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Molecular defects of the platelet P2 receptors

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Human platelets express three types of P2 receptors, which play important roles in platelet function: P2X1, P2Y1 and P2Y12. Only patients with either quantitative or qualitative abnormalities of the platelet P2Y12 receptor have been well-characterized so far. Deficiencies of P2Y12 are associated with nucleotide deletions in the open-reading frame, frameshifts, and early truncation of the protein, or with a nucleotide substitution in the transduction initiation codon. Congenital dysfunctions of P2Y12 are associated with molecular defects involving the sixth trans-membrane domain or the adjacent third extracellular loop of the receptor, which identify a region of the protein whose integrity is necessary for normal receptor function. A mutation, predicting a lysine to glutamate (Lys174Glu) substitution was associated with decreased ligand binding to the receptor, suggesting that it is responsible for disruption of the adenosine diphosphate (ADP)-binding site of the receptor. Patients with P2Y12 defects display a mild-to-moderate bleeding diathesis, characterized by mucocutaneous bleedings and excessive post-surgical and post-traumatic blood loss. Defects of P2Y12 should be suspected when ADP, even at high concentrations (≥10 μM), is unable to induce full, irreversible platelet aggregation. Tests that evaluate the degree of inhibition of adenylyl cyclase by ADP should be used to confirm the diagnosis.

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Correspondence to Marco Cattaneo.

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Cattaneo, M. Molecular defects of the platelet P2 receptors. Purinergic Signalling 7, 333–339 (2011). https://doi.org/10.1007/s11302-011-9217-z

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  • Platelets
  • P2Y12
  • P2 receptors
  • Adenosine diphosphate
  • Platelet function disorders
  • Platelet physiology