nutrition and Human Health Beijing Technology and Business University Beijing China
- Beijing Engineering and Technology Research Center of Food Additives School of Food and Chemical Technology Beijing Technology and Business University Beijing China
| | - Muhammad Usman
- Beijing Advance Innovation Center for Food Nutrition and Human Health Beijing Technology and Business University Beijing China
- Beijing Engineering and Technology Research Center of Food Additives School of Food and Chemical Technology Beijing Technology and Business University Beijing China
| | - Prasanna Patil
- Beijing Advance Innovation Center for Food Nutrition and Human Health Beijing Technology and Business University Beijing China
- Beijing Engineering and Technology Research Center of Food Additives School of Food and Chemical Technology Beijing Technology and Business University Beijing China
| | - Lei Zhao
- Beijing Advance Innovation Center for Food Nutrition and Human Health Beijing Technology and Business University Beijing China
- Beijing Engineering and Technology Research Center of Food Additives School of Food and Chemical Technology Beijing Technology and Business University Beijing China
| | - Chengtao Wang
- Beijing Advance Innovation Center for Food Nutrition and Human Health Beijing Technology and Business University Beijing China
- Beijing Engineering and Technology Research Center of Food Additives School of Food and Chemical Technology Beijing Technology and Business University Beijing China
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12
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Coronary Stents and Metal Allergy. Contact Dermatitis 2020. [DOI: 10.1007/978-3-319-72451-5_81-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Godoy LC, Farkouh ME. Personalised Approaches to Improving the Effect of Anti-platelet Agents: Where Do We Stand? Eur Cardiol 2019; 14:179-180. [PMID: 31933688 PMCID: PMC6950347 DOI: 10.15420/ecr.2019.14.3.ge1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Lucas C Godoy
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto Toronto, Ontario, Canada
- Instituto do Coracao (InCor), Faculdade de Medicina FMUSP, Universidade de Sao Paulo São Paulo, Brazil
| | - Michael E Farkouh
- Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto Toronto, Ontario, Canada
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15
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Cavallari LH, Obeng AO. Genetic Determinants of P2Y 12 Inhibitors and Clinical Implications. Interv Cardiol Clin 2018; 6:141-149. [PMID: 27886818 DOI: 10.1016/j.iccl.2016.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
There is significant interpatient variability in clopidogrel effectiveness, which is due in part to cytochrome P450 (CYP) 2C19 genotype. Approximately 30% of individuals carry CYP2C19 loss-of-function alleles, which have been consistently shown to reduce clopidogrel effectiveness after an acute coronary syndrome and percutaneous coronary intervention. Guidelines recommend consideration of prasugrel or ticagrelor in these patients. A clinical trial examining outcomes with CYP2C19 genotype-guided antiplatelet therapy is ongoing. In the meantime, based on the evidence available to date, several institutions have started clinically implementing CYP2C19 genotyping to assist with antiplatelet selection after percutaneous coronary intervention.
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Affiliation(s)
- Larisa H Cavallari
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida, 1333 Center Drive, PO Box 100486, Gainesville, FL 32610, USA.
| | - Aniwaa Owusu Obeng
- Division of General Internal Medicine, Department of Medicine, The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, USA; Department of Pharmacy, The Mount Sinai Hospital, New York, NY, USA
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16
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Lu N, Li L, Zheng X, Zhang S, Li Y, Yuan J, Wei Q, Xu Y, Meng F. Synthesis of a Novel Series of Amino Acid Prodrugs Based on Thienopyridine Scaffolds and Evaluation of Their Antiplatelet Activity. Molecules 2018; 23:molecules23051041. [PMID: 29710801 PMCID: PMC6102589 DOI: 10.3390/molecules23051041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 11/16/2022] Open
Abstract
The thienopyridines class of drugs used as P2Y12 receptor antagonists plays a vital role in antiplatelet therapy. To further optimized this compound class, we designed and synthesized a series of amino acid prodrugs of 2-hydroxytetrahydrothienopyridine. All compounds were then evaluated for their inhibitory effect on ADP-induced platelet aggregation in rats and then ED50 and bleeding time of the most potent compounds were compared with commercial drugs. The results showed compound 5c could be a potent and safe candidate for further research.
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Affiliation(s)
- Nan Lu
- School of Pharmaceutical Engineering, and Key Laboratory of Structure-Based Drug Design & Discovery (Ministry of Education), Shenyang Pharmaceutical University, Shenyang 110016, China.
- Tianjin Key Laboratory of Molecular Design and Drug Discovery, Tianjin Institute of Pharmaceutical Research, Tianjin 300193, China.
| | - Lingjun Li
- Tianjin Key Laboratory of Molecular Design and Drug Discovery, Tianjin Institute of Pharmaceutical Research, Tianjin 300193, China.
| | - Xuemin Zheng
- Tianjin Key Laboratory of Molecular Design and Drug Discovery, Tianjin Institute of Pharmaceutical Research, Tianjin 300193, China.
| | - Shijun Zhang
- Tianjin Key Laboratory of Molecular Design and Drug Discovery, Tianjin Institute of Pharmaceutical Research, Tianjin 300193, China.
| | - Yuquan Li
- Tianjin Key Laboratory of Molecular Design and Drug Discovery, Tianjin Institute of Pharmaceutical Research, Tianjin 300193, China.
| | - Jing Yuan
- Tianjin Key Laboratory of Molecular Design and Drug Discovery, Tianjin Institute of Pharmaceutical Research, Tianjin 300193, China.
| | - Qunchao Wei
- Tianjin Key Laboratory of Molecular Design and Drug Discovery, Tianjin Institute of Pharmaceutical Research, Tianjin 300193, China.
| | - Youjun Xu
- School of Pharmaceutical Engineering, and Key Laboratory of Structure-Based Drug Design & Discovery (Ministry of Education), Shenyang Pharmaceutical University, Shenyang 110016, China.
| | - Fancui Meng
- Tianjin Key Laboratory of Molecular Design and Drug Discovery, Tianjin Institute of Pharmaceutical Research, Tianjin 300193, China.
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17
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Xu H, Lu H, Zhu X, Wang W, Zhang Z, Fu H, Ma S, Luo Y, Fu J. Inhibitory effects of luteolin‑4'‑O‑β‑D‑glucopyranoside on P2Y12 and thromboxane A2 receptor‑mediated amplification of platelet activation in vitro. Int J Mol Med 2018; 42:615-624. [PMID: 29693158 DOI: 10.3892/ijmm.2018.3634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 03/27/2018] [Indexed: 11/06/2022] Open
Abstract
Platelet activation and subsequent accumulation at sites of vascular injury are central to thrombus formation, which is considered to be a trigger of several cardiovascular diseases. Callicarpa nudiflora (C. nudiflora) Hook is a traditional Chinese medicinal herb for promoting blood circulation by removing blood stasis. In our previous study, several compounds extracted from this herb, including luteolin‑4'‑O‑β‑D‑glucopyranoside (LGP), were revealed to exert inhibitory effects on adenosine diphosphate (ADP)‑induced platelet aggregation. The aim of present study was to confirm these antiplatelet effects and elucidate the potential mechanisms. Using a platelet‑aggregation assay, it was revealed that LGP significantly inhibited platelet aggregation induced by ADP, U46619 and arachidonic acid. It was also found that LGP exhibited marked inhibitory effects on the activation of αIIbβ3 integrin, the secretion of serotonin from granules, and the synthesis of thromboxane A2. In addition, the results showed that LGP suppressed Ras homolog family member A and phosphoinositide 3‑kinase/Akt/glycogen synthase kinase 3β signal transduction. Data from a radiolabeled ligand‑binding assay indicated that LGP exhibited apparent competing effects on thromboxane receptor (TP) and P2Y12 receptors. In conclusion, the data presented here demonstrated that LGP, a natural compound from C. nudiflora Hook, inhibited the development of platelet aggregation and amplification of platelet activation. These inhibitory effects may be associated with its dual‑receptor inhibition on P2Y12 and TP receptors.
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Affiliation(s)
- Huanjun Xu
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi 330004, P.R. China
| | - Hong Lu
- Network and Educational Technology Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi 330004, P.R. China
| | - Xiaocui Zhu
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi 330004, P.R. China
| | - Wei Wang
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi 330004, P.R. China
| | - Zhoumiao Zhang
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi 330004, P.R. China
| | - Huizheng Fu
- Jiangxi Provincial Institute for Drug Control, Nanchang, Jiangxi 330029, P.R. China
| | - Shuangcheng Ma
- National Institutes for Food and Drug Control, Beijing 100050, P.R. China
| | - Yuehua Luo
- Jiangxi Provincial Institute for Drug Control, Nanchang, Jiangxi 330029, P.R. China
| | - Jianjiang Fu
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi 330004, P.R. China
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18
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Abstract
Antiplatelet drugs, such as aspirin, P2Y12 antagonists, and glycoprotein (GP) IIb/IIIa inhibitors, have proved to be successful in reducing the morbidity and mortality associated with arterial thrombosis. These agents are, therefore, the cornerstone of therapy for patients with acute coronary syndromes. However, these drugs all carry an inherent risk of bleeding, which is associated with adverse cardiovascular outcomes and mortality. Thus, the potential benefits of more potent, conventional antiplatelet drugs are likely be offset by the increased risk of bleeding. Data from experiments in vivo have highlighted potentially important differences between haemostasis and thrombosis, raising the prospect of developing new antiplatelet drugs that are not associated with bleeding. Indeed, in preclinical studies, several novel antiplatelet therapies that seem to inhibit thrombosis while maintaining haemostasis have been identified. These agents include inhibitors of phosphatidylinositol 3-kinase-β (PI3Kβ), protein disulfide-isomerase, activated GPIIb/IIIa, GPIIb/IIIa outside-in signalling, protease-activated receptors, and platelet GPVI-mediated adhesion pathways. In this Review, we discuss how a therapeutic ceiling has been reached with existing antiplatelet drugs, whereby increased potency is offset by elevated bleeding risk. The latest advances in our understanding of thrombus formation have informed the development of new antiplatelet drugs that are potentially safer than currently available therapies.
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19
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Fu J, Zhu X, Wang W, Lu H, Zhang Z, Liu T, Xu H, Fu H, Ma S, Luo Y. 1, 6-di-O-caffeoyl-β-D-glucopyranoside, a natural compound from Callicarpa nudiflora Hook impairs P2Y 12 and thromboxane A 2 receptor-mediated amplification of platelet activation and aggregation. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2017; 36:273-282. [PMID: 29157825 DOI: 10.1016/j.phymed.2017.10.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 08/15/2017] [Accepted: 10/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Platelet activation and subsequent accumulation at sites of vascular injury perform a central role in thrombus formation, which is believed to be the trigger of several cardiovascular diseases, such as atherosclerosis, myocardial infarction and strokes. In this sense, the search for agents that are capable of blocking platelets aggregation has important implications for these diseases. Callicarpa nudiflora (C. nudiflora) Hook is a traditional Chinese medicine herb for eliminating stasis to subdue swelling and hemostasis. Our previous study found several compounds extracted from this herb, including 1, 6-di-O-caffeoyl-β-D-glucopyranoside (CGP), showed inhibitory effects on adenosine diphosphate (ADP) induced platelet aggregation. PURPOSE The aim of current study is confirmation of the anti-platelet effects and elucidation of the probable mechanisms. METHODS The experiments were performed on platelet rich plasma freshly isolated from SD rat. ADP, U46619 or arachidonic acid (AA) induced platelet aggregation assay were performed to evaluate the anti-platelet properties of CGP. Activated αIIbβ3 integrin abundance, serotonin (5-HT) secretion, thromboxane A2 (TXA2) synthesis was determined to assess the effects of CGP on platelet activation. Furthermore, RhoA and PI3K/Akt/GSK3β signal transduction were analyzed by Western Blotting assay. In addition, radiolabelled ligand binding assay was involved to evaluate the ability of CGP binding to thromboxane prostanoid (TP) and P2Y12 receptors. RESULTS CGP inhibited platelet aggregation induced by ADP, U46619 and arachidonic acid (AA), significantly. Furthermore, it is also found that LGP exhibited obvious inhibitory effects on αIIbβ3 integrin activation, serotonin (5-HT) secretion from granule and thromboxane A2 (TXA2) synthesis. Next, we found that CGP suppressed RhoA and PI3K/Akt/GSK3β signal transduction. Data from radiolabelled ligand binding assay showed that CGP displayed apparent competing effects on TP and P2Y12 receptors. CONCLUSION Collectively, the data presented here demonstrated that CGP, a natural compound from Callicarpa nudiflora Hook, inhibited the development of platelet aggregation and amplification of platelet activation. These inhibitory effects may be associated with its dual-receptor inhibition on P2Y12 and TP receptors.
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Affiliation(s)
- Jianjiang Fu
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China.
| | - Xiaocui Zhu
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Wei Wang
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Hong Lu
- Network and Educational Technology Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Zhoumiao Zhang
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Ting Liu
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Huanjun Xu
- Department of Pharmacology, School of Pharmacy, Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, China
| | - Huizheng Fu
- Jiangxi Provincial Institute for Drug Control, Nanchang, 330029, China
| | - Shuangcheng Ma
- National Institutes for Food and Drug Control, Beijing, 100050, China
| | - Yuehua Luo
- Jiangxi Provincial Institute for Drug Control, Nanchang, 330029, China.
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20
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Platelet Integrins in Tumor Metastasis: Do They Represent a Therapeutic Target? Cancers (Basel) 2017; 9:cancers9100133. [PMID: 28956830 PMCID: PMC5664072 DOI: 10.3390/cancers9100133] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 09/22/2017] [Accepted: 09/25/2017] [Indexed: 12/14/2022] Open
Abstract
Platelets are small anucleated cell fragments that ensure the arrest of bleeding after a vessel wall injury. They are also involved in non-hemostatic function such as development, immunity, inflammation, and in the hematogeneous phase of metastasis. While the role of platelets in tumor metastasis has been recognized for 60 years, the molecular mechanism underlying this process remains largely unclear. Platelets physically and functionally interact with various tumor cells through surface receptors including integrins. Platelets express five integrins at their surface, namely α2β1, α5β1, α6β1, αvβ3, and αIIbβ3, which bind preferentially to collagen, fibronectin, laminin, vitronectin, and fibrinogen, respectively. The main role of platelet integrins is to ensure platelet adhesion and aggregation at sites of vascular injury. Two of these, α6β1 and αIIbβ3, were proposed to participate in platelet–tumor cell interaction and in tumor metastasis. It has also been reported that pharmacological agents targeting both integrins efficiently reduce experimental metastasis, suggesting that platelet integrins may represent new anti-metastatic targets. This review focuses on the role of platelet integrins in tumor metastasis and discusses whether these receptors may represent new potential targets for novel anti-metastatic approaches.
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21
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Agrawal K, Melliou E, Li X, Pedersen TL, Wang SC, Magiatis P, Newman JW, Holt RR. Oleocanthal-rich extra virgin olive oil demonstrates acute anti-platelet effects in healthy men in a randomized trial. J Funct Foods 2017; 36:84-93. [PMID: 29904393 PMCID: PMC5995573 DOI: 10.1016/j.jff.2017.06.046] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The phenolic profiles of extra virgin olive oils (EVOOs) may influence their cardiovascular benefits. In a randomized crossover of acute EVOO intake on platelet function, participants (n=9) consumed 40 mL of EVOO weekly. EVOOs were matched for total phenolic content and were either tyrosol-poor with 1:2 oleacein/oleocanthal (D2i0.5), or 2:1 oleacein/oleocanthal (D2i2), or predominantly tyrosol (D2i0). Ibuprofen provided a platelet inhibition control. Blood was collected pre- and 2 hr post-EVOO intake. D2i0.5 and D2i2 reduced 1 µg/mL collagen-stimulated maximum platelet aggregation (Pmax), with effects best correlated to oleocanthal intake (R=0.56, P=0.002). Total phenolic intake was independently correlated to eicosanoid production inhibition, suggesting that cyclooxygenase blockade was not responsible for the Pmax inhibition. Five participants exhibited >25% ΔPmax declines with D2i0.5 and D2i2 intake and plasma metabolomic profiles discriminated subjects by oil responsivity. Platelet responses to acute EVOO intake are associated with oil phenolic composition and may be influenced by diet.
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Affiliation(s)
- Karan Agrawal
- Department of Nutrition, University of California-Davis, One Shields Avenue, Davis, CA 95616, USA
- West Coast Metabolomics Center, Genome Center, 451 Health Sciences Drive, Davis, CA 95616, USA
| | - Eleni Melliou
- Department of Pharmacognosy and Natural Products Chemistry, Faculty of Pharmacy, National and Kapodistrian University of Athens, Panepistimioupolis Zografou 15 771, Athens, Greece
| | - Xueqi Li
- UC Davis Olive Center, University of California-Davis, 392 Old Davis Road, Davis, CA 95616, USA
| | - Theresa L. Pedersen
- Obesity and Metabolism Research Unit, USDA - Agricultural Research Service - Western Human Nutrition Research Center, 430 W Health Sciences Drive, Davis, CA 95616, USA
| | - Selina C. Wang
- UC Davis Olive Center, University of California-Davis, 392 Old Davis Road, Davis, CA 95616, USA
- Department of Food Science and Technology, University of California-Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Prokopios Magiatis
- Department of Pharmacognosy and Natural Products Chemistry, Faculty of Pharmacy, National and Kapodistrian University of Athens, Panepistimioupolis Zografou 15 771, Athens, Greece
| | - John W. Newman
- Department of Nutrition, University of California-Davis, One Shields Avenue, Davis, CA 95616, USA
- West Coast Metabolomics Center, Genome Center, 451 Health Sciences Drive, Davis, CA 95616, USA
- Obesity and Metabolism Research Unit, USDA - Agricultural Research Service - Western Human Nutrition Research Center, 430 W Health Sciences Drive, Davis, CA 95616, USA
| | - Roberta R. Holt
- Department of Nutrition, University of California-Davis, One Shields Avenue, Davis, CA 95616, USA
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22
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Elaskalani O, Berndt MC, Falasca M, Metharom P. Targeting Platelets for the Treatment of Cancer. Cancers (Basel) 2017; 9:E94. [PMID: 28737696 PMCID: PMC5532630 DOI: 10.3390/cancers9070094] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 12/21/2022] Open
Abstract
The majority of cancer-associated mortality results from the ability of tumour cells to metastasise leading to multifunctional organ failure and death. Disseminated tumour cells in the blood circulation are faced with major challenges such as rheological shear stresses and cell-mediated cytotoxicity mediated by natural killer cells. Nevertheless, circulating tumour cells with metastatic ability appear equipped to exploit host cells to aid their survival. Despite the long interest in targeting tumour-associated host cells such as platelets for cancer treatment, the clinical benefit of this strategy is still under question. In this review, we provide a summary of the latest mechanistic and clinical evidence to evaluate the validity of targeting platelets in cancer.
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Affiliation(s)
- Omar Elaskalani
- Faculty of Health Sciences, Curtin University, Perth 6100, Australia.
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth 6100, Australia.
| | - Michael C Berndt
- Faculty of Health Sciences, Curtin University, Perth 6100, Australia.
| | - Marco Falasca
- Faculty of Health Sciences, Curtin University, Perth 6100, Australia.
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth 6100, Australia.
- School of Biomedical Sciences, Curtin University, Perth 6100, Australia.
| | - Pat Metharom
- Faculty of Health Sciences, Curtin University, Perth 6100, Australia.
- Curtin Health Innovation Research Institute (CHIRI), Curtin University, Perth 6100, Australia.
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23
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Maatougui AE, Yáñez M, Crespo A, Fraiz N, Coelho A, Raviña E, Laguna R, Cano E, Loza MI, Brea J, Gutiérrez de Terán H, Sotelo E. 3-Oxopyridazin-5-yl-Chalcone Hybrids: Potent Antiplatelet Agents That Prevent Glycoprotein IIb/IIIa Activation. ChemistrySelect 2017. [DOI: 10.1002/slct.201700243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Abdelaziz El Maatougui
- Centro Singular de Investigación en Química Biolóxica e Materiais Moleculares (CIQUS); Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - Matilde Yáñez
- Departamento de Farmacología, Facultade de Farmacia; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - Abel Crespo
- Centro Singular de Investigación en Química Biolóxica e Materiais Moleculares (CIQUS); Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - Nuria Fraiz
- Departamento de Farmacología, Facultade de Farmacia; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - Alberto Coelho
- Departamento de Química Orgánica, Facultade de Farmacia; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - Enrique Raviña
- Departamento de Química Orgánica, Facultade de Farmacia; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - Reyes Laguna
- Departamento de Farmacología, Facultade de Farmacia; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - Ernesto Cano
- Departamento de Farmacología, Facultade de Farmacia; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - María I. Loza
- Departamento de Farmacología, Facultade de Farmacia; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
- Centro Singular de Investigación en Medicina Molecular y Enfermedades Crónicas (CIMUS).; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | - José Brea
- Centro Singular de Investigación en Medicina Molecular y Enfermedades Crónicas (CIMUS).; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
| | | | - Eddy Sotelo
- Centro Singular de Investigación en Química Biolóxica e Materiais Moleculares (CIQUS); Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
- Departamento de Química Orgánica, Facultade de Farmacia; Universidade de Santiago de Compostela; 15782 Santiago de Compostela Spain
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24
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Zhao T, Chang L, Zhang B, Lu M, Wang X, Orgah JO, Wang Y, Tian X, Yang J, Fan G, Zhang B, Zhu Y. Specific Combination of Salvianolic Acids As Core Active Ingredients of Danhong Injection for Treatment of Arterial Thrombosis and Its Derived Dry Gangrene. Front Pharmacol 2017; 8:361. [PMID: 28659797 PMCID: PMC5468438 DOI: 10.3389/fphar.2017.00361] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/26/2017] [Indexed: 01/03/2023] Open
Abstract
Although single-targeting anti-platelet agents are used extensively in clinics, their limitations in resistance and bleeding have started a trend of combination therapy. Danhong injection (DHI) is a widely prescribed injection medicine for cardiovascular and cerebrovascular diseases in China. However, its precise clinical efficacy and functional components remain unexplored. In this study, we investigated the anti-thrombotic role and its chemical basis of DHI. In a photochemically-induced thrombosis model, DHI effectively dissolved thrombus and ameliorated its derived dry gangrene. DHI inhibited multiple GPCR agonists-induced platelet adhesion, aggregation and downstream Ca2+ and cAMP signaling pathways. A functional screen of DHI library identified its major active components as a cluster of seven salvianolic acids. A combination of salvianolic acid A and C synergistically inhibited platelet aggregation in vitro while salvianolic acid B antagonized this effect. Our study revealed the anti-thrombotic activity of DHI. The multi-targeting mechanism of DHI proves the effectiveness of a natural anti-thrombotic combination therapy. The identification of salvianolic acids as a core anti-thrombotic activity of DHI and the discovery that their different combinations could either synergistically or antagonistically provide a better guidance for safer clinical application and paves the way for further development of DHI.
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Affiliation(s)
- Tiechan Zhao
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Lianying Chang
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Boyong Zhang
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Ming Lu
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Xiaoyi Wang
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - John O Orgah
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Yuefei Wang
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Xiaoxuan Tian
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Jing Yang
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Guanwei Fan
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Boli Zhang
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China
| | - Yan Zhu
- Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese MedicineTianjin, China.,Research and Development Center of TCM, Tianjin International Joint Academy of Biotechnology and MedicineTianjin, China.,Tufts Medical Center, Molecular Cardiology Research Institute, Tufts University School of MedicineBoston, MA, United States
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25
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Shatzel JJ, Olson SR, Tao DL, McCarty OJT, Danilov AV, DeLoughery TG. Ibrutinib-associated bleeding: pathogenesis, management and risk reduction strategies. J Thromb Haemost 2017; 15:835-847. [PMID: 28182323 PMCID: PMC6152914 DOI: 10.1111/jth.13651] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Indexed: 01/02/2023]
Abstract
Ibrutinib is an irreversible inhibitor of Bruton's tyrosine kinase (Btk) that has proven to be an effective therapeutic agent for multiple B-cell-mediated lymphoproliferative disorders. Ibrutinib, however, carries an increased bleeding risk compared with standard chemotherapy. Bleeding events range from minor mucocutaneous bleeding to life-threatening hemorrhage, due in large part to the effects of ibrutinib on several distinct platelet signaling pathways. There is currently a minimal amount of data to guide clinicians regarding the use of ibrutinib in patients at high risk of bleeding or on anticoagulant or antiplatelet therapy. In addition, the potential cardiovascular protective effects of ibrutinib monotherapy in patients at risk of vascular disease are unknown. Patients should be cautioned against using non-steroidal anti-inflammatory drugs, fish oils, vitamin E and aspirin-containing products, and consider replacing ibrutinib with a different agent if dual antiplatelet therapy is indicated. Patients should not take vitamin K antagonists concurrently with ibrutinib; direct oral anticoagulants should be used if extended anticoagulation is strongly indicated. In this review, we describe the pathophysiology of ibrutinib-mediated bleeding and suggest risk reduction strategies for common clinical scenarios associated with ibrutinib.
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Affiliation(s)
- Joseph J. Shatzel
- Division of Hematology and Medical Oncology, Oregon Health
& Science University, Knight Cancer Institute, Portland, Oregon
| | - Sven R. Olson
- Division of Hematology and Medical Oncology, Oregon Health
& Science University, Knight Cancer Institute, Portland, Oregon
| | - Derrick L. Tao
- Division of Hematology and Medical Oncology, Oregon Health
& Science University, Knight Cancer Institute, Portland, Oregon
| | - Owen J. T. McCarty
- Division of Hematology and Medical Oncology, Oregon Health
& Science University, Knight Cancer Institute, Portland, Oregon
- Department of Biomedical Engineering, School of Medicine,
Oregon Health & Science University, Portland, Oregon
| | - Alexey V. Danilov
- Division of Hematology and Medical Oncology, Oregon Health
& Science University, Knight Cancer Institute, Portland, Oregon
| | - Thomas G. DeLoughery
- Division of Hematology and Medical Oncology, Oregon Health
& Science University, Knight Cancer Institute, Portland, Oregon
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26
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Platelet CD36 promotes thrombosis by activating redox sensor ERK5 in hyperlipidemic conditions. Blood 2017; 129:2917-2927. [PMID: 28336528 DOI: 10.1182/blood-2016-11-750133] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/13/2017] [Indexed: 12/19/2022] Open
Abstract
Atherothrombosis is a process mediated by dysregulated platelet activation that can cause life-threatening complications and is the leading cause of death by cardiovascular disease. Platelet reactivity in hyperlipidemic conditions is enhanced when platelet scavenger receptor CD36 recognizes oxidized lipids in oxidized low-density lipoprotein (oxLDL) particles, a process that induces an overt prothrombotic phenotype. The mechanisms by which CD36 promotes platelet activation and thrombosis remain incompletely defined. In this study, we identify a mechanism for CD36 to promote thrombosis by increasing activation of MAPK extracellular signal-regulated kinase 5 (ERK5), a protein kinase known to be exquisitely sensitive to redox stress, through a signaling pathway requiring Src kinases, NADPH oxidase, superoxide radical anion, and hydrogen peroxide. Pharmacologic inhibitors of ERK5 blunted platelet activation and aggregation in response to oxLDL and targeted genetic deletion of ERK5 in murine platelets prevented oxLDL-induced platelet deposition on immobilized collagen in response to arterial shear. Importantly, in vivo thrombosis experiments after bone marrow transplantation from platelet-specific ERK5 null mice into hyperlipidemic apolipoprotein E null mice showed decreased platelet accumulation and increased thrombosis times compared with mice transplanted with ERK5 expressing control bone marrows. These findings suggest that atherogenic conditions critically regulate platelet CD36 signaling by increasing superoxide radical anion and hydrogen peroxide through a mechanism that promotes activation of MAPK ERK5.
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27
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Gesheff T, Barbour C. Oral antiplatelet agents for the management of acute coronary syndromes: A review for nurses and allied healthcare professionals. J Am Assoc Nurse Pract 2017; 29:104-115. [PMID: 28139897 DOI: 10.1002/2327-6924.12438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/30/2016] [Indexed: 12/12/2022]
Abstract
PURPOSE We review the use of oral antiplatelet (OAP) therapies in acute coronary syndrome (ACS) management for nurse practitioners (NPs), focusing on current guideline recommendations. DATA SOURCES Treatment guidelines and clinical articles from PubMed. CONCLUSIONS Guidelines recommend that dual antiplatelet therapy with a P2Y12 inhibitor and aspirin be initiated for ACS management. The P2Y12 inhibitor clopidogrel has established efficacy, but is associated with suboptimal and delayed platelet inhibition and variability in response. The newer P2Y12 inhibitors prasugrel and ticagrelor have demonstrated superior efficacy outcomes versus clopidogrel. Consequently, non-ST-segment elevation ACS (NSTE-ACS) guidelines now recommend that ticagrelor be used in preference to clopidogrel for patients treated with stents or managed medically. Because of their higher potency, prasugrel and ticagrelor are associated with increased bleeding rates versus clopidogrel, but with no increased risk of severe or life-threatening bleeding. Guidelines recommend dual antiplatelet therapy be continued ≥12 months in both medically managed and stented ACS patients, and in some cases beyond this, in absence of high bleeding risk. Updated guidelines assign preference to ticagrelor over clopidogrel for maintenance therapy in patients with NSTE-ACS and ST-elevation myocardial infarction. IMPLICATIONS FOR PRACTICE Enhanced NP understanding of OAP agents and current guidelines could contribute to improved ACS patient management.
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Affiliation(s)
- Tania Gesheff
- Kaufman Cancer Center, University of Maryland, Bel Air, Maryland
| | - Cescelle Barbour
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, Virginia
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Eisen A, Bhatt DL. Optimal duration of dual antiplatelet therapy after acute coronary syndromes and coronary stenting. Heart 2016; 103:871-884. [PMID: 27888209 DOI: 10.1136/heartjnl-2015-309022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Alon Eisen
- Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Deepak L Bhatt
- Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, Massachusetts, USA
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Abstract
Certain antithrombotic drugs exhibit high patient-to-patient variability that significantly impacts the safety and efficacy of therapy. Pharmacogenetics offers the possibility of tailoring drug treatment to patients based on individual genotypes, and this type of testing has been recommended for 2 oral antithrombotic agents, warfarin and clopidogrel, to influence use and guide dosing. Limited studies have identified polymorphisms that affect the metabolism and activity of newer oral antithrombotic drugs, without clear evidence of the clinical relevance of such polymorphisms. This article provides an overview of the current status of pharmacogenetics in oral antithrombotic therapy.
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Affiliation(s)
- Cheryl L Maier
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Emory University School of Medicine, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA.
| | - Alexander Duncan
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Emory University School of Medicine, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA
| | - Charles E Hill
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Emory University School of Medicine, 1364 Clifton Road Northeast, Atlanta, GA 30322, USA
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Kim GE, Yoon W, Kim SK, Kim BC, Heo TW, Baek BH, Lee YY, Yim NY. Incidence and Clinical Significance of Acute Reocclusion after Emergent Angioplasty or Stenting for Underlying Intracranial Stenosis in Patients with Acute Stroke. AJNR Am J Neuroradiol 2016; 37:1690-5. [PMID: 27079369 DOI: 10.3174/ajnr.a4770] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/09/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A major concern after emergent intracranial angioplasty in cases of acute stroke with underlying intracranial stenosis is the acute reocclusion of the treated arteries. This study reports the incidence and clinical outcomes of acute reocclusion of arteries following emergent intracranial angioplasty with or without stent placement for the management of patients with acute stroke with underlying intracranial atherosclerotic stenosis. MATERIALS AND METHODS Forty-six patients with acute stroke received emergent intracranial angioplasty with or without stent placement for intracranial atherosclerotic stenosis and underwent follow-up head CTA. Acute reocclusion was defined as "hypoattenuation" within an arterial segment with discrete discontinuation of the arterial contrast column, both proximal and distal to the hypoattenuated lesion, on CTA performed before discharge. Angioplasty was defined as "suboptimal" if a residual stenosis of ≥50% was detected on the postprocedural angiography. Clinical and radiologic data of patients with and without reocclusion were compared. RESULTS Of the 46 patients, 29 and 17 underwent angioplasty with and without stent placement, respectively. Acute reocclusion was observed in 6 patients (13%) and was more frequent among those with suboptimal angioplasty than among those without it (71.4% versus 2.6%, P < .001). The relative risk of acute reocclusion in patients with suboptimal angioplasty was 27.857 (95% confidence interval, 3.806-203.911). Furthermore, a good outcome was significantly less frequent in patients with acute reocclusion than in those without it (16.7% versus 67.5%, P = .028). CONCLUSIONS Acute reocclusion of treated arteries was common after emergent intracranial angioplasty with or without stent placement in patients with acute stroke with intracranial atherosclerotic stenosis and was associated with a poor outcome. Suboptimal results of angioplasty appear to be associated with acute reocclusion, irrespective of whether stent placement was performed.
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Affiliation(s)
- G E Kim
- From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.)
| | - W Yoon
- From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.)
| | - S K Kim
- From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.)
| | - B C Kim
- Neurology (B.C.K.), Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - T W Heo
- From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.)
| | - B H Baek
- From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.)
| | - Y Y Lee
- From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.)
| | - N Y Yim
- From the Departments of Radiology (G.E.K., W.Y., S.K.K., T.W.H., B.H.B., Y.Y.L., N.Y.Y.)
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Abstract
Platelets play a key role in mediating stent thrombosis, which is the major cause of ischemic events immediately after percutaneous coronary intervention (PCI). Antiplatelet therapy is therefore the cornerstone of antithrombotic therapy after PCI. However, the use of antiplatelet agents increases bleeding risk, with more potent antiplatelet agents further increasing bleeding risk. In the past 5 years, potent and fast-acting P2Y12 inhibitors have augmented the antiplatelet armamentarium available to interventional cardiologists. This article reviews the preclinical and clinical data surrounding these new agents, and discusses the significant questions and controversies that still exist regarding the optimal antiplatelet strategy.
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Affiliation(s)
| | - Sunil V Rao
- Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27705, USA.
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Schaff M, Gachet C, Mangin PH. [Anti-platelets without a bleeding risk: novel targets and strategies]. Biol Aujourdhui 2016; 209:211-28. [PMID: 26820829 DOI: 10.1051/jbio/2015023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Indexed: 01/29/2023]
Abstract
Anti-platelet agents such as aspirin, clopidogrel and antagonists of integrin αIIbβ3 allowed to efficiently reduce morbidity and mortality associated with arterial thrombosis. A major limit of these drugs is that they increase the risk of bleeding. During the last few years, several innovative anti-thrombotic strategies with a potentially low bleeding risk were proposed. These approaches target the collagen receptor glycoprotein (GP) VI, the GPIb/von Willebrand factor axis, the thrombin receptor PAR-1, the activated form of integrin αIIbβ3 or the ADP receptor P2Y1. While an antagonist of PAR-1 was recently marketed, the clinical proofs of the efficiency and safety of the other agents remain to be established. This review evaluates these new anti-platelet approaches toward safer anti-thrombotic therapies.
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Affiliation(s)
- Mathieu Schaff
- Atherothrombosis and Vascular Biology Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australie
| | - Christian Gachet
- UMR_S949, INSERM, Etablissement Français du Sang (EFS)-Alsace, Université de Strasbourg, Strasbourg, France
| | - Pierre Henri Mangin
- UMR_S949, INSERM, Etablissement Français du Sang (EFS)-Alsace, Université de Strasbourg, Strasbourg, France
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De Meyer SF, Denorme F, Langhauser F, Geuss E, Fluri F, Kleinschnitz C. Thromboinflammation in Stroke Brain Damage. Stroke 2016; 47:1165-72. [PMID: 26786115 DOI: 10.1161/strokeaha.115.011238] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/26/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Simon F De Meyer
- From the Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium (S.F.D.M., F.D.); and Department of Neurology, University Clinic of Würzburg, Würzburg, Germany (F.L., E.G., F.F., C.K.).
| | - Frederik Denorme
- From the Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium (S.F.D.M., F.D.); and Department of Neurology, University Clinic of Würzburg, Würzburg, Germany (F.L., E.G., F.F., C.K.)
| | - Friederike Langhauser
- From the Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium (S.F.D.M., F.D.); and Department of Neurology, University Clinic of Würzburg, Würzburg, Germany (F.L., E.G., F.F., C.K.)
| | - Eva Geuss
- From the Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium (S.F.D.M., F.D.); and Department of Neurology, University Clinic of Würzburg, Würzburg, Germany (F.L., E.G., F.F., C.K.)
| | - Felix Fluri
- From the Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium (S.F.D.M., F.D.); and Department of Neurology, University Clinic of Würzburg, Würzburg, Germany (F.L., E.G., F.F., C.K.)
| | - Christoph Kleinschnitz
- From the Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium (S.F.D.M., F.D.); and Department of Neurology, University Clinic of Würzburg, Würzburg, Germany (F.L., E.G., F.F., C.K.).
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35
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Maluf CB, Barreto SM, dos Reis RC, Vidigal PG. Platelet volume is associated with the Framingham risk score for cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ACTA ACUST UNITED AC 2016; 54:879-87. [DOI: 10.1515/cclm-2015-0686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/06/2015] [Indexed: 11/15/2022]
Abstract
AbstractBackground:Platelet volume indices (PVI), an easy and inexpensive surrogate measure of platelet function, have been associated with cardiovascular diseases (CVD) and their risk factors. However, results are conflicting because of the lack of standardized procedures. The purpose of this study is to investigate the relationship of PVI with the Framingham risk score (FRS).Methods:Baseline data (2008–2010) of 3115 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were used. PVI measurements were strictly controlled. The cohort was distributed according to risk factors and the general FRS was estimated. Multiple linear regression analysis was used to estimate the association between PVI and FRS.Results:Mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) independently correlated (p≤0.01) with FRS after adjustment for confounding variables. One unit increase in MPV, PDW, or P-LCR increased the FRS by 0.59%, 0.40%, and 0.08%, respectively. Diabetics had higher (p≤0.004) MPV, PDW, and P-LCR, and hypertensive individuals had higher (p≤0.045) PDW and P-LCR.Conclusions:Increased PVI was independently correlated with higher CVD risk based on the FRS, diabetes, and systolic hypertension. Prospective follow up of this cohort is warranted to confirm that PVI is associated with the development of CVD.
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36
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Schooling CM, Leung GM. Learning from anomalies: the case of cholesterol and ischaemic heart disease. Int J Epidemiol 2015; 45:290-2. [PMID: 26668047 DOI: 10.1093/ije/dyv308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Mary Schooling
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, China and School of Urban Public Health at Hunter College and City University of New York School of Public Health, New York, NY, USA
| | - Gabriel M Leung
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region, China and
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Yanachkov IB, Chang H, Yanachkova MI, Dix EJ, Berny-Lang MA, Gremmel T, Michelson AD, Wright GE, Frelinger AL. New highly active antiplatelet agents with dual specificity for platelet P2Y1 and P2Y12 adenosine diphosphate receptors. Eur J Med Chem 2015; 107:204-18. [PMID: 26588064 DOI: 10.1016/j.ejmech.2015.10.055] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 10/27/2015] [Accepted: 10/30/2015] [Indexed: 10/25/2022]
Abstract
Currently approved platelet adenosine diphosphate (ADP) receptor antagonists target only the platelet P2Y12 receptor. Moreover, especially in patients with acute coronary syndromes, there is a strong need for rapidly acting and reversible antiplatelet agents in order to minimize the risk of thrombotic events and bleeding complications. In this study, a series of new P(1),P(4)-di(adenosine-5') tetraphosphate (Ap4A) derivatives with modifications in the base and in the tetraphosphate chain were synthesized and evaluated with respect to their effects on platelet aggregation and function of the platelet P2Y1, P2Y12, and P2X1 receptors. The resulting structure-activity relationships were used to design Ap4A analogs which inhibit human platelet aggregation by simultaneously antagonizing both P2Y1 and P2Y12 platelet receptors. Unlike Ap4A, the analogs do not activate platelet P2X1 receptors. Furthermore, the new compounds exhibit fast onset and offset of action and are significantly more stable than Ap4A to degradation in plasma, thus presenting a new promising class of antiplatelet agents.
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Affiliation(s)
| | - Hung Chang
- Center for Platelet Function Studies, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA; Hematology Division, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
| | | | | | - Michelle A Berny-Lang
- Center for Platelet Research Studies, Division of Hematology/Oncology, Boston Children's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Thomas Gremmel
- Center for Platelet Research Studies, Division of Hematology/Oncology, Boston Children's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Alan D Michelson
- Center for Platelet Research Studies, Division of Hematology/Oncology, Boston Children's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Center for Platelet Function Studies, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Andrew L Frelinger
- Center for Platelet Research Studies, Division of Hematology/Oncology, Boston Children's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Center for Platelet Function Studies, Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
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Marcucci R, Grifoni E, Giusti B. On-treatment platelet reactivity: State of the art and perspectives. Vascul Pharmacol 2015; 77:8-18. [PMID: 26520003 DOI: 10.1016/j.vph.2015.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/20/2015] [Accepted: 10/12/2015] [Indexed: 01/01/2023]
Abstract
High on-clopidogrel platelet reactivity (HcPR) during dual-antiplatelet therapy is a marker of vascular risk, in particular stent thrombosis, in patients with acute coronary syndromes (ACS). Genetic determinants (CYP2C19*2 polymorphism), advanced age, female gender, diabetes and reduced ventricular function are related to a higher risk to develop HcPR. In addition, inflammation and increased platelet turnover, as revealed by the elevated percentage of reticulated platelets in patients' blood, that characterize the acute phase of acute coronary syndromes, are associated with HcPR. To overcome the limitation of clopidogrel, new antiplatelet agents (prasugrel and ticagrelor) were developed and the demonstration of their superiority over clopidogrel was obtained in the two randomized trials, TRITON TIMI 38 and PLATO. Emerging evidence is accumulating on the role of high-on aspirin platelet reactivity (HaPR), especially in the clinical context of diabetes. Finally, the presence of new, potent antiplatelet drugs has shifted the focus from thrombotic to bleeding risk. Recent data document that low on-treatment platelet reactivity (LPR) is associated with a significantly higher bleeding risk. Due to the current possibility to choose between multiple antiplatelet strategies, the future perspective is to include in the management of ACS, in addition to clinical data and classical risk factors, the definition of platelet function during treatment in order to set a tailored therapy.
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Affiliation(s)
- Rossella Marcucci
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Center for Aterothrombotic Diseases, AOU Careggi, Florence, Italy.
| | - Elisa Grifoni
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Center for Aterothrombotic Diseases, AOU Careggi, Florence, Italy
| | - Betti Giusti
- Department of Experimental and Clinical Medicine, University of Florence, Italy; Center for Aterothrombotic Diseases, AOU Careggi, Florence, Italy
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Zalpour A, Oo TH. Update on Edoxaban for the Prevention and Treatment of Thromboembolism: Clinical Applications Based on Current Evidence. Adv Hematol 2015; 2015:920361. [PMID: 26351456 PMCID: PMC4553175 DOI: 10.1155/2015/920361] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 06/18/2015] [Accepted: 06/21/2015] [Indexed: 11/21/2022] Open
Abstract
Vitamin K antagonists (VKA) and heparins have been utilized for the prevention and treatment of thromboembolism (arterial and venous) for decades. Targeting and inhibiting specific coagulation factors have led to new discoveries in the pharmacotherapy of thromboembolism management. These targeted anticoagulants are known as direct oral anticoagulants (DOACs). Two pharmacologically distinct classes of targeted agents are dabigatran etexilate (Direct Thrombin Inhibitor (DTI)) and rivaroxaban, apixaban, and edoxaban (direct oral factor Xa inhibitors (OFXaIs)). Emerging evidence from the clinical trials has shown that DOACs are noninferior to VKA or low-molecular-weight heparins in the prevention and treatment of thromboembolism. This review examines the role of edoxaban, a recently approved OFXaI, in the prevention and treatment of thromboembolism based on the available published literature. The management of edoxaban in the perioperative setting, reversibility in bleeding cases, its role in cancer patients, the relevance of drug-drug interactions, patient satisfaction, financial impacts, and patient education will be discussed.
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Affiliation(s)
- Ali Zalpour
- University of Texas MD Anderson Cancer Center, 1400 Pressler Avenue, Unit 1465, FCT 13.5021, Houston, TX 77030, USA
| | - Thein Hlaing Oo
- Section of Thrombosis & Benign Hematology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Yang H, Xu S, Li J, Wang L, Wang X. Potassium 2-(1-hydroxypentyl)-benzoate inhibits ADP-induced rat platelet aggregation through P2Y1-PLC signaling pathways. Naunyn Schmiedebergs Arch Pharmacol 2015; 388:983-90. [PMID: 25787305 DOI: 10.1007/s00210-015-1113-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 03/03/2015] [Indexed: 01/09/2023]
Abstract
Potassium 2-(1-hydroxypenty1)-benzoate (dl-PHPB) is a new drug candidate for treatment of ischemic stroke with antiplatelet effect. In this study, we investigated the mechanisms of dl-PHPB in inhibiting platelet aggregation. The ADP-activated P2Y1-Gq-PLC and P2Y12-Gi-AC pathways were observed, respectively. Intravenous injection of dl-PHPB (1.3, 3.9, 12.9 mg/kg) significantly inhibited ADP-, collagen-, and arachidonic acid-induced rat platelet aggregation in a dose-dependent manner, and dl-PHPB had a relatively more potent inhibitory effect on ADP-induced rat platelet aggregation than other agonists. Dl-PHPB also showed a decreased expression of CD62P (a marker for platelet activation) mediated by ADP. Both dl-PHPB and ticlopidine (P2Y12 receptor antagonist) decreased cytoplasmic Ca(2+) concentration. But, dl-PHPB did not reverse the inhibition of PGE1-induced platelet cAMP formation by ADP, which was different from ticlopidine. Further, dl-PHPB instead of ticlopidine showed increasing phospholipase C-β phosphorylation (ser(1105)). The m-3M3FBS, a phospholipase C activator, attenuated the inhibitory effect of dl-PHPB on ADP-induced platelet aggregation and enhanced IP1 accumulation in rat platelets. Dl-PHPB decreased IP1 accumulation induced by ADP but had no effect on IP1 level enhanced by m-3M3FBS. Our results suggest that dl-PHPB has a potent antiplatelet effect, which is mainly through blockade of P2Y1 receptor-PLC-IP3 pathway and decreasing cytoplasmic calcium.
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Affiliation(s)
- Hongyan Yang
- State Key laboratory of Bioactive Substances and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing, 100050, China
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Brown DG, Wilkerson EC, Love WE. A review of traditional and novel oral anticoagulant and antiplatelet therapy for dermatologists and dermatologic surgeons. J Am Acad Dermatol 2015; 72:524-34. [DOI: 10.1016/j.jaad.2014.10.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 09/29/2014] [Accepted: 10/16/2014] [Indexed: 12/22/2022]
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Jiang P, Jandrot-Perrus M. New advances in treating thrombotic diseases: GPVI as a platelet drug target. Drug Discov Today 2014; 19:1471-5. [PMID: 24931218 DOI: 10.1016/j.drudis.2014.06.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 06/09/2014] [Indexed: 12/21/2022]
Abstract
The recent introduction of highly effective antiplatelet drugs has contributed to the significant improvement in the treatment of acute coronary syndromes. However, limitations remain. Recurrence of ischaemic vascular events results in poor prognosis. Drugs of high antithrombotic efficacy are associated with an increased risk of bleeding, which is important in patients at risk of stroke. An attractive target for the development of new antithrombotics is platelet glycoprotein VI (GPVI) because its blockade seems to combine ideally efficiency and safety. In this review, we summarise current knowledge on the physiological role of GPVI in haemostasis and thrombosis. We also discuss evidence regarding the effectiveness and safety of strategies to inhibit GPVI.
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Affiliation(s)
- Peng Jiang
- INSERM, UMR_S1148 LVTS, 46 rue Henri Huchard, Paris 75018, France; University Paris Diderot - Paris 7, UMR_S1148, 46 rue Henri Huchard, Paris 75018, France
| | - Martine Jandrot-Perrus
- INSERM, UMR_S1148 LVTS, 46 rue Henri Huchard, Paris 75018, France; University Paris Diderot - Paris 7, UMR_S1148, 46 rue Henri Huchard, Paris 75018, France; AP-HP, Hôpital Bichat, 46 rue Henri Huchard, Paris 75018, France.
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43
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Abstract
While platelet activation is essential to maintain blood vessel patency and minimize loss of blood upon injury, untimely or excessive activity can lead to unwanted platelet activation and aggregation. Resultant thrombosis has the potential to block blood vessels, causing myocardial infarction or stroke. To tackle this major cause of mortality, clinical therapies that target platelet responsiveness (antiplatelet therapy) can successfully reduce cardiovascular events, especially in people at higher risk; however, all current antiplatelet therapies carry an increased probability of bleeding. This review will evaluate new and emerging targets for antithrombotics, focusing particularly on platelet glycoprotein VI, as blockade or depletion of this platelet-specific receptor conveys benefits in experimental models of thrombosis and thromboinflammation without causing major bleeding complications.
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Affiliation(s)
- Robert K Andrews
- Australian Centre for Blood Diseases, Monash University, Melbourne, VIC, Australia
| | - Jane F Arthur
- Australian Centre for Blood Diseases, Monash University, Melbourne, VIC, Australia
| | - Elizabeth E Gardiner
- Australian Centre for Blood Diseases, Monash University, Melbourne, VIC, Australia
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Hu CH, Qiao JX, Han Y, Wang TC, Hua J, Price LA, Wu Q, Shen H, Huang CS, Rehfuss R, Wexler RR, Lam PYS. 2-Amino-1,3,4-thiadiazoles in the 7-hydroxy-N-neopentyl spiropiperidine indolinyl series as potent P2Y1 receptor antagonists. Bioorg Med Chem Lett 2014; 24:2481-5. [PMID: 24767843 DOI: 10.1016/j.bmcl.2014.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 04/01/2014] [Accepted: 04/04/2014] [Indexed: 12/15/2022]
Abstract
Blockade of the P2Y1 receptor is important to the treatment of thrombosis with potentially improved safety margins compared with P2Y12 receptor antagonists. Investigation of a series of urea surrogates of the diaryl urea lead 3 led to the discovery of 2-amino-1,3,4-thiadiazoles in the 7-hydroxy-N-neopentyl spiropiperidine indolinyl series as potent P2Y1 receptor antagonists, among which compound 5a was the most potent and the first non-urea analog with platelet aggregation (PA) IC50 less than 0.5 μM with 10 μM ADP. Several 2-amino-1,3,4-thiadiazole analogs such as 5b and 5f had a more favorable pharmacokinetic profile, such as higher Ctrough, lower Cl, smaller Vdss, and similar bioavailability compared with 3.
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Affiliation(s)
- Carol H Hu
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA.
| | - Jennifer X Qiao
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA.
| | - Ying Han
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Tammy C Wang
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Ji Hua
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Laura A Price
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Qimin Wu
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Hong Shen
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Christine S Huang
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Robert Rehfuss
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Ruth R Wexler
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
| | - Patrick Y S Lam
- Medicinal Chemistry, Molecular Sciences and Candidate Optimization, Bristol-Myers Squibb, 311 Pennington-Rocky Hill Road, Pennington, NJ 08534, USA
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Gasparovic H, Petricevic M, Biocina B. Management of antiplatelet therapy resistance in cardiac surgery. J Thorac Cardiovasc Surg 2014; 147:855-62. [DOI: 10.1016/j.jtcvs.2013.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 09/24/2013] [Accepted: 10/06/2013] [Indexed: 12/01/2022]
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Shah R, Keough LA, Belalcazar-Portacio A, Ramanathan KB. Ticagrelor as an alternative in clopidogrel-associated neutropenia. Platelets 2014; 26:80-2. [DOI: 10.3109/09537104.2013.867427] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Abstract
The molecular pathways that regulate megakaryocyte production have historically been identified through multiple candidate gene approaches. Several transcription factors critical for generating megakaryocytes were identified by promoter analysis of megakaryocyte-specific genes, and their biological roles then verified by gene knockout studies; for example, GATA-1, NF-E2, and RUNX1 were identified in this way. In contrast, other transcription factors important for megakaryopoiesis were discovered through a systems approach; for example, c-Myb was found to be critical for the erythroid versus megakaryocyte lineage decision by genome-wide loss-of-function studies. The regulation of the levels of these transcription factors is, for the most part, cell intrinsic, although that assumption has recently been challenged. Epigenetics also impacts megakaryocyte gene expression, mediated by histone acetylation and methylation. Several cytokines have been identified to regulate megakaryocyte survival, proliferation, and differentiation, most prominent of which is thrombopoietin. Upon binding to its receptor, the product of the c-Mpl proto-oncogene, thrombopoietin induces a conformational change that activates a number of secondary messengers that promote cell survival, proliferation, and differentiation, and down-modulate receptor signaling. Among the best studied are the signal transducers and activators of transcription (STAT) proteins; phosphoinositol-3-kinase; mitogen-activated protein kinases; the phosphatases PTEN, SHP1, SHP2, and SHIP1; and the suppressors of cytokine signaling (SOCS) proteins. Additional signals activated by these secondary mediators include mammalian target of rapamycin; β(beta)-catenin; the G proteins Rac1, Rho, and CDC42; several transcription factors, including hypoxia-inducible factor 1α(alpha), the homeobox-containing proteins HOXB4 and HOXA9, and a number of signaling mediators that are reduced, including glycogen synthase kinase 3α(alpha) and the FOXO3 family of forkhead proteins. More recently, systematic interrogation of several aspects of megakaryocyte formation have been conducted, employing genomics, proteomics, and chromatin immunoprecipitation (ChIP) analyses, among others, and have yielded many previously unappreciated signaling mechanisms that regulate megakaryocyte lineage determination, proliferation, and differentiation. This chapter focuses on these pathways in normal and neoplastic megakaryopoiesis, and suggests areas that are ripe for further study.
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Tselepis AD. Cilostazol-based triple antiplatelet therapy in the era of generic clopidogrel and new potent antiplatelet agents. Curr Med Res Opin 2014; 30:51-4. [PMID: 24089998 DOI: 10.1185/03007995.2013.850070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Alexandros D Tselepis
- Laboratory of Biochemistry/Atherothrombosis Research Centre, University of Ioannina , Ioannina , Greece
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McFadyen JD, Jackson SP. Differentiating haemostasis from thrombosis for therapeutic benefit. Thromb Haemost 2013; 110:859-67. [PMID: 23945664 DOI: 10.1160/th13-05-0379] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 07/18/2013] [Indexed: 12/27/2022]
Abstract
The central role of platelets in the formation of the primary haemostatic plug as well as in the development of arterial thrombosis is well defined. In general, the molecular events underpinning these processes are broadly similar. Whilst it has long been known that disturbances in blood flow, changes in platelet reactivity and enhanced coagulation reactions facilitate pathological thrombus formation, the precise details underlying these events remain incompletely understood. Intravital microscopy studies have highlighted the dynamic and heterogeneous nature of thrombus development and demonstrated that there are considerable spatiotemporal differences in the activation states of platelets within a forming thrombus. In this review we will consider the factors regulating the activation state of platelets in a developing thrombus and discuss how specific prothrombotic factors may influence this process, leading to excessive thrombus propagation. We will also discuss some potentially novel therapeutic approaches that may reduce excess thrombus development whilst minimising bleeding risk.
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Affiliation(s)
- J D McFadyen
- Shaun P. Jackson, Australian Centre for Blood Diseases, Alfred Medical Research and Education Precinct (AMREP), 6th level Burnet Tower, 89 Commercial Rd, Melbourne, Victoria 3004, Australia, Tel.: +613 9903 0131, Fax: +613 9903 0228, E-mail:
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