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P2Y(12) 拮抗剂作为血小板功能抑制剂的作用模式。

Mode of action of P2Y(12 ) antagonists as inhibitors of platelet function.

机构信息

Cardiovascular Medicine, Queen's Medical Centre, Nottingham, UK.

出版信息

Thromb Haemost. 2011 Jan;105(1):96-106. doi: 10.1160/TH10-07-0482. Epub 2010 Oct 12.


DOI:10.1160/TH10-07-0482
PMID:20941457
Abstract

P2Y(12) receptor antagonists are antithrombotic agents that inhibit platelet function by blocking the effects of adenosine diphosphate (ADP) at P2Y (12)receptors. However, some P2Y(12) receptor antagonists may affect platelet function through additional mechanisms. It was the objective of this study to investigate the possibility that P2Y(12) antagonists inhibit platelet function through interaction with G-protein-coupled receptors other than P2Y(12) receptors. We compared the effects of cangrelor, ticagrelor and the prasugrel active metabolite on platelet aggregation and on phosphorylation of vasodilator-stimulated phosphoprotein (VASP). We compared their effects with those of selective IP, EP4 and A2A agonists, which act at Gs-coupled receptors. All three P2Y(12) antagonists were strong inhibitors of ADP-induced platelet aggregation but only partial inhibitors of aggregation induced by thrombin receptor activating peptide (TRAP) or the thromboxane A2 mimetic U46619. Further, after removing ADP and its metabolites using apyrase and adenosine deaminase, the P2Y(12) antagonists produced only minor additional inhibition of TRAP or U46619-induced aggregation. Conversely, the Gs-coupled receptor agonists always produced strong inhibition of aggregation irrespective of whether ADP was removed. Other experiments using selective receptor agonists and antagonists provided no evidence of any of the P2Y(12) antagonists acting through PAR1, TP, IP, EP4, A2A or EP3 receptors. All three P2Y (12)antagonists enhanced VASP-phosphorylation to a small and equal extent but the effects were much smaller than those of the IP, EP4 and A2A agonists. The effects of cangrelor, ticagrelor and prasugrel on platelet function are mediated mainly through P2Y(12)receptors and not through another G-protein-coupled receptor.

摘要

P2Y(12) 受体拮抗剂是抗血小板药物,通过阻断 P2Y(12) 受体对二磷酸腺苷 (ADP) 的作用来抑制血小板功能。然而,一些 P2Y(12) 受体拮抗剂可能通过其他机制影响血小板功能。本研究旨在探讨 P2Y(12) 拮抗剂是否通过与 P2Y(12) 受体以外的 G 蛋白偶联受体相互作用来抑制血小板功能。我们比较了坎格雷洛、替格瑞洛和普拉格雷活性代谢物对血小板聚集和血管扩张刺激磷酸蛋白 (VASP) 磷酸化的影响。我们将它们的作用与作用于 Gs 偶联受体的选择性 IP、EP4 和 A2A 激动剂的作用进行了比较。三种 P2Y(12) 拮抗剂均为 ADP 诱导的血小板聚集的强抑制剂,但仅为凝血酶受体激活肽 (TRAP) 或血栓烷 A2 模拟物 U46619 诱导的聚集的部分抑制剂。此外,在用脱氨酶和腺苷脱氨酶去除 ADP 及其代谢物后,P2Y(12) 拮抗剂仅对 TRAP 或 U46619 诱导的聚集产生较小的额外抑制。相反,Gs 偶联受体激动剂始终产生强烈的聚集抑制作用,无论是否去除 ADP。其他使用选择性受体激动剂和拮抗剂的实验未提供任何证据表明任何一种 P2Y(12) 拮抗剂通过 PAR1、TP、IP、EP4、A2A 或 EP3 受体发挥作用。三种 P2Y(12) 拮抗剂均能以较小的程度增强 VASP 磷酸化,但作用远小于 IP、EP4 和 A2A 激动剂。坎格雷洛、替格瑞洛和普拉格雷对血小板功能的作用主要通过 P2Y(12) 受体介导,而不是通过另一种 G 蛋白偶联受体介导。

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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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