U. 770 INSERM, Hôpital de Bicêtre, France.
Semin Thromb Hemost. 2010 Nov;36(8):833-44. doi: 10.1055/s-0030-1267037. Epub 2010 Nov 3.
Membrane remodeling, phosphatidylserine (PS) exposure, and subsequent microparticle (MP) shedding regulation is a critical step in maintaining vascular homeostasis. Shed MP, more particularly those of platelet origin, could be viewed as a way to increase the catalytic procoagulant surface relying on the essential presence of PS for optimal hemostatic response. Whether "flip-flop" is mandatory for the release of MP is suggested from the phenotype of Scott's syndrome, a rare bleeding disorder in which both PS exposure and MP shedding are deficient. PS exposure results from a specific cytoskeleton degradation pathway involving caspases, tuned by mitochondria permeability changes, and requiring a sustained increase in intracellular calcium. The actual roles of transmembrane ion transport or transient transmembrane pores in PS exposure remain to be more firmly established. Considering that an excess of plasma membrane procoagulant activity is associated with an increased risk of thrombosis, the identification of effectors of PS exposure and MP release appear relevant targets in thrombosis research and focused drug design. In this view, animal models of Scott's syndrome should prove of primary importance for the characterization of the genetic trait(s) accounting for the associated defect that would provide an important hint toward the control of PS exposure and subsequent MP release.
膜重塑、磷脂酰丝氨酸(PS)暴露以及随后的微粒(MP)脱落调节是维持血管内稳态的关键步骤。脱落的 MP,特别是那些来自血小板的 MP,可以被视为增加催化促凝表面的一种方式,这依赖于 PS 的存在以实现最佳止血反应。Scott 综合征是一种罕见的出血性疾病,其 PS 暴露和 MP 脱落均缺乏,这表明“翻转”是否是 MP 释放的必要条件。PS 暴露是由涉及半胱天冬酶的特定细胞骨架降解途径引起的,该途径受线粒体通透性变化的调节,需要细胞内钙离子持续增加。PS 暴露中跨膜离子转运或瞬时跨膜孔的实际作用仍有待更牢固的确立。考虑到过量的血浆膜促凝活性与血栓形成风险增加相关,因此鉴定 PS 暴露和 MP 释放的效应物似乎是血栓形成研究和靶向药物设计中的相关目标。在这种情况下,Scott 综合征的动物模型应该对鉴定导致相关缺陷的遗传特征具有重要意义,这将为 PS 暴露和随后的 MP 释放提供重要线索,以实现对其的控制。