Division of Hematology, Brigham and Women's Hospital and Department of Medicine, Harvard Medical School, Harvard Institutes of Medicine, Boston, Massachusetts, USA.
Curr Opin Hematol. 2018 Sep;25(5):410-415. doi: 10.1097/MOH.0000000000000451.
Platelets are small, anucleate cells that circulate within the blood and play essential roles in preserving vascular integrity. However, abnormalities in either platelet production or destruction can result in thrombocytopenia, clinically defined by a platelet count lower than 150 000/μL of whole blood. Thrombocytopenia is frequently associated with impaired hemostatic responses to vascular injury and can be life-threatening because of bleeding complications. Megakaryocytes are the precursor cells responsible for platelet production, a process commonly referred to as thrombopoiesis. This review specifically discusses how perturbation of molecular mechanisms governing megakaryocyte differentiation and development manifest in various forms of thrombocytopenia.
This review highlights the identification of novel transcriptional regulators of megakaryocyte maturation and platelet production. We also provide an update into the essential role of cytoskeletal regulation in thrombopoiesis, and how both megakaryopoiesis and platelet production are altered by anticancer therapeutics. Lastly, we focus on recent investigative approaches to treat thrombocytopenia and discuss future prospects in the field of megakaryocyte research.
In patients where thrombocytopenia is not due to heightened platelet destruction or clearance, defects in megakaryocyte development should be considered.
血小板是一种循环于血液中的无核小细胞，在维持血管完整性方面发挥着重要作用。然而，血小板的生成或破坏异常可导致血小板减少症，临床上定义为全血血小板计数低于 150000/μL。血小板减少症常伴有血管损伤后止血反应受损，且可能因出血并发症而危及生命。巨核细胞是负责血小板生成的前体细胞，这一过程通常被称为血小板生成。本篇综述专门讨论了调控巨核细胞分化和发育的分子机制异常在各种形式的血小板减少症中的表现。
本综述强调了鉴定巨核细胞成熟和血小板生成的新型转录调控因子。我们还更新了细胞骨架调节在血小板生成中的重要作用，以及抗癌治疗如何改变巨核细胞生成和血小板生成。最后，我们关注治疗血小板减少症的最新研究方法，并讨论巨核细胞研究领域的未来前景。
在血小板减少症不是由于血小板破坏或清除增加引起的患者中，应考虑巨核细胞发育缺陷。
