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Platelets in Ischemic Stroke

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Molecular and Cellular Biology of Platelet Formation

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Abstract

Ischemic stroke is among the leading causes of mortality and permanent disability worldwide. Treatment approaches in acute stroke patients aim at rapid recanalization of occluded extra- and intracranial vessels. However, progressive stroke can still develop in patients despite successful recanalization, a process termed “reperfusion injury”. It has long been recognized that pathological platelet activity essentially contributes to initiation and progression of ischemic stroke. However, the exact mechanisms and signaling pathways governing the detrimental effects of platelets in reperfusion injury have remained elusive. This chapter summarizes recent experimental data which have revealed that the pathophysiology of ischemic stroke critically depends on the activity of the von Willebrand factor receptor glycoprotein (GP)Ib and the major collagen receptor GPVI which are both involved in early platelet adhesion and activation. By contrast, interference with GPIIb/IIIa-dependent platelet aggregation and thrombus formation does not improve the outcome of acute brain ischemia and dramatically increases the susceptibility to intracranial hemorrhage. Furthermore, this chapter focuses on recent experimental data documenting a complex cascade of pathological events, involving interactions between platelets, immune cells, endothelial cells and the contact activation system in ischemic stroke progression. The potential translational impact of several key findings is briefly discussed.

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Acknowledgments

Prof. Dr. Bernhard Nieswandt holds the Chair of Experimental Biomedicine at the University Hospital and the Rudolf Virchow Center, University of Würzburg, Germany. This work was supported by the Deutsche Forschungsgemeinschaft (SFB 688) and the Rudolf Virchow Center. Dr. Deya Cherpokova was supported by a grant of the German Excellence Initiative to the Graduate School of Life Sciences, University of Würzburg. The authors thank Prof. Dr. Guido Stoll and Prof. Dr. Christoph Kleinschnitz for continuous support and long-standing collaboration.

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  1. Department of Experimental Biomedicine, University of Würzburg, University Hospital and Rudolf Virchow Center, Wurzburg, Germany

    Deya Cherpokova & Bernhard Nieswandt

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  2. Bernhard Nieswandt
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Correspondence to Deya Cherpokova .

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  1. Institute of Experimental Biomedicine I, University Hospital Würzburg, Würzburg, Germany

    Harald Schulze

  2. Vascular Biology Programm, Harvard Medical School, Boston, Massachusetts, USA

    Joseph Italiano

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Cherpokova, D., Nieswandt, B. (2016). Platelets in Ischemic Stroke. In: Schulze, H., Italiano, J. (eds) Molecular and Cellular Biology of Platelet Formation. Springer, Cham. https://doi.org/10.1007/978-3-319-39562-3_13

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