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(Circulation. 2000;102:1931.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
P-Selectin Expression on Platelets Determines Size and Stability of Platelet Aggregates
From the Division of Cardiology (M.M.) and the Division of Hematology (P.T.), Department of Internal Medicine, University of Texas Houston Medical School.
Correspondence to Michael Merten, MD, Division of Cardiology, Department of Internal Medicine, University of Texas Houston Medical School, 6431 Fannin, MSB 5.284, Houston, TX 77030. E-mail michael_merten{at}yahoo.com
Background—P-selectin mediates rolling of platelets and leukocytes on activated endothelial cells. After platelet activation, P-selectin is translocated from intracellular granules to the external membrane, whereas fibrinogen aggregates platelets by bridging glycoprotein (GP) IIb/IIIa between adjacent platelets.
Methods and Results—In this study, we define a novel role for P-selectin in platelet aggregation. Expression of P-selectin on the platelet surface correlated strongly with the mean platelet aggregate size. Inhibition of P-selectin binding to its ligand by either monoclonal anti–P-selectin antibodies directed against the lectin domain or soluble human P-selectin reversed platelet aggregation even when added up to 5 minutes after activation; however, fibrinogen binding to platelets was not affected. This deaggregating effect significantly reduced the maximal size and number of platelet aggregates. When added 1 minute after platelet activation, anti–P-selectin antibody achieved 95% to 100% of the deaggregating effect of EDTA, whereas the anti-GP IIb/IIIa antibody abciximab had no effect. Monoclonal antibodies against known P-selectin ligands, such as P-selectin GP ligand-1 (PSGL-1) or GP Ib, had no effect on platelet aggregation, suggesting a different ligand for P-selectin in platelet aggregate stabilization. In kinetic studies, P-selectin was maximally expressed 10 minutes after platelet activation, whereas maximal activation of GP IIb/IIIa occurred within the first 10 seconds, suggesting that P-selectin operates after fibrinogen binding to activated GP IIb/IIIa.
Conclusions—These results indicate that P-selectin interaction with a ligand, different from PSGL-1 or GP Ib, stabilizes initial GP IIb/IIIa–fibrinogen interactions, allowing the formation of large stable platelet aggregates.
Key Words: platelet-derived factors • glycoproteins • fibrinogen
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