Protective effects of triflusal on secondary thrombus growth and vascular cyclooxygenase-2

Flavonoids and Platelet-Derived Thrombotic Disorders

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Thrombotic disorders are characterized by an increase in the probability of the formation of unnecessary thrombi that might be due to the activation of the coagulation cascade or the circulating platelets. Platelets or thrombocytes play an essential role in hemostasis but abnormal platelet function leads to the development of a number of cardiovascular complications, including thrombotic disorders. Under pathological conditions, platelets are associated with the development of different thrombotic disorders, including atherosclerosis, arterial thrombosis and stroke, deep venous thrombosis and pulmonary embolism; therefore, platelets are the target of a number of anti-thrombotic strategies. Flavonoids, a large group of polyphenols ubiquitously expressed in fruits and vegetables that have attracted considerable attention because of their benefits in human health, including the reduction of the risk of cardiovascular disease. Flavonoids have been reported to reduce platelet activity by attenuating agonist-induced GPIIb/IIIa receptor activation, mobilization of intracellular free Ca2+, granule exocytosis, as well as activation of different signaling molecules such as mitogen- activated protein kinases or phospholipases. This review summarizes the current studies concerning the modulation of platelet activation by flavonoids, giving especial attention to those events associated to thrombotic disorders.

Lipoproteins, platelets and atherothrombosis

Atherosclerosis and thrombosis associated with the rupture of vulnerable plaque are the main causes of cardiovascular events, including acute coronary syndrome. Low-density lipoprotein (LDL) plays a key role in the pathogenesis of atherothrombotic processes. LDLs modify the antithrombotic properties of the vascular endothelium and change vessel contractility by reducing the availability of endothelial nitric oxide and activating proinflammatory signaling pathways. In addition, LDLs also influence the functions and interactions of cells present in atherosclerotic lesions, whether they come from the circulation or are resident in vessel walls. In fact, LDLs entering affected vessels undergo modifications (e.g. oxidation, aggregation and glycosylation) that potentiate their atherogenic properties. Once modified, these intravascular LDLs promote the formation of foam cells derived from smooth muscle cells and macrophages, thereby increasing the vulnerability of atherosclerotic plaque. Moreover, they also increase the thrombogenicity of both plaque and blood, in which circulating tissue factor levels are raised and platelet reactivity is enhanced. This review focuses on the importance of native and modified LDL for the pathogenesis of atherothrombosis. It also discusses current studies on LDL and its effects on the actions of vascular cells and blood cells, particularly platelets, and considers novel potential therapeutic targets.