Imaging platelet biogenesis in vivo Schulze, Harald; Stegner, David
Research and practice in thrombosis and haemostasis,
July 2018, Letnik:
2, Številka:
3
Journal Article
Recenzirano
Odprti dostop
In this review paper, we give a historical perspective of the development of imaging modalities to visualize platelet biogenesis and how this contributed to our current understanding of ...megakaryopoiesis and thrombopoiesis. We provide some insight how distinct in vivo and in situ imaging methods, including ultramicrographs, have contributed to the current concepts of platelet formation. The onset of intravital microscopy into the mouse bone marrow has markedly modified and challenged our thinking of platelet biogenesis during the last decade. Finally, we discuss ongoing work, which was presented at the recent International Society on Thrombosis and Haemostasis (ISTH) meeting.
Abstract
Inherited platelet disorders (IPD) form a rare and heterogeneous disease entity that is present in about 8% of patients with non-acquired bleeding diathesis. Identification of the defective ...cellular pathway is an important criterion for stratifying the patient's individual risk profile and for choosing personalized therapeutic options. While costs of high-throughput sequencing technologies have rapidly declined over the last decade, molecular genetic diagnosis of bleeding and platelet disorders is getting more and more suitable within the diagnostic algorithms. In this study, we developed, verified, and evaluated a targeted, panel-based next-generation sequencing approach comprising 59 genes associated with IPD for a cohort of 38 patients with a history of recurrent bleeding episodes and functionally suspected, but so far genetically undefined IPD. DNA samples from five patients with genetically defined IPD with disease-causing variants in
WAS
,
RBM8A
,
FERMT3
,
P2YR12
, and
MYH9
served as controls during the validation process. In 40% of 35 patients analyzed, we were able to finally detect 15 variants, eight of which were novel, in 11 genes,
ACTN1
,
AP3B1
,
GFI1B
,
HPS1
,
HPS4
,
HPS6
,
MPL
,
MYH9
,
TBXA2R
,
TPM4
, and
TUBB1
, and classified them according to current guidelines. Apart from seven variants of uncertain significance in 11% of patients, nine variants were classified as likely pathogenic or pathogenic providing a molecular diagnosis for 26% of patients. This report also emphasizes on potentials and pitfalls of this tool and prospectively proposes its rational implementation within the diagnostic algorithms of IPD.
Allogeneic hematopoietic stem cell transplantation (HSCT) is often accompanied by bleeding complications due to delayed platelet engraftment. Despite having prolonged thrombocytopenia, patients can ...also develop thrombotic events. The mechanisms leading to HSCT-related hemorrhage and thrombosis, and especially platelet activity in these patients are yet unknown. Our study aimed to decipher post HSCT megakaryocyte (MK) engraftment and platelet function in a murine model of bone marrow transplantation (BMT) and in patients undergoing HSCT. C57BL/6 mice were lethally irradiated with 10 Gy total body irradiation prior to BMT. Radiation exposure led to massive BM remodeling, including extracellular matrix degradation, vasodilation and aberrant pericyte morphology, accompanied by extensive ectopic platelet release into the BM cavity, which might contribute to thrombocytopenia. We used Actb dsRed reporter mice as BM donors allowing us to track all donor-derived (dsRed +) cells after BMT. Femurs were removed after 14 days and subjected to confocal laser immunofluorescence microscopy using lineage-specific markers. While we found an overall homogenous engraftment pattern for red blood cells and most leukocyte sub-lineages, the engraftment pattern for MKs and Ly6G + cells was characterized by long triangular clusters at the bone cortex. We manipulated BM engraftment by transplanting different numbers of graft cells. Within 2 weeks after BMT with 6 x 10 6 BM cells per mouse, a complete chimerism was achieved for both MKs in BM and platelets in peripheral blood. These newly formed platelets had an increased platelet size, while the surface expression levels (CD41/CD42/GPVI) were decreased by half, implying a massive reduction in receptor density. Flow cytometry analyses of agonist-stimulated platelets revealed a severely impaired granule release and integrin activation that was confirmed by aggregometry. When only 1 x 10 6 BM cells per mouse were transplanted, we found an extended mixed MK chimerism after BMT. During the first 28 days, we detected both dsRed - (recipient-derived) and dsRed + (donor-derived) MKs in the recipient BM and, concomitantly, dsRed - and dsRed + platelets in peripheral blood. Unexpectedly, we observed opposing agonist-induced platelet reactivity with hyporeactive dsRed - platelets, while dsRed + platelets were hyperreactive, indicating that 2 BM MK subpopulations generate 2 functionally distinct platelet subpopulations. Intriguingly, we found an upregulation of annexin V binding on dsRed -, but not on dsRed + resting platelets, implying that the myeloablative conditions preceding HSCT result in increased phosphatidylserine (PS) exposure, a key sign of pro-coagulant platelets. In vitro thrombus formation was assessed under flow using a whole blood collagen-coated microfluidic device. While surface coverage was mildly increased, thrombus volume remained comparable to controls. dsRed + platelets exhibited a distinct incorporation pattern by preferentially attaching to the edges of growing thrombi, indicating that dsRed - and dsRed + platelets may differ in thrombus initiation and growth. While platelet count and other blood cell parameters are routinely monitored in HSCT patients, the functional capacity of graft-derived platelets has not yet been systematically assessed. We thus performed extended platelet function analyses in 13 adult patients (aged 24-73 years) undergoing allogeneic HSCT for malignant leukemic diseases (mostly acute myeloid leukemia) and detected a massive platelet hyporeactivity for up to 100 days observation time after HSCT. Integrin activation was severely impaired upon stimulation of PAR-1 or GPVI. In contrast to mice, α granule release, monitored by P-selectin neo-exposure, was only slightly reduced compared to healthy controls, suggesting a decoupling of integrin activation and P-selectin exposure. In line with our findings in mice, we detected a pronounced upregulation in the proportion of pro-coagulant PS-positive platelets with a reduced mitochondrial membrane potential. Our data demonstrate that a mixed chimerism after HSCT results in two co-existing platelet subpopulations with opposing response profiles. This unexpected finding provides the first experimental evidence why bleedings and thromboembolic events can both occur after HSCT and hints toward pro-coagulant platelets as a potential therapeutic target.
Each bone marrow megakaryocyte (MK) releases thousands of platelets into the circulation, and the underlying molecular and cellular mechanisms recently have received intense scrutiny. Genetic studies ...are beginning to clarify the mechanisms by which transcription factors help distinguish MK progenitors from other blood cell lineages and subsequently confer unique cellular properties. Other investigations demonstrate that platelets are assembled de novo during a terminal phase of MK differentiation in which the cell extends cytoplasmic projections known as proplatelets. This review focuses on the roles of selected transcription factors with key roles in MK differentiation, and on human and murine models of thrombocytopenia that result from impaired MK differentiation. The findings we review help construct a framework to appreciate thrombopoietic mechanisms in the context of underlying lineage and morphologic transitions. Many of these mechanisms are unique to MKs but appear to rely both on genes that are expressed only in that lineage and others that are expressed widely.
Collagen receptors GPVI (also known as GP6) and integrin α2β1 are highly expressed on blood platelets and megakaryocytes, their immediate precursors. After vessel injury, subendothelial collagen ...becomes exposed and induces platelet activation to prevent blood loss. Collagen types I and IV are thought to have opposite effects on platelet biogenesis, directing proplatelet formation (PPF) towards the blood vessels to prevent premature release within the marrow cavity. We used megakaryocytes lacking collagen receptors or treated megakaryocytes with blocking antibodies, and could demonstrate that collagen-I-mediated inhibition of PPF is specifically controlled by GPVI. Other collagen types competed for binding and diminished the inhibitory signal, which was entirely dependent on receptor-proximal Src family kinases, whereas Syk and LAT were dispensable. Adhesion assays indicate that megakaryocyte binding to collagens is mediated by α2β1, and that collagen IV at the vascular niche might displace collagen I from megakaryocytes and thus contribute to prevention of premature platelet release into the marrow cavity and thereby directionally promote PPF at the vasculature.
Platelet-restricted β1 tubulin is required for optimal thrombopoiesis and discoid cell shape. To identify interacting factors, we used the divergent β1-tubulin C-terminus as the bait in a yeast ...2-hybrid screen of megakaryocyte (MK) cDNAs. We isolated secretory leukocyte protease inhibitor (SLPI), a serine protease antagonist characterized principally as a secreted factor with multiple roles in inflammation. SLPI is expressed in MKs and platelets in 2 discrete compartments. One pool resides in punctate cytoplasmic structures, whereas a significant fraction localizes along peripheral microtubules (MTs) and is lost with cold-induced MT disruption or in β1 tubulin-/- platelets. These findings reveal unexpected interaction between a prominent cytoskeletal protein and an inhibitor of proteolysis. SLPI-/- mice show intact proplatelet formation, platelet numbers and shape, and marginal MT bands; thus, SLPI is not essential for thrombopoiesis. However, SLPI is released upon platelet activation, which also reverses its association with the resting marginal band. Platelet SLPI inhibits neutrophil elastase, an activity that is reduced when β1 tubulin is absent. We conclude that SLPI localizes in part along the MK and platelet MT cytoskeleton by virtue of specific interactions with β1 tubulin. SLPI may thus have unanticipated roles in MK and platelet functions, including regulated proteolysis after activation. (Blood. 2004;104:3949-3957)
Summary
Platelets are not only centrally involved in haemostasis, but also in antimicrobial defence and inflammation. Since evaluation of platelet physiology in the particular patient group of ...preterm and term neonatal infants is highly restricted for ethical reasons, there are hardly any data available in healthy and much less in extremely immature or ill neonates. By summarising current knowledge and addressing both platelet researchers and neonatologists, we describe neonatal platelet count and morphology, report on previous analyses of neonatal platelet function in primary haemostasis and provide insights into recent advances in platelet immunology that considerably impacts our clinical view on the critically ill neonatal infant. We conclude that neonatal platelets, originating from liver megakaryocytes, substantially differ from adult platelets and may play a pivotal role in the pathophysiology of neonatal sepsis or intraventricular haemorrhage, both complications which seriously augment perinatal morbidity and mortality.