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Laboratory Markers of Platelet Production and Turnover

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Abstract

Platelets are formed from bone marrow megakaryocytes, circulate in blood for 7-10 days, and then are destroyed in the spleen and/or liver. Platelet production depends on the megakaryocyte population state in the bone marrow: number and size of the cells. The platelet turnover, i.e., the number of platelets passing through the bloodstream in a certain time, is determined by both the rate of their production and the rate of their destruction. The review considers laboratory markers, which are used to assess platelet production and turnover in the patients with hematologic and cardiovascular pathologies. These markers include some characteristics of platelets themselves: (i) content of reticulated (“young”) forms in the blood detected by their staining with RNA dyes; (ii) indicators of the platelet size determined in hematology analyzers (mean volume, percentage of large forms) and in flow cytometers (light scattering level). Alterations of platelet production and turnover lead to the changes in blood plasma concentrations of such molecules as thrombopoietin (TPO, main mediator of megakaryocyte maturation and platelet formation in the bone marrow) and glycocalicin (soluble fragment of the membrane glycoprotein Ib detached from the surface of platelets during their destruction). Specific changes in the markers of platelet production and turnover have been observed in: (i) hypoproductive thrombocytopenias caused by suppression of megakaryocytes in the bone marrow; (ii) immune thrombocytopenias caused by accelerated clearance of the autoantibody-sensitized platelets; and (iii) thrombocytosis (both primary and reactive). The paper presents the data indicating that in patients with cardiovascular diseases an increased platelet turnover and changes in the corresponding markers (platelet size indexes and content of reticulated forms) are associated with the decreased efficacy of antiplatelet drugs and increased risk of thrombotic events, myocardial infarction, and unstable angina (acute coronary syndrome).

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Abbreviations

ACS:

acute coronary syndrome

CAD:

coronary artery disease

FSC:

forward scattering

GP:

glycoprotein

ITP:

immune thrombocytopenia

LCR:

platelet large cell ratio

MPV:

mean platelet volume

PDW:

platelet distribution width

P-RPs:

reticulated platelets

TPO:

thrombopoietin

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Funding

The work was financially supported by the Russian Science Foundation (project no. 22-15-00005).

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  1. Chazov National Medical Research Center of Cardiology, Ministry of Health of the Russian Federation, 121552, Moscow, Russia

    Valeria V. Bodrova, Olga N. Shustova, Svetlana G. Khaspekova & Alexey V. Mazurov

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  1. Valeria V. Bodrova
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  2. Olga N. Shustova
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V.V.B. – tables, text; O.N.S. – figures, text; S.G.K. – design, text; A.V.M. – idea, design, text. All authors were also involved in the analysis of cited literature.

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Correspondence to Alexey V. Mazurov.

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The authors declare no conflicts of interest in financial or any other sphere. This article does not contain any studies involving human participants or animals performed by any of the authors.

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Translated from Uspekhi Biologicheskoi Khimii, 2023, Vol. 63, pp. 79-102.

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Bodrova, V.V., Shustova, O.N., Khaspekova, S.G. et al. Laboratory Markers of Platelet Production and Turnover. Biochemistry Moscow 88 (Suppl 1), S39–S51 (2023). https://doi.org/10.1134/S0006297923140031

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