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Semin Thromb Hemost 2010; 36(2): 129-130
DOI: 10.1055/s-0030-1251495
PREFACE

© Thieme Medical Publishers

Platelets, Inflammation and Cardiovascular Diseases. New Concepts and Therapeutic Implications

Meinrad Gawaz1 , Emmanuel J. Favaloro2
  • 1Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard Karls-Universität Tübingen, Tübingen, Germany
  • 2Department of Haematology, ICPMR, Westmead Hospital, Westmead, NSW Australia
Further Information

Publication History

Publication Date:
22 April 2010 (online)

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Platelets play a critical role in hemostasis and thrombosis. The role of platelets in hemostasis, clinically relevant bleeding resulting from defects and/or deficiencies in platelets and/or platelet components, and the diagnosis of such defects was the subject of a previous recent issue of Seminars in Thrombosis and Hemostasis.[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] That platelets are of considerable interest to readers of this journal can also be highlighted by the popularity of a previous review published here, “Platelets: Physiology and Biochemistry.[14] Published in 2005, this article was included in the top-20 most popular article listings from this journal in three separate years, 2005, 2006, and 2007,[15] and was also subsequently awarded one of the inaugural (2009) Eberhard F. Mammen awards for most popular articles.[16]

The current issue of Seminars in Thrombosis and Hemostasis is dedicated to the role of platelets in inflammation and cardiovascular disease. The last time we extensively explored this topic was in 2007,[17] [18] [19] [20] [21] [22] [23] [24] [25] [26] [27] [28] [29] [30] and much research in the field has progressed since then.

The classical role of platelets is to control vascular hemostasis. Once vascular lesions are formed, platelets are recruited to the site of injury, form a microthrombus, and seal the infringement to prevent further blood loss. An uncontrolled vascular platelet activation results in intravascular thrombus formation and disturbance of blood flow, which in turn leads to tissue ischemia and organ dysfunction.

As highlighted in this issue, uncontrolled platelet function is the major component of, and is involved in, a variety of cardiovascular diseases such as atherosclerosis, myocardial infarction, inflammatory heart disease, myocarditis, and tissue regeneration. Platelet-derived thrombosis, present in all these cardiovascular diseases, is bonded, however, to inflammatory reactions in the microenvironment of platelet-rich thrombi. Further, release of platelet-derived cytokines and the interaction of platelets with other vascular and blood-borne cells results in a generalized inflammatory response not exclusively limited to the proximate surroundings of the platelet thrombus. Platelet-mediated inflammation leads to a systemic inflammatory response syndrome that is a consequence of the release of highly potent platelet-derived cytokines and the pleiotropic effect on inflammatory cells such as endothelial cells or moncytes.[31] [32]

Accordingly, the present issue of explores various aspects of platelets, inflammation, and cardiovascular diseases. Additional new insights into the pathomechanisms of inflammatory cardiomyopathy and regeneration are also recapitulated.

In the first article, Langer and colleagues summarize the role of platelet interaction with endothelium in regard to the development of atherosclerosis and coronary artery disease. Platelets also interact with progenitor cells and control progenitor cell proliferation and differentiation into macrophages and foam cells, and this topic is explored by Stellos et al in the following article. New molecular mechanisms are being explored to better understand the role of oxidized low-density lipoprotein (oxLDL) and scavenger receptors in platelet-mediated inflammation, as respectively explored in this issue by Daub et al and Seizer et al. OxLDL is a major proinflammatory mediator that binds to platelets, is internalized into granules, and results in further platelet activation, a process in which scavenger receptors are key mediators.

Inflammation and regeneration are closely related terms and definitions. Thus the potential of platelet-derived chemokines in vascular remodeling and atherosclerosis is elucidated by Koenen and coworkers, and for vascular regeneration is extensively explored by both Lisman et al and Stellos et al.

The second part of the current issue concentrates on diagnostic and therapeutic aspects, especially for inflammatory cardiomyopathy or myocarditis. The importance of inflammatory molecules such as RAGE or osteopontin in the assessment of myocarditis is respectively discussed by Volz et al and Klingel et al. In the subsequent article, the role of platelet glycoprotein VI for diagnosis and therapy of cardiovascular diseases is summarized by Bigalke and coworkers.

In the last two articles, novel therapeutic strategies in the treatment of inflammatory cardiomyopathy are highlighted. Jahns and coworkers summarize a new strategy that targets receptor-antibodies in immunocardiomyopathy. New immunomodulatory strategies are discussed in the final chapter authored by Leder and coworkers.

In summary, the present issue represents a state-of-the-art summary of novel aspects of platelet-mediated inflammation and the consequences on cardiovascular diseases. We believe the current issue of Seminars in Thrombosis and Hemostasis will be of utmost interest to our readers and should also stimulate further exciting research within this field. We thank all the authors for their interesting contributions.

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