Vogel Sebastian, Bodenstein Rebecca, Chen Qiwei, Feil Susanne, Feil Robert, Rheinlaender Johannes, Schäffer Tilman E, Bohn Erwin, Frick Julia-Stefanie, Borst Oliver, Münzer Patrick, Walker Britta, Markel Justin, Csanyi Gabor, Pagano Patrick J, Loughran Patricia, Jessup Morgan E, Watkins Simon C, Bullock Grant C, Sperry Jason L, Zuckerbraun Brian S, Billiar Timothy R, Lotze Michael T, Gawaz Meinrad, Neal Matthew D
J Clin Invest. 2015 Dec;125(12):4638-54. doi: 10.1172/JCI81660. Epub 2015 Nov 9.
Thrombosis and inflammation are intricately linked in several major clinical disorders, including disseminated intravascular coagulation and acute ischemic events. The damage-associated molecular pattern molecule high-mobility group box 1 (HMGB1) is upregulated by activated platelets in multiple inflammatory diseases; however, the contribution of platelet-derived HMGB1 in thrombosis remains unexplored. Here, we generated transgenic mice with platelet-specific ablation of HMGB1 and determined that platelet-derived HMGB1 is a critical mediator of thrombosis. Mice lacking HMGB1 in platelets exhibited increased bleeding times as well as reduced thrombus formation, platelet aggregation, inflammation, and organ damage during experimental trauma/hemorrhagic shock. Platelets were the major source of HMGB1 within thrombi. In trauma patients, HMGB1 expression on the surface of circulating platelets was markedly upregulated. Moreover, evaluation of isolated platelets revealed that HMGB1 is critical for regulating platelet activation, granule secretion, adhesion, and spreading. These effects were mediated via TLR4- and MyD88-dependent recruitment of platelet guanylyl cyclase (GC) toward the plasma membrane, followed by MyD88/GC complex formation and activation of the cGMP-dependent protein kinase I (cGKI). Thus, we establish platelet-derived HMGB1 as an important mediator of thrombosis and identify a HMGB1-driven link between MyD88 and GC/cGKI in platelets. Additionally, these findings suggest a potential therapeutic target for patients sustaining trauma and other inflammatory disorders associated with abnormal coagulation.
血栓形成与炎症在几种主要临床疾病中紧密相连,包括弥散性血管内凝血和急性缺血性事件。损伤相关分子模式分子高迁移率族蛋白B1(HMGB1)在多种炎症性疾病中被活化的血小板上调;然而,血小板衍生的HMGB1在血栓形成中的作用仍未被探索。在此,我们构建了血小板特异性敲除HMGB1的转基因小鼠,并确定血小板衍生的HMGB1是血栓形成的关键介质。血小板中缺乏HMGB1的小鼠在实验性创伤/失血性休克期间出血时间延长,血栓形成、血小板聚集、炎症和器官损伤减少。血小板是血栓内HMGB1的主要来源。在创伤患者中,循环血小板表面的HMGB1表达明显上调。此外,对分离血小板的评估显示,HMGB1对调节血小板活化、颗粒分泌、黏附至关重要。这些作用是通过TLR4和MyD88依赖的血小板鸟苷酸环化酶(GC)向质膜募集介导的,随后形成MyD88/GC复合物并激活环鸟苷酸依赖性蛋白激酶I(cGKI)。因此,我们确立了血小板衍生的HMGB1作为血栓形成的重要介质,并确定了血小板中MyD88与GC/cGKI之间由HMGB1驱动的联系。此外,这些发现提示了创伤患者以及其他与异常凝血相关的炎症性疾病患者潜在的治疗靶点。