Alterations in platelet behavior after major trauma: adaptive or maladaptive?
Platelets are damage sentinels of the intravascular compartment, initiating and coordinating the primary response to tissue injury. Severe trauma and hemorrhage induce profound alterations in platelet behavior. During the acute post-injury phase, platelets develop a state of impaired ex vivo agonist...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-04-01
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| Series: | Platelets |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/09537104.2020.1718633 |
| _version_ | 1797684208210018304 |
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| author | Paul Vulliamy Lucy Z. Kornblith Matthew E. Kutcher Mitchell J. Cohen Karim Brohi Matthew D. Neal |
| author_facet | Paul Vulliamy Lucy Z. Kornblith Matthew E. Kutcher Mitchell J. Cohen Karim Brohi Matthew D. Neal |
| author_sort | Paul Vulliamy |
| collection | DOAJ |
| description | Platelets are damage sentinels of the intravascular compartment, initiating and coordinating the primary response to tissue injury. Severe trauma and hemorrhage induce profound alterations in platelet behavior. During the acute post-injury phase, platelets develop a state of impaired ex vivo agonist responsiveness independent of platelet count, associated with systemic coagulopathy and mortality risk. In patients surviving the initial insult, platelets become hyper-responsive, associated with increased risk of thrombotic events. Beyond coagulation, platelets constitute part of a sterile inflammatory response to injury: both directly through release of immunomodulatory molecules, and indirectly through modifying behavior of innate leukocytes. Both procoagulant and proinflammatory aspects have implications for secondary organ injury and multiple-organ dysfunction syndromes. This review details our current understanding of adaptive and maladaptive alterations in platelet biology induced by severe trauma, mechanisms underlying these alterations, potential platelet-focused therapies, and existing knowledge gaps and their research implications. |
| first_indexed | 2024-03-12T00:26:19Z |
| format | Article |
| id | doaj.art-7c67f68c99cc4addac9700161caa9268 |
| institution | Directory Open Access Journal |
| issn | 0953-7104 1369-1635 |
| language | English |
| last_indexed | 2024-03-12T00:26:19Z |
| publishDate | 2021-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Platelets |
| spelling | doaj.art-7c67f68c99cc4addac9700161caa92682023-09-15T10:38:07ZengTaylor & Francis GroupPlatelets0953-71041369-16352021-04-0132329530410.1080/09537104.2020.17186331718633Alterations in platelet behavior after major trauma: adaptive or maladaptive?Paul Vulliamy0Lucy Z. Kornblith1Matthew E. Kutcher2Mitchell J. Cohen3Karim Brohi4Matthew D. Neal5Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonZuckerberg San Francisco General Hospital and the University of CaliforniaUniversity of Mississippi Medical CenterUniversity of ColoradoBlizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of LondonUniversity of PittsburghPlatelets are damage sentinels of the intravascular compartment, initiating and coordinating the primary response to tissue injury. Severe trauma and hemorrhage induce profound alterations in platelet behavior. During the acute post-injury phase, platelets develop a state of impaired ex vivo agonist responsiveness independent of platelet count, associated with systemic coagulopathy and mortality risk. In patients surviving the initial insult, platelets become hyper-responsive, associated with increased risk of thrombotic events. Beyond coagulation, platelets constitute part of a sterile inflammatory response to injury: both directly through release of immunomodulatory molecules, and indirectly through modifying behavior of innate leukocytes. Both procoagulant and proinflammatory aspects have implications for secondary organ injury and multiple-organ dysfunction syndromes. This review details our current understanding of adaptive and maladaptive alterations in platelet biology induced by severe trauma, mechanisms underlying these alterations, potential platelet-focused therapies, and existing knowledge gaps and their research implications.http://dx.doi.org/10.1080/09537104.2020.1718633coagulopathyhemorrhageimmunothrombosistrauma |
| spellingShingle | Paul Vulliamy Lucy Z. Kornblith Matthew E. Kutcher Mitchell J. Cohen Karim Brohi Matthew D. Neal Alterations in platelet behavior after major trauma: adaptive or maladaptive? Platelets coagulopathy hemorrhage immunothrombosis trauma |
| title | Alterations in platelet behavior after major trauma: adaptive or maladaptive? |
| title_full | Alterations in platelet behavior after major trauma: adaptive or maladaptive? |
| title_fullStr | Alterations in platelet behavior after major trauma: adaptive or maladaptive? |
| title_full_unstemmed | Alterations in platelet behavior after major trauma: adaptive or maladaptive? |
| title_short | Alterations in platelet behavior after major trauma: adaptive or maladaptive? |
| title_sort | alterations in platelet behavior after major trauma adaptive or maladaptive |
| topic | coagulopathy hemorrhage immunothrombosis trauma |
| url | http://dx.doi.org/10.1080/09537104.2020.1718633 |
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