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Dysfunction and disintegration of platelets
an essential part of apoptosis, but for the anucleate platelet the cell’s development and lifespan are determined by the intrinsic pathway of apoptosis.19 On the other hand, whether or not apoptosis is involved in the fate of platelets after activation has been controversial, but other death pathways cannot be excluded.45
Irrespective of the mechanisms underlying platelet death as an outcome of thrombin-induced activation, our data suggest a pathway for enhanced elimination of acti- vated platelets from the circulation in (pro)thrombotic conditions associated with thrombinemia. In severe thrombotic conditions, such as disseminated intravascular coagulation46 or trauma-induced coagulopathy,47 platelets may vanish due to removal of platelet fragments from the blood, perhaps by monocytes, dendritic cells and macrophages.48 Thrombin-induced platelet disintegration may therefore be a pathogenic mechanism that modulates platelet counts, functionality, and fate in disease states associated with hypercoagulability and high thrombin activity in blood.
In conclusion, following thrombin-induced platelet activation, a substantial fraction of platelets later undergo structural disintegration into subcellular particles. This fragmentation of platelets is accompanied by dramatic rearrangements of platelet cytoskeletal components, including redistribution of actin and microtubule dynam- ics. Thrombin-induced platelet fragmentation is concur-
rent with severe impairment of platelet functionality, including mitochondrial depolarization, metabolic ATP depletion, generation of ROS, and loss of platelet contrac- tility. The lack of caspase activity and increased calpain activity in energy-exhausted thrombin-treated platelets undergoing fragmentation suggests a calpain-dependent platelet death pathway. Fragmentation of activated platelets suggests that platelet death is an underappreciat- ed mechanism for enhanced elimination of platelets from the circulation in (pro)thrombotic conditions or under other conditions once these cells have performed their functions. Analogous to eryptosis, suicidal death of ery- throcytes, the platelet death pathway described here could be named “thromboptosis” or “plateleptosis”.
Acknowledgments
We would like to thank Dr. Xiaolu Yang for fruitful discus- sions. The work was supported by National Institutes of Health grants UO1HL116330 and R01 HL135254, National Science Foundation grant DMR1505662, the Program for Competitive Growth at Kazan Federal University, grant 18-415-160004 from the Russian Foundation for Basic Research, American Heart Association grants 17SDG33680177 and 16PRE30260002, and grant EPSRC EP/C513037/1 to P. R. Williams (Swansea University, Wales, UK) for the TA Instruments ARG2 rheometer. Transmission electron microscopy was carried out on the equip- ment of CSF-SAC FRC KSC RAS (Kazan, Russia).
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