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Patrolling the vascular borders: platelets in immunity to infection and cancer

Abstract

Platelets are small anucleate cellular fragments that are released by megakaryocytes and safeguard vascular integrity through a process termed ‘haemostasis’. However, platelets have important roles beyond haemostasis as they contribute to the initiation and coordination of intravascular immune responses. They continuously monitor blood vessel integrity and tightly coordinate vascular trafficking and functions of multiple cell types. In this way platelets act as ‘patrolling officers of the vascular highway’ that help to establish effective immune responses to infections and cancer. Here we discuss the distinct biological features of platelets that allow them to shape immune responses to pathogens and tumour cells, highlighting the parallels between these responses.

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Fig. 1: Disturbance of platelet homeostasis in cancer and infectious diseases.
Fig. 2: Platelet–endothelial cell interaction during infection and cancer.
Fig. 3: Platelet interaction with invasive pathogens and cancer cells.
Fig. 4: Platelets coordinate leukocyte trafficking across vessel walls and modulate leukocyte functions.

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Acknowledgements

This study was supported by SFB914 (S.M.), SFB1123 (S.M.), SFB1312 (S.M.) and the Deutsches Zentrum für Herz-Kreislaufforschung (S.M. and F.G.). F.G. received funding from the European Union’s Horizon 2020 research and innovation programme under Marie Skłodowska-Curie grant agreement no. 747687.

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Nature Reviews Immunology thanks E. Josefsson and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Glossary

Coelomic circulation

The circulatory system of the main body cavity.

Haemolymph

Fluid that circulates in the interior of the arthropod body that is analogous to the blood in vertebrates.

Thrombopoietin

(TPO). A glycoprotein hormone produced by the liver and kidney. TPO binds to and activates TPO receptor (CD110) on haematopoietic stem and progenitor cells, which is necessary for megakaryocyte proliferation and maturation.

Ticagrelor

A reversible inhibitor of the ADP receptor subtype P2Y12 used to treat patients with acute coronary syndromes.

P2Y12

A subtype of the platelet ADP receptor family that triggers strong platelet activation.

Neutrophil extracellular traps

Web-like structures consisting of extracellular DNA strands decorated with antimicrobial proteins such as histones and neutrophil proteases.

Factor XIII

A transglutaminase that crosslinks and stabilizes the fibrin meshwork

Clopidogrel

An irreversible inhibitor of the platelet ADP receptor subtype P2Y12 used clinically to prevent thrombotic events in patients receiving percutaneous coronary intervention for coronary atherosclerosis.

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Gaertner, F., Massberg, S. Patrolling the vascular borders: platelets in immunity to infection and cancer. Nat Rev Immunol 19, 747–760 (2019). https://doi.org/10.1038/s41577-019-0202-z

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