Platelet-derived microparticles and the potential of glycoprotein IIb/IIIa antagonists in treating acute coronary syndrome.

Platelet glycoprotein IIb/IIIa receptors are major platelet membrane constituents. They are integral to the formation of the surface fibrinogen receptor on activated platelets, in which 73% of platelet-derived microparticles are positive for the glycoprotein IIa/IIIb receptor. Activated platelets can shed platelet-derived microparticles, especially during the course of an acute coronary syndrome. Data have shown that platelet-derived microparticles can bind to the endothelium, to leukocytes, and to the submatrix of vascular walls, and launch some signal-transduction pathways, such as the pertussis-toxin-sensitive G protein, extracellular signal-regulated kinase, and phosphoinositide 3-kinase pathways. One research group found that platelet-derived microparticles transfer glycoprotein IIb/IIIa receptors to isolated and whole-blood neutrophils. The receptors can co-localize with beta(2)-integrins and cooperate in the activation of nuclear factor kappaB (NF-kappaB), which can be inhibited by glycoprotein IIb/IIIa receptor antagonists. Accordingly, it is possible that glycoprotein IIb/IIIa receptor antagonists produce a direct and marked effect on endothelial cells, smooth-muscle cells, and leukocytes through a platelet-derived microparticle pathway that will lead to a potential treatment for acute coronary syndrome.Herein, we review the medical literature and discuss the potential application of platelet-derived microparticles toward the treatment of acute coronary syndrome.