1
|
Schneider DJ. Effective and Safe Transition Between Intravenous and Oral P2Y 12 Antagonists. JACC Cardiovasc Interv 2023; 16:2540-2541. [PMID: 37879805 DOI: 10.1016/j.jcin.2023.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 10/27/2023]
Affiliation(s)
- David J Schneider
- Department of Medicine, Cardiovascular Research Institute, The University of Vermont, Burlington, Vermont, USA.
| |
Collapse
|
2
|
Ma BB, Montgomery AP, Chen B, Kassiou M, Danon JJ. Strategies for targeting the P2Y 12 receptor in the central nervous system. Bioorg Med Chem Lett 2022; 71:128837. [PMID: 35640763 DOI: 10.1016/j.bmcl.2022.128837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/10/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
Abstract
The purinergic 2Y type 12 receptor (P2Y12R) is a well-known biological target for anti-thrombotic drugs due to its role in platelet aggregation and blood clotting. While the importance of the P2Y12R in the periphery has been known for decades, much less is known about its expression and roles in the central nervous system (CNS), where it is expressed exclusively on microglia - the first responders to brain insults and neurodegeneration. Several seminal studies have shown that P2Y12 is a robust, translatable biomarker for anti-inflammatory and neuroprotective microglial phenotypes in models of degenerative diseases such as multiple sclerosis and Alzheimer's disease. An enduring problem for studying this receptor in vivo, however, is the lack of selective, high-affinity small molecule ligands that can bypass the blood-brain barrier and accumulate in the CNS. In this Digest, we discuss previous attempts by researchers to target the P2Y12R in the CNS and opine on strategies that may be employed to design and assess the suitability of novel P2Y12 ligands for this purpose going forward.
Collapse
Affiliation(s)
- Ben B Ma
- School of Chemistry, The University of Sydney, Sydney, NSW 2006, Australia
| | | | - Biling Chen
- School of Chemistry, The University of Sydney, Sydney, NSW 2006, Australia
| | - Michael Kassiou
- School of Chemistry, The University of Sydney, Sydney, NSW 2006, Australia
| | - Jonathan J Danon
- School of Chemistry, The University of Sydney, Sydney, NSW 2006, Australia.
| |
Collapse
|
3
|
Zhong H, Waresi M, Zhang W, Han L, Zhao Y, Chen Y, Zhou P, Chang L, Pan G, Wu B, Li J, Zhang S, Shi H, Luo X, Gao W, Qi Z, Ding Z. NOD2-mediated P2Y 12 upregulation increases platelet activation and thrombosis in sepsis. Biochem Pharmacol 2021; 194:114822. [PMID: 34748820 DOI: 10.1016/j.bcp.2021.114822] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/14/2021] [Accepted: 11/02/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Platelets from septic patients exhibit increased reactivity. However, the underlying mechanism of sepsis-induced platelet hyperactivity is still not completely understood. OBJECTIVE P2Y12 is a central receptor for platelet activation. In this study, we investigated the role of platelet P2Y12 in platelet hyperactivity during sepsis. METHODS We measured platelet P2Y12 expression and aggregation in response to ADP in septic patients and cecal ligation and puncture (CLP)-treated mice. We also detected the downstream signaling of P2Y12 in resting platelets from patients and mice with sepsis. The role of nucleotide-binding oligomerization domain 2 (NOD2)/RIP2/NF-κB/P65 pathway in sepsis-induced platelet P2Y12 high expression was also investigated. Finally, we compared the antiplatelet and antithrombotic effects of clopidogrel, prasugrel, and ticagrelor in experimental sepsis in mice and rats. RESULTS Compared to healthy subjects, platelets from septic patients exhibit P2Y12 hyperactivity and higher P2Y12 expression. pAkt is enhanced and pVASP is impaired in resting platelets from the patients, indicating the constitutive activation of platelet P2Y12 receptor. Mouse sepsis model recapitulates the findings in septic patients. NOD2 deficiency attenuates sepsis-induced platelet P2Y12 high expression, hyperactivity, and thrombosis. Prasugrel and ticagrelor are potent P2Y12 inverse agonists, and exhibit superior antiplatelet and antithrombotic efficacy over clopidogrel in mice and rats with sepsis. CONCLUSIONS NOD2 activation upregulates platelet P2Y12 expression, which is constitutively activated and contributes to platelet hyperactivity in septic status. Compared to clopidogrel, prasugrel and ticagrelor are potent P2Y12 inverse agonists with superior antiplatelet and antithrombotic efficacy in experimental sepsis.
Collapse
Affiliation(s)
- Haoxuan Zhong
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Maieryemu Waresi
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Wei Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Liping Han
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Yikai Zhao
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Yufei Chen
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Peng Zhou
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Lin Chang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Guanxing Pan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Bangwei Wu
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Jian Li
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Si Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Haiming Shi
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Xinping Luo
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China
| | - Wen Gao
- Department of Cardiology, Huashan Hospital, Fudan University. Shanghai, China.
| | - Zhiyong Qi
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai, China.
| | - Zhongren Ding
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, Shanghai, China; School of Pharmacy, Tianjin Medical University, Tianjin, China.
| |
Collapse
|
4
|
Jean SS, Hsueh SC, Hwang JJ, Hsueh PR. Ticagrelor: A promising role in preventing multi-organ failure among patients with sepsis due to resistant gram-positive cocci. J Microbiol Immunol Infect 2019; 52:513-515. [PMID: 31280973 DOI: 10.1016/j.jmii.2019.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 06/16/2019] [Accepted: 06/20/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Shio-Shin Jean
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medicine University, Taipei, Taiwan
| | - Shun-Chung Hsueh
- Department of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Juey-Jen Hwang
- Cardiovascular Center, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; Cardiovascular Division, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
| |
Collapse
|
5
|
Kimmelstiel C, Stevenson R, Nguyen N, Van Doren L, Zhang P, Perkins J, Kapur NK, Weintraub A, Castaneda V, Kuliopulos A, Covic L. Enhanced potency of prasugrel on protease-activated receptors following bivalirudin treatment for PCI as compared to clopidogrel. Thromb Res 2019; 177:59-69. [PMID: 30851630 DOI: 10.1016/j.thromres.2019.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/20/2018] [Accepted: 01/28/2019] [Indexed: 01/22/2023]
Abstract
ACS patients undergoing percutaneous coronary intervention (PCI) when treated with bivalirudin and clopidogrel had increased frequency of early stent thrombosis. 24 patients referred for intervention with planned bivalirudin therapy, not previously treated with a P2Y12 inhibitor and not receiving heparins or αIIbβ3 inhibitors were randomized to treatment with either clopidogrel (600 mg) or prasugrel (60 mg). Platelet aggregation (PA) was measured by light transmission aggregometry (LTA) of platelet-rich plasma in response to ADP, PAR1/PAR4 thrombin receptor agonists and collagen at baseline and at 1, 2, 4 and 16 h following the cessation of bivalirudin infusion. Prasugrel-mediated inhibition of PA was significantly greater than that of clopidogrel at all time points for ADP as well as PAR1. There was an unanticipated, significantly greater protection of PAR4-mediated platelet aggregation only detected with prasugrel and not observed with clopidogrel. We further examined the effect of the hyperreactive PAR4 Thr120 variant in the protease-activated receptor 4 (PAR4), single nucleotide polymorphism (SNP) rs773902 on aggregation protection. The PAR4 protective effect with prasugrel was lost in individuals carrying the PAR4 Thr120 variant, and not in Ala120 homozygote. PAR1, ADP and collagen inhibition was not significantly affected in the hyperreactive PAR4 Thr120 variant. We documented that the P2Y12 ADP receptor-mediated regulation of the strength of the high-affinity conformation of αIIbβ3 as detected by PAC-1 ab, and in control of platelet adhesiveness through Rap1 GTPase protein activation. Importantly, the PAR4 Thr120 variant resulted in the increased rate and magnitude of Rap1 activation. Human platelet PAR4 mediated-activation of αIIbβ3 was phospholipase C beta (PLCβ)-dependent and unlike mouse platelet PI3K-independent. These data identify a PAR4-dependent inhibitory mechanism for the prasugrel-mediated platelet inhibition, not seen with clopidogrel that could explain the reduction in stent thrombosis documented in clinical trials with prasugrel.
Collapse
Affiliation(s)
- Carey Kimmelstiel
- Cardiac Catheterization Laboratory and the Division of Cardiology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Ryan Stevenson
- Hemostasis and Thrombosis Laboratory, Division of Hematology/Oncology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Nga Nguyen
- Hemostasis and Thrombosis Laboratory, Division of Hematology/Oncology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Layla Van Doren
- Hemostasis and Thrombosis Laboratory, Division of Hematology/Oncology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Ping Zhang
- Hemostasis and Thrombosis Laboratory, Division of Hematology/Oncology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - James Perkins
- Hemostasis and Thrombosis Laboratory, Division of Hematology/Oncology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Navin K Kapur
- Cardiac Catheterization Laboratory and the Division of Cardiology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Andrew Weintraub
- Cardiac Catheterization Laboratory and the Division of Cardiology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Vilma Castaneda
- Cardiac Catheterization Laboratory and the Division of Cardiology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Athan Kuliopulos
- Hemostasis and Thrombosis Laboratory, Division of Hematology/Oncology, Tufts Medical Center, Boston, MA 02111, United States of America
| | - Lidija Covic
- Hemostasis and Thrombosis Laboratory, Division of Hematology/Oncology, Tufts Medical Center, Boston, MA 02111, United States of America.
| |
Collapse
|
6
|
Pouget T, Pillois X, Fiore M. Adenylate cyclase inhibition is required for normal redistribution of platelet surface GPIb in response to PAR1 activation. Thromb Res 2018; 173:151-154. [PMID: 30530120 DOI: 10.1016/j.thromres.2018.11.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/09/2018] [Accepted: 11/22/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Thomas Pouget
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Xavier Pillois
- Centre de Référence des Pathologies Plaquettaires, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - Mathieu Fiore
- Laboratoire d'Hématologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France; Centre de Référence des Pathologies Plaquettaires, Centre Hospitalier Universitaire de Bordeaux, Pessac, France.
| |
Collapse
|
7
|
Laidlaw TM, Cahill KN, Cardet JC, Murphy K, Cui J, Dioneda B, Kothari P, Raby BA, Israel E, Boyce JA. A trial of type 12 purinergic (P2Y 12) receptor inhibition with prasugrel identifies a potentially distinct endotype of patients with aspirin-exacerbated respiratory disease. J Allergy Clin Immunol 2018; 143:316-324.e7. [PMID: 29890239 DOI: 10.1016/j.jaci.2018.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/15/2018] [Accepted: 06/03/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Aspirin-exacerbated respiratory disease (AERD) is characterized by asthma, recurrent nasal polyposis, and respiratory reactions on ingestion of COX-1 inhibitors. Increased numbers of platelet-leukocyte aggregates are present in the sinus tissue and blood of patients with AERD compared with that of aspirin-tolerant patients, and platelet activation can contribute to aspirin-induced reactions. OBJECTIVE We sought to determine whether treatment with prasugrel, which inhibits platelet activation by blocking the type 12 purinergic (P2Y12) receptor, would attenuate the severity of sinonasal and respiratory symptoms induced during aspirin challenge in patients with AERD. METHODS Forty patients with AERD completed a 10-week, double-blind, placebo-controlled crossover trial of prasugrel. All patients underwent oral aspirin challenges after 4 weeks of prasugrel and after 4 weeks of placebo. The primary outcome was a change in the provocative dose of aspirin that would elicit an increase in Total Nasal Symptom Score (TNSS) of 2 points. Changes in lung function, urinary eicosanoids, plasma tryptase, platelet-leukocyte aggregates, and platelet activation were also recorded. RESULTS Prasugrel did not significantly change the mean increase in TNSS of 2 points (79 ± 15 for patients receiving placebo and 139 ± 32 for patients receiving prasugrel, P = .10), platelet-leukocyte aggregates, or increases in urinary leukotriene E4 and prostaglandin D2 metabolite levels during aspirin-induced reactions in the study population as a whole. Five subjects (responders) reacted to aspirin while receiving placebo but did not have any reaction to aspirin challenge after the prasugrel arm. In contrast to prasugrel nonresponders (35 subjects), the prasugrel responders had smaller reaction-induced increases in TNSS; did not have significant aspirin-induced increases in urinary leukotriene E4, prostaglandin D2 metabolite, or thromboxane B2 levels; and did not display increases in serum tryptase levels during aspirin reactions on the placebo arm, all of which were observed in the nonresponders. CONCLUSION In the overall study population, prasugrel did not attenuate aspirin-induced symptoms, possibly because it failed to decrease the frequencies of platelet-adherent leukocytes or to diminish aspirin-induced mast cell activation. In a small subset of patients with AERD who had greater baseline platelet activation and milder upper respiratory symptoms during aspirin-induced reactions, P2Y12 receptor antagonism with prasugrel completely inhibited all aspirin-induced reaction symptoms, suggesting a contribution from P2Y12 receptor signaling in this subset.
Collapse
Affiliation(s)
- Tanya M Laidlaw
- Department of Medicine, Harvard Medical School, the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and the Jeff and Penny Vinik Center, Boston, Mass.
| | - Katherine N Cahill
- Department of Medicine, Harvard Medical School, the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and the Jeff and Penny Vinik Center, Boston, Mass
| | - Juan Carlos Cardet
- Department of Medicine, Harvard Medical School, Boston, Mass, and the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, Mass
| | - Katherine Murphy
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Mass
| | - Jing Cui
- Department of Medicine, Harvard Medical School, the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and the Jeff and Penny Vinik Center, Boston, Mass
| | - Brittney Dioneda
- Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, Mass
| | - Parul Kothari
- Department of Medicine, Harvard Medical School, the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and the Jeff and Penny Vinik Center, Boston, Mass
| | - Benjamin A Raby
- Department of Medicine, Harvard Medical School, Boston, Mass, and the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, Mass
| | - Elliot Israel
- Department of Medicine, Harvard Medical School, Boston, Mass, and the Pulmonary and Critical Care Division, Brigham and Women's Hospital, Boston, Mass
| | - Joshua A Boyce
- Department of Medicine, Harvard Medical School, the Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and the Jeff and Penny Vinik Center, Boston, Mass
| |
Collapse
|
8
|
Zhang J, Li Z, Hu X, Su Q, He C, Liu J, Ren H, Qian M, Liu J, Cui S, Jiang W. Knockout of P2Y 12 aggravates experimental autoimmune encephalomyelitis in mice via increasing of IL-23 production and Th17 cell differentiation by dendritic cells. Brain Behav Immun 2017; 62:245-255. [PMID: 27939246 DOI: 10.1016/j.bbi.2016.12.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/18/2016] [Accepted: 12/03/2016] [Indexed: 10/20/2022] Open
Abstract
Experimental autoimmune encephalomyelitis (EAE), a common model of multiple sclerosis (MS), is mainly mediated by CD4+ T cells with demyelination and neurodegeneration of central nervous system (CNS). The loss of P2Y12 receptor might be associated with the pathogenesis of MS/EAE, but its potential mechanism is still not clear. In this study, more severe EAE developed in P2Y12-knockout (P2Y12-KO) mice compared to WT mice. Knockout of P2Y12 increased expression of IL-17A in the sera and proportion of Th17 cells in spleen and CNS. However, in vitro studies showed that P2Y12 did not influence cell differentiation and proliferation of CD4+ T cells. In bone marrow-derived dendritic cells (BMDCs), loss of P2Y12 significantly increased the production of IL-23 in contrast to the wild-type (WT) BMDCs. FACS analysis indicated that the culture supernatant from P2Y12-deficient DCs promoted more naïve CD4+ T cells to differentiate into Th17 cells. Our finding demonstrated that genetic deletion of P2Y12 receptor broke the balance of Th subtypes by affecting the cytokine profile of BMDCs and resulted in the aggravated EAE, which suggested that P2Y12 may be a potential target in treating MS.
Collapse
Affiliation(s)
- Jiang Zhang
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Zhenlong Li
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Xuefei Hu
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Qiong Su
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Cong He
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Jing Liu
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Hua Ren
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Min Qian
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China
| | - Junling Liu
- Department of Biochemistry and Molecular Cell Biology, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shufang Cui
- Laboratory Animal Center, Second Military Medical University, Shanghai, China.
| | - Wenzheng Jiang
- Shanghai Key Laboratory of Regulatory Biology, School of Life Sciences, East China Normal University, Shanghai, China.
| |
Collapse
|
9
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
10
|
Amison RT, Momi S, Morris A, Manni G, Keir S, Gresele P, Page CP, Pitchford SC. RhoA signaling through platelet P2Y₁ receptor controls leukocyte recruitment in allergic mice. J Allergy Clin Immunol 2014; 135:528-38. [PMID: 25445826 DOI: 10.1016/j.jaci.2014.09.032] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 07/21/2014] [Accepted: 09/19/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND Clinical studies reveal platelet activation in patients with asthma, allergic rhinitis, and eczema. This is distinct from platelet aggregation, which is critical for the maintenance of hemostasis and in which a role for platelet purinergic receptors is well documented. However, purines are also essential for inflammatory cell trafficking in animal models of allergic lung inflammation, which are known to be platelet dependent, yet the role of purines in the platelet activation accompanying inflammation is unknown. OBJECTIVES We investigated whether the involvement of purine activation of platelets during allergic inflammation is distinct from purine involvement in platelet aggregation. METHODS BALB/c mice were sensitized to ovalbumin and subsequent airway ovalbumin challenge. Bronchoalveolar lavage fluid was analyzed for inflammatory cells, and blood samples were assessed for platelet activation. The role of platelet purinergic receptors and associated signaling mechanisms (RhoA) were assessed. RESULTS P2Y₁, but not P2Y₁₂ or P2X₁, antagonism inhibited pulmonary leukocyte recruitment. The formation of platelet-leukocyte complexes in vivo and platelet/P-selectin-dependent polymorphonuclear cell migration in vitro were exclusively platelet P2Y₁ receptor dependent. Furthermore, platelet P2Y₁ activation resulted in RhoA activity in vivo after allergen challenge, and RhoA signaling in platelets through P2Y₁ stimulation was required for platelet-dependent leukocyte chemotaxis in vitro. Leukocyte recruitment in thrombocytopenic mice remained suppressed after reinfusion of platelets pretreated with a P2Y₁ antagonist or a Rho-associated kinase 1 inhibitor, confirming the crucial role of platelet P2Y₁ receptor and subsequent activation of RhoA. CONCLUSION RhoA signaling downstream of platelet P2Y₁, but not P2Y₁₂, represents a clear dichotomy in platelet activation during allergic inflammation versus hemostasis.
Collapse
Affiliation(s)
- Richard T Amison
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom
| | - Stefania Momi
- Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Abigail Morris
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom
| | - Giorgia Manni
- Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Sandra Keir
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom
| | - Paolo Gresele
- Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Clive P Page
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom
| | - Simon C Pitchford
- Sackler Institute of Pulmonary Pharmacology, Institute of Pharmaceutical Science, King's College London, London, United Kingdom.
| |
Collapse
|
11
|
Cattaneo M, Schulz R, Nylander S. Adenosine-mediated effects of ticagrelor: evidence and potential clinical relevance. J Am Coll Cardiol 2014; 63:2503-2509. [PMID: 24768873 DOI: 10.1016/j.jacc.2014.03.031] [Citation(s) in RCA: 240] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/21/2014] [Accepted: 03/24/2014] [Indexed: 02/08/2023]
Abstract
This review constitutes a critical evaluation of recent publications that have described an additional mode of action of the P2Y12 receptor antagonist ticagrelor. The effect is mediated by inhibition of the adenosine transporter ENT1 (type 1 equilibrative nucleoside transporter), which provides protection for adenosine from intracellular metabolism, thus increasing its concentration and biological activity, particularly at sites of ischemia and tissue injury where it is formed. Understanding the mode of action of ticagrelor is of particular interest given that its clinical profile, both in terms of efficacy and adverse events, differs from that of thienopyridine P2Y12 antagonists.
Collapse
Affiliation(s)
- Marco Cattaneo
- Unità di Medicina 3, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy.
| | - Rainer Schulz
- Institute of Physiology, Justus-Liebig University Giessen, Giessen, Germany
| | - Sven Nylander
- AstraZeneca Research and Development, Mölndal, Sweden
| |
Collapse
|
12
|
Kim KA, Song WG, Lee HM, Joo HJ, Park JY. Effect of P2Y1 and P2Y12 genetic polymorphisms on the ADP-induced platelet aggregation in a Korean population. Thromb Res 2013; 132:221-6. [PMID: 23849096 DOI: 10.1016/j.thromres.2013.06.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 05/30/2013] [Accepted: 06/17/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND P2Y1 and P2Y12 receptors are expressed in platelet membranes and are involved in ADP-induced platelet aggregation. Genetic polymorphisms of P2Y1 and P2Y12 play a major role in the variation of ADP-induced platelet aggregation and in response in antiplatelet therapy. OBJECTIVE To evaluate the allele frequencies of P2Y1 and P2Y12 genetic polymorphisms in a Korean population and to assess their role in ADP (5 μmol/L)-induced maximal platelet aggregation. METHODS P2Y1 (c.1622A>G) and P2Y12 (i-139C>T, i-744T>C, i-ins801, c.52G>T, c.34C>T) polymorphisms were analyzed in 158 Korean healthy participants using pyrosequencing methods. Their ADP-induced maximal platelet aggregation was assessed by the turbidometric method. RESULTS The observed allele frequencies of P2Y1 and P2Y12 were as follows: 0.3101 for P2Y1 c.1622A>G; 0.1804 for P2Y12 i-139C>T, 0.1804 for i-744T>C, 0.1804 for i-801insA, 0.1266 for P2Y12 c.52G>T, and 0.2658 for P2Y12 c.34C>T. ADP-induced maximal platelet aggregation was not influenced by the P2Y1 c.1622A>G polymorphism and was also not affected by three intronic P2Y12 polymorphisms and the P2Y12 c.34C>T polymorphism. However, the P2Y12 c.52G>T polymorphism caused a substantial difference in ADP-induced maximal platelet aggregation (62.75% for c.52GG, 66.27% for c.52GT, and 80.60% for c.52TT; P=0.0092). CONCLUSIONS The P2Y1 and P2Y12 genes were very polymorphic in a Korean population. Three intronic P2Y12 polymorphisms (i-139C>T, i-744T>C, i-801insA) were in complete linkage disequilibrium but not with the c.52C>T polymorphism in this population. Maximal platelet aggregation in response to ADP is associated with the c.52C>T polymorphism but not with the three intronic polymorphisms or the P2Y1 c.1622A>T polymorphism.
Collapse
|