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Arterioscler Thromb Vasc Biol. 2009 Apr;29(4):449-57. doi: 10.1161/ATVBAHA.108.176388. Epub 2008 Nov 20.

G-protein-coupled receptors as signaling targets for antiplatelet therapy.

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1
Veterans Affairs Medical Center, Department of Medicine, Physiology, and Pharmacology, University of Kentucky, Lexington, KY, USA. susansmyth@uky.edu

Abstract

Platelet G protein-coupled receptors (GPCRs) initiate and reinforce platelet activation and thrombus formation. The clinical utility of antagonists of the P2Y(12) receptor for ADP suggests that other GPCRs and their intracellular signaling pathways may represent viable targets for novel antiplatelet agents. For example, thrombin stimulation of platelets is mediated by 2 protease-activated receptors (PARs), PAR-1 and PAR-4. Signaling downstream of PAR-1 or PAR-4 activates phospholipase C and protein kinase C and causes autoamplification by production of thromboxane A(2), release of ADP, and generation of more thrombin. In addition to ADP receptors, thrombin and thromboxane A(2) receptors and their downstream effectors-including phosphoinositol-3 kinase, Rap1b, talin, and kindlin-are promising targets for new antiplatelet agents. The mechanistic rationale and available clinical data for drugs targeting disruption of these signaling pathways are discussed. The identification and development of new agents directed against specific platelet signaling pathways may offer an advantage in preventing thrombotic events while minimizing bleeding risk.

PMID:
19023091
DOI:
10.1161/ATVBAHA.108.176388
[Indexed for MEDLINE]
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