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Blood. 2019 Aug 29;134(9):727-740. doi: 10.1182/blood.2019000200. Epub 2019 Jul 16.

TNF-α-driven inflammation and mitochondrial dysfunction define the platelet hyperreactivity of aging.

Author information

1
Center for Cancer and Blood Disorders, Department of Pediatrics and.
2
Division of Hematology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.
3
Irish Center for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland.
4
Department of Mechanical Engineering, Colorado State University, Fort Collins, CO.
5
Cardiovascular Pulmonary Research Laboratory, Department of Pediatrics and.
6
Cardiovascular Pulmonary Research Laboratory, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.
7
Molecular Medicine Program and.
8
Department of Internal Medicine, University of Utah, Salt Lake City, UT.
9
Department of Biochemistry and Molecular Genetics and.
10
Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO.
11
Department of Internal Medicine, University of Washington, Seattle, WA.
12
Division of Geriatrics, University of Utah, Salt Lake City, UT.
13
Geriatric Research, Education, and Clinical Center, George E. Wahlen Department of Veterans Affairs Medical Center (VAMC), Salt Lake City, UT.
14
División de Genética, Centro de Investigación Biomédica de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
15
Department of Pathology and Laboratory Medicine, Children's Hospital Colorado, Aurora, CO; and.
16
Department of Pathology, University of Utah, Salt Lake City, UT.

Abstract

Aging and chronic inflammation are independent risk factors for the development of atherothrombosis and cardiovascular disease. We hypothesized that aging-associated inflammation promotes the development of platelet hyperreactivity and increases thrombotic risk during aging. Functional platelet studies in aged-frail adults and old mice demonstrated that their platelets are hyperreactive and form larger thrombi. We identified tumor necrosis factor α (TNF-α) as the key aging-associated proinflammatory cytokine responsible for platelet hyperreactivity. We further showed that platelet hyperreactivity is neutralized by abrogating signaling through TNF-α receptors in vivo in a mouse model of aging. Analysis of the bone marrow compartments showed significant platelet-biased hematopoiesis in old mice reflected by increased megakaryocyte-committed progenitor cells, megakaryocyte ploidy status, and thrombocytosis. Single-cell RNA-sequencing analysis of native mouse megakaryocytes showed significant reprogramming of inflammatory, metabolic, and mitochondrial gene pathways in old mice that appeared to play a significant role in determining platelet hyperreactivity. Platelets from old mice (where TNF-α was endogenously increased) and from young mice exposed to exogenous TNF-α exhibited significant mitochondrial changes characterized by elevated mitochondrial mass and increased oxygen consumption during activation. These mitochondrial changes were mitigated upon TNF-α blockade. Similar increases in platelet mitochondrial mass were seen in platelets from patients with myeloproliferative neoplasms, where TNF-α levels are also increased. Furthermore, metabolomics studies of platelets from young and old mice demonstrated age-dependent metabolic profiles that may differentially poise platelets for activation. Altogether, we present previously unrecognized evidence that TNF-α critically regulates megakaryocytes resident in the bone marrow niche and aging-associated platelet hyperreactivity and thrombosis.

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