Trans-disciplinary research approaches: integration of fluid mechanics with cell biology

At the level of the individual molecule, outstanding discoveries leading the the 2012 Nobel Prize in Chemistry clarified G-protein coupled receptors (GPCRs) crystallographic structures and functions. Nevertheless, a large number of such receptors cooperate to ultimately determine the cell response. Henceforth, understanding their group effects becomes crucial to predict the activity of the GPCRs populating the various cell aggregates

P2Y12 Receptor Blockade Augments Glycoprotein IIb‐IIIa Antagonist Inhibition of Platelet Activation, Aggregation, and Procoagulant Activity

Background: New antiplatelet agents that provide greater, more consistent inhibition of the platelet ADP receptor P2Y12 may be used in combination with glycoprotein (GP) IIb‐IIIa antagonists, but their combined effect on platelet function and procoagulant activity is not well studied. Therefore, the objective of this study was to evaluate the independent and complementary effects of P2Y12 and GPIIb‐IIIa inhibition on platelet function and procoagulant activity. Methods and Results: Healthy donor blood was treated with the active metabolite of prasugrel (R‐138727 5 μmol/L), GPIIb‐IIIa antagonists (abciximab 3 μg/mL or eptifibatide 0.9 μg/mL), and combinations thereof, exposed to physiologically relevant agonists (collagen and ADP) and then evaluated for markers of platelet activation and procoagulant activity. Significant interactions between R‐138727 and GPIIb‐IIIa antagonists were observed. R‐138727 and the GPIIb‐IIIa antagonists had additive inhibitory effects on collagen‐stimulated platelet aggregation and on the collagen plus ADP–stimulated level of activated platelet surface GPIIb‐IIIa. R‐138727 and abciximab each inhibited collagen plus ADP–stimulated platelet phosphatidylserine expression and prothrombin cleavage, and the combination produced greater inhibition than achieved with abciximab alone. In contrast, eptifibatide did not inhibit, but instead enhanced, collagen plus ADP–stimulated prothrombin cleavage. Addition of R‐138727 reduced prothrombin cleavage in eptifibatide‐treated samples, suggesting a novel mechanism for potential benefit from combined prasugrel and eptifibatide treatment. Conclusions: The complementary effects of abciximab and R‐138727 on platelet activation, aggregation, and procoagulant activity suggest their combined use may, to a greater degree than with either agent alone, reduce thrombus formation in vivo

Patel-ISTH-15Jul2011IP_ToPrint.pptx-1.pdf

Occlusive thrombi that cause cardiovascular diseases form on the walls of blood vessels and propagate across the lumen under pressure gradient-driven flow, impaired antithrombotic, and enhanced prothrombotic conditions. Development of a well controlled and validated ex vivo model that can mimic these pathological conditions would provide a useful tool for the investigation of prothrombotic and antithrombotic molecular mechanisms, supplementing or replacing animal experimentationKeywords: Rational design, Ex vivo, Thrombosi

Rational Design of Ex Vivo Model of Thrombosis

Occlusive thrombi that cause cardiovascular diseases form on the walls of blood vessels and propagate across the lumen under pressure gradient-driven flow, impaired antithrombotic, and enhanced prothrombotic conditions. Development of a well controlled and validated ex vivo model that can mimic these pathological conditions would provide a useful tool for the investigation of prothrombotic and antithrombotic molecular mechanisms, supplementing or replacing animal experimentatio

New highly active antiplatelet agents with dual specificity for platelet P2Y1 and P2Y12 adenosine diphosphate receptors

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\u27) 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

Modification of Pulsed Electric Field Conditions Results in Distinct Activation Profiles of Platelet-Rich Plasma

Background: Activated autologous platelet-rich plasma (PRP) used in therapeutic wound healing applications is poorly characterized and standardized. Using pulsed electric fields (PEF) to activate platelets may reduce variability and eliminate complications associated with the use of bovine thrombin. We previously reported that exposing PRP to sub-microsecond duration, high electric field (SMHEF) pulses generates a greater number of platelet-derived microparticles, increased expression of prothrombotic platelet surfaces, and differential release of growth factors compared to thrombin. Moreover, the platelet releasate produced by SMHEF pulses induced greater cell proliferation than plasma. Aims To determine whether sub-microsecond duration, low electric field (SMLEF) bipolar pulses results in differential activation of PRP compared to SMHEF, with respect to profiles of activation markers, growth factor release, and cell proliferation capacity. Methods: PRP activation by SMLEF bipolar pulses was compared to SMHEF pulses and bovine thrombin. PRP was prepared using the Harvest SmartPreP2 System from acid citrate dextrose anticoagulated healthy donor blood. PEF activation by either SMHEF or SMLEF pulses was performed using a standard electroporation cuvette preloaded with CaCl2 and a prototype instrument designed to take into account the electrical properties of PRP. Flow cytometry was used to assess platelet surface P-selectin expression, and annexin V binding. Platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), endothelial growth factor (EGF) and platelet factor 4 (PF4), and were measured by ELISA. The ability of supernatants to stimulate proliferation of human epithelial cells in culture was also evaluated. Controls included vehicle-treated, unactivated PRP and PRP with 10 mM CaCl2 activated with 1 U/mL bovine thrombin. Results: PRP activated with SMLEF bipolar pulses or thrombin had similar light scatter profiles, consistent with the presence of platelet-derived microparticles, platelets, and platelet aggregates whereas SMHEF pulses primarily resulted in platelet-derived microparticles. Microparticles and platelets in PRP activated with SMLEF bipolar pulses had significantly lower annexin V-positivity than those following SMHEF activation. In contrast, the % P-selectin positivity and surface P-selectin expression (MFI) for platelets and microparticles in SMLEF bipolar pulse activated PRP was significantly higher than that in SMHEF-activated PRP, but not significantly different from that produced by thrombin activation. Higher levels of EGF were observed following either SMLEF bipolar pulses or SMHEF pulses of PRP than after bovine thrombin activation while VEGF, PDGF, and PF4 levels were similar with all three activating conditions. Cell proliferation was significantly increased by releasates of both SMLEF bipolar pulse and SMHEF pulse activated PRP compared to plasma alone. Conclusions: PEF activation of PRP at bipolar low vs. monopolar high field strength results in differential platelet-derived microparticle production and activation of platelet surface procoagulant markers while inducing similar release of growth factors and similar capacity to induce cell proliferation. Stimulation of PRP with SMLEF bipolar pulses is gentler than SMHEF pulses, resulting in less platelet microparticle generation but with overall activation levels similar to that obtained with thrombin. These results suggest that PEF provides the means to alter, in a controlled fashion, PRP properties thereby enabling evaluation of their effects on wound healing and clinical outcomes

Flow cytometric analysis of platelets and platelet-derived microparticles (PDMP) in PRP following activation with SMLEF bipolar pulses, SMHEF monopolar pulses and thrombin.

<p>A) Representative forward- and side-light scatter profiles of (CD41/CD42b double positive) particles in activated and unactivated PRP samples. The oval indicates the location of the normal forward and side-light scatter distribution for intact platelets; CD41+/CD42b+ particles with lower forward and side light scatter are considered PDMP. B) PDMP as % of all CD41/CD42b double positive particles. Platelet count prior to stimulation was 1095.2 ± 192.9 x 10⁹/L (mean ± SD). C) Percentage of PDMP positive for surface phosphatidylserine as detected by annexin V binding; D) Percentage of platelets positive for surface phosphatidylserine as detected by annexin V binding; E) Percentage of all CD41/CD42b double positive particles positive for surface P-selectin. F) P-selectin mean fluorescence intensity (MFI) per particle. Upper and lower boundaries of boxes represent 25^th and 75^th %tile, whiskers represent 10^th and 90^th %tiles, line indicates median, n = 5. *p<0.05, **p<0.01, ***p<0.001.</p

Differential effects of SMLEF bipolar pulses, SMHEF pulses and thrombin on PRP activation, growth factor release, and cell proliferation.

<p>Differential effects of SMLEF bipolar pulses, SMHEF pulses and thrombin on PRP activation, growth factor release, and cell proliferation.</p