Clinical Relevance and Research Perspectives
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Since the recognition that platelets have an essential role in the pathogenesis of acute coronary syndromes (ACS) and other thrombotic disorders, extensive research has been devoted to understanding platelet physiology and to the development of effective antiplatelet therapy. For several decades, it has been known that the circulating platelet population is heterogeneous in size and age. This population includes young platelets, recently released from the bone marrow by megakaryocytes, which are termed reticulated platelets (RPs). Circulating RPs are identified by staining for messenger ribonucleic acid (mRNA). They are characterized by increased mean volume and a greater number of dense granules than older circulating platelets, and a capacity for ongoing protein synthesis by the residual mRNA. The proportion of RPs in the circulation is increased in situations of enhanced platelet turnover, including ACS. However, it is not clear whether, in ACS, enhanced platelet turnover is the cause or the consequence of the acute atherothrombotic event.
The proportion of RPs in the circulation is generally assessed by flow cytometry using thiazole orange staining of mRNA. This method, however, has several limitations. It is relatively expensive and technically demanding, and it lacks standardization of the type and concentration of dye used. For these reasons, a simpler automated method has …