Shaun P. Jackson, Australian Centre for Blood Diseases, Alfred Medical Research and Education Precinct (AMREP), 6th level Burnet Tower, 89 Commercial Rd, Melbourne, Victoria 3004, Australia, Tel.: +613 9903 0131, Fax: +613 9903 0228, E-mail:
Thromb Haemost. 2013 Nov;110(5):859-67. doi: 10.1160/TH13-05-0379. Epub 2013 Aug 15.
The central role of platelets in the formation of the primary haemostatic plug as well as in the development of arterial thrombosis is well defined. In general, the molecular events underpinning these processes are broadly similar. Whilst it has long been known that disturbances in blood flow, changes in platelet reactivity and enhanced coagulation reactions facilitate pathological thrombus formation, the precise details underlying these events remain incompletely understood. Intravital microscopy studies have highlighted the dynamic and heterogeneous nature of thrombus development and demonstrated that there are considerable spatiotemporal differences in the activation states of platelets within a forming thrombus. In this review we will consider the factors regulating the activation state of platelets in a developing thrombus and discuss how specific prothrombotic factors may influence this process, leading to excessive thrombus propagation. We will also discuss some potentially novel therapeutic approaches that may reduce excess thrombus development whilst minimising bleeding risk.
血小板在初级止血塞形成以及动脉血栓形成中的核心作用已得到明确界定。一般来说，这些过程的基础分子事件非常相似。尽管人们早就知道血流紊乱、血小板反应性改变和增强的凝血反应会促进病理性血栓形成，但这些事件背后的确切细节仍不完全清楚。活体显微镜研究强调了血栓形成的动态和异质性，并表明在形成中的血栓中，血小板的激活状态存在相当大的时空差异。在这篇综述中，我们将考虑调节形成中的血栓中血小板激活状态的因素，并讨论特定的促血栓形成因子如何影响这一过程，导致过度的血栓增殖。我们还将讨论一些潜在的新的治疗方法，这些方法可以在减少出血风险的同时减少过度的血栓形成。
