De Meyer Simon F, Vanhoorelbeke Karen, Broos Katleen, Salles Isabelle I, Deckmyn Hans
Laboratory for Thrombosis Research, IRC, KU Leuven Campus Kortrijk, Kortrijk, Belgium.
Br J Haematol. 2008 Aug;142(4):515-28. doi: 10.1111/j.1365-2141.2008.07233.x. Epub 2008 May 30.
Platelets play a major role in thromboembolic diseases, and so antiplatelet therapy remains crucial in treatment and prophylaxis. Upon vascular injury, platelets rapidly adhere to the exposed subendothelial matrix, after which they become activated, resulting in the recruitment of additional platelets from the circulation to eventually form a stable arterial platelet plug. Although controlled plug formation is desired for the prevention of excessive blood loss and for promoting wound healing, several pathological conditions may result in the formation of occlusive thrombi leading to severe clinical complications, including myocardial infarction and ischaemic stroke. Many antiplatelet approaches have been investigated, interfering with one or more of the different stages in thrombus formation. This review discusses antiplatelet agents that interfere with the three principal phases in thrombus formation: platelet adhesion, amplification of platelet activation and platelet aggregation. For each stage, novel experimental targets and clinically established antiplatelet strategies will be reviewed. Limitations and possible benefits will be discussed for each target.
血小板在血栓栓塞性疾病中起主要作用,因此抗血小板治疗在治疗和预防中仍然至关重要。血管损伤时,血小板迅速黏附于暴露的内皮下基质,随后被激活,导致循环中更多血小板募集,最终形成稳定的动脉血小板栓。虽然为预防过度失血和促进伤口愈合需要控制栓子形成,但一些病理状况可能导致闭塞性血栓形成,引发严重临床并发症,包括心肌梗死和缺血性中风。人们研究了许多抗血小板方法,干扰血栓形成的一个或多个不同阶段。本综述讨论干扰血栓形成三个主要阶段的抗血小板药物:血小板黏附、血小板激活的放大和血小板聚集。对于每个阶段,将综述新的实验靶点和临床已确立的抗血小板策略。将讨论每个靶点的局限性和可能的益处。