PLATELET ADHESION

Adhesion of blood platelets to an injured vessel wall is the first and crucial step in the haemostatic process. Plug formation only occurs when platelets first adhere to the subendothelium or to connective tissue components. Platelet adhesion is also the first step in the development of a thrombus when subendothelial structures are exposed to the circulation after a superficial injury of the vessel wall, e.g. after a rupture of an atherosclerotic plaque. The clinical outcome of atherosclerotic disease is determined by occlusion of blood vessels by thrombi growing on such a disrupted atherosclerotic lesion. Platelet adhesion is strongly dependent on the flow rate of the blood. Knowledge of the factors determining platelet adhesion was therefore greatly enhanced by the development of perfusion systems enabling the study of platelet adhesion from flowing blood in vitro. The introduction of the annular perfusion chamber by Baumgartner & Haudenschildt (1 9 72) made it possible to study the influence of plasma components, platelet membrane glycoproteins, red blood cells and the shear rate of the blood on platelet adhesion to the subendothelium of blood vessels. The development of a flat perfusion chamber (Sakariassen et al. 1983: Sixma et al. 1987) also made it possible to study isolated purified subendothelial proteins and isolated cultured vessel wall cells. In this annotation we will discuss the most recent knowledge about the factors influencing the adhesion of platelets to vessel wall components.

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