Page Martin J, Pretorius Etheresia
Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, Private Bag X1 Matieland, South Africa.
Semin Thromb Hemost. 2022 Apr;48(3):382-404. doi: 10.1055/s-0041-1733960. Epub 2021 Oct 8.
The functions of platelets are broad. Platelets function in hemostasis and thrombosis, inflammation and immune responses, vascular regulation, and host defense against invading pathogens, among others. These actions are achieved through the release of a wide set of coagulative, vascular, inflammatory, and other factors as well as diverse cell surface receptors involved in the same activities. As active participants in these physiological processes, platelets become involved in signaling pathways and pathological reactions that contribute to diseases that are defined by inflammation (including by pathogen-derived stimuli), vascular dysfunction, and coagulation. These diseases include Alzheimer's and Parkinson's disease, the two most common neurodegenerative diseases. Despite their unique pathological and clinical features, significant shared pathological processes exist between these two conditions, particularly relating to a central inflammatory mechanism involving both neuroinflammation and inflammation in the systemic environment, but also neurovascular dysfunction and coagulopathy, processes which also share initiation factors and receptors. This triad of dysfunction-(neuro)inflammation, neurovascular dysfunction, and hypercoagulation-illustrates the important roles platelets play in neuropathology. Although some mechanisms are understudied in Alzheimer's and Parkinson's disease, a strong case can be made for the relevance of platelets in neurodegeneration-related processes.
血小板的功能广泛。血小板在止血和血栓形成、炎症和免疫反应、血管调节以及宿主抵御入侵病原体等方面发挥作用。这些作用是通过释放一系列凝血、血管、炎症和其他因子以及参与相同活动的多种细胞表面受体来实现的。作为这些生理过程的积极参与者,血小板参与信号通路和病理反应,这些反应会导致由炎症(包括病原体衍生刺激引起的炎症)、血管功能障碍和凝血所定义的疾病。这些疾病包括阿尔茨海默病和帕金森病,这两种最常见的神经退行性疾病。尽管它们具有独特的病理和临床特征,但这两种病症之间存在显著的共同病理过程,特别是涉及神经炎症和全身环境炎症的中枢炎症机制,以及神经血管功能障碍和凝血病,这些过程也共享起始因子和受体。这种功能障碍三联征——(神经)炎症、神经血管功能障碍和高凝状态——说明了血小板在神经病理学中的重要作用。尽管在阿尔茨海默病和帕金森病中,一些机制尚未得到充分研究,但有充分理由认为血小板与神经退行性相关过程有关。