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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

Combination of cyclic nucleotide modulators with P2Y(12) receptor antagonists as anti-platelet therapy

Texto completo
Autor(es):
Armstrong, Paul C. [1] ; Ferreira, Plinio M. [1] ; Chan, Melissa V. [1] ; Lundberg Slingsby, Martina H. [1] ; Crescente, Marilena [1] ; Shih, Chih-Chin [1] ; Kirkby, Nicholas S. [2] ; Hobbs, Adrian J. [3] ; Warner, Timothy D. [1]
Número total de Autores: 9
Afiliação do(s) autor(es):
[1] Queen Mary Univ London, Blizard Inst, Barts & London Sch Med & Dent, 4 Newark St, London E1 2AT - England
[2] Imperial Coll London, Natl Heart & Lung Inst, Cardiothorac Pharmacol, London - England
[3] Queen Mary Univ London, William Harvey Res Inst, Barts & London Sch Med & Dent, London - England
Número total de Afiliações: 3
Tipo de documento: Artigo Científico
Fonte: Journal of Thrombosis and Haemostasis; v. 18, n. 7 MAY 2020.
Citações Web of Science: 0
Resumo

Background Endothelium-derived prostacyclin and nitric oxide elevate platelet cyclic nucleotide levels and maintain quiescence. We previously demonstrated that a synergistic relationship exists between cyclic nucleotides and P2Y(12) receptor inhibition. A number of clinically approved drug classes can modulate cyclic nucleotide tone in platelets including activators of NO-sensitive guanylyl cyclase (GC) and phosphodiesterase (PDE) inhibitors. However, the doses required to inhibit platelets produce numerous side effects including headache. Objective We investigated using GC-activators in combination with P2Y(12) receptor antagonists as a way to selectively amplify the anti-thrombotic effect of both drugs. Methods In vitro light transmission aggregation and platelet adhesion under flow were performed on washed platelets and platelet rich plasma. Aggregation in whole blood and a ferric chloride-induced arterial thrombosis model were also performed. Results The GC-activator BAY-70 potentiated the action of the P2Y(12) receptor inhibitor prasugrel active metabolite in aggregation and adhesion studies and was associated with raised intra-platelet cyclic nucleotide levels. Furthermore, mice administered sub-maximal doses of the GC activator cinaciguat together with the PDE inhibitor dipyridamole and prasugrel, showed significant inhibition of ex vivo platelet aggregation and significantly reduced in vivo arterial thrombosis in response to injury without alteration in basal carotid artery blood flow. Conclusions Using in vitro, ex vivo, and in vivo functional studies, we show that low dose GC activators synergize with P2Y(12) inhibition to produce powerful anti-platelet effects without altering blood flow. Therefore, modulation of intra-platelet cyclic nucleotide levels alongside P2Y(12) inhibition can provide a strong, focused anti-thrombotic regimen while minimizing vasodilator side effects. (AU)

Processo FAPESP: 14/04478-5 - Interações de subpopulações plaquetárias e a sua relevância para a terapia antiplaquetária
Beneficiário:Plinio Minghin Freitas Ferreira
Modalidade de apoio: Bolsas no Exterior - Estágio de Pesquisa - Doutorado Direto