Inhibition of ADP-induced P-selectin Expression and Platelet-Leukocyte Conjugate Formation by Clopidogrel and the P2Y12 Receptor Antagonist AR-C69931MX but not Aspirin

Summary Platelet-leukocyte interactions are recognised to have pro-inflammatory effects, which may be important in the pathophysiology of ischaemic heart disease. Clopidogrel and the novel intravenous antithrombotic agent AR-C69931MX act at the level of the platelet P2Y12 receptor, which is known to amplify platelet activation, aggregation and other responses induced by numerous platelet agonists. We studied the effects of clopidogrel and aspirin on ADP-induced platelet-leukocyte conjugate formation and P-selectin expression in healthy volunteers. The effects of clopidogrel and AR-C69931MX administered to patients with ischaemic heart disease were also assessed. AR-C69931MX and aspirin were also studied in vitro. Clopidogrel and AR-C69931MX suppressed ADP-induced platelet aggregation, P-selectin expression and platelet-leukocyte conjugate formation whereas aspirin had no inhibitory effect. These effects of clopidogrel and AR-C69931MX may confer therapeutic benefits in the management of acute coronary syndromes.

[1]  J. Herbert,et al.  P2Y12, A New Platelet ADP Receptor, Target of Clopidogrel , 2003, Seminars in vascular medicine.

[2]  B. Furie,et al.  A Journey with Platelet P-Selectin: The Molecular Basis of Granule Secretion, Signalling and Cell Adhesion , 2001, Thrombosis and Haemostasis.

[3]  C. Gachet ADP Receptors of Platelets and their Inhibition , 2001, Thrombosis and Haemostasis.

[4]  R. Wilcox,et al.  Open Multicentre Study of the P 2T Receptor Antagonist AR-C69931MX Assessing Safety, Tolerability and Activity in Patients with Acute Coronary Syndromes , 2001, Thrombosis and Haemostasis.

[5]  David Julius,et al.  Identification of the platelet ADP receptor targeted by antithrombotic drugs , 2001, Nature.

[6]  R. Storey The P2Y 12 receptor as a therapeutic target in cardiovascular disease , 2001, Platelets.

[7]  R. Storey,et al.  The central role of the P2T receptor in amplification of human platelet activation, aggregation, secretion and procoagulant activity , 2000, British journal of haematology.

[8]  M. Bertrand,et al.  Double-blind study of the safety of clopidogrel with and without a loading dose in combination with aspirin compared with ticlopidine in combination with aspirin after coronary stenting : the clopidogrel aspirin stent international cooperative study (CLASSICS). , 2000, Circulation.

[9]  B. Payrastre,et al.  A key role of adenosine diphosphate in the irreversible platelet aggregation induced by the PAR1-activating peptide through the late activation of phosphoinositide 3-kinase. , 1999, Blood.

[10]  S. Kunapuli,et al.  Molecular Mechanism of Thromboxane A2-induced Platelet Aggregation , 1999, The Journal of Biological Chemistry.

[11]  A. Bailey,et al.  Antagonists of the platelet P2T receptor: a novel approach to antithrombotic therapy. , 1999, Journal of medicinal chemistry.

[12]  L. Koenderman,et al.  P‐selectin and MAC‐1 mediate monocyte rolling and adhesion to ECM‐bound platelets under flow conditions , 1998, Journal of leukocyte biology.

[13]  A. M. Lefer,et al.  Synergism between platelets and neutrophils in provoking cardiac dysfunction after ischemia and reperfusion: role of selectins. , 1998, Circulation.

[14]  David Schultz,et al.  A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE) , 1996, The Lancet.

[15]  D. Waters,et al.  The inflammatory etiology of unstable angina. , 1996, American heart journal.

[16]  A. Weyrich,et al.  Activated platelets signal chemokine synthesis by human monocytes. , 1996, The Journal of clinical investigation.

[17]  M. Vadas,et al.  P-selectin interacts with a beta 2-integrin to enhance phagocytosis. , 1994, Journal of immunology.

[18]  G. Pellegrini,et al.  P-selectin induces the expression of tissue factor on monocytes. , 1994, Proceedings of the National Academy of Sciences of the United States of America.

[19]  C. Benjamin,et al.  Leukocyte accumulation promoting fibrin deposition is mediated in vivo by P-selectin on adherent platelets , 1992, Nature.

[20]  B. Smith,et al.  Activated and unactivated platelet adhesion to monocytes and neutrophils. , 1991, Blood.

[21]  J. Kaplan,et al.  Platelet Modulation of Neutrophil Superoxide Anion Production , 1990, Thrombosis and Haemostasis.

[22]  R. McEver,et al.  GMP-140 mediates adhesion of stimulated platelets to neutrophils. , 1990, Blood.

[23]  D. Wagner,et al.  PADGEM protein: A receptor that mediates the interaction of activated platelets with neutrophils and monocytes , 1989, Cell.

[24]  M. Kazatchkine,et al.  Platelet‐dependent induction and amplification of polymorphonuclear leucocyte lysosomal enzyme release , 1989, British journal of haematology.

[25]  J. Hauert,et al.  Clopidogrel loading dose regimens: kinetic profile of pharmacodynamic response in healthy subjects. , 1999, Seminars in thrombosis and hemostasis.

[26]  S. P. Kunapuli Functional characterization of platelet ADP receptors. , 1998, Platelets.

[27]  I. Feuerstein,et al.  Role of P-selectin and leukocyte activation in polymorphonuclear cell adhesion to surface adherent activated platelets under physiologic shear conditions (an injury vessel wall model). , 1994, Blood.

[28]  K. Schrör The basic pharmacology of ticlopidine and clopidogrel. , 1993, Platelets.

[29]  B. Smith,et al.  Aspirin does not inhibit adenosine diphosphate-induced platelet alpha-granule release. , 1993, Blood.