[HTML][HTML] Platelets protect from septic shock by inhibiting macrophage-dependent inflammation via the cyclooxygenase 1 signalling pathway

B Xiang, G Zhang, L Guo, XA Li, AJ Morris… - Nature …, 2013 - nature.com
Nature communications, 2013nature.com
Although it has long been known that patients with sepsis often have thrombocytopenia and
that septic patients with severe thrombocytopenia have a poor prognosis and higher
mortality, the role of platelets in the pathogenesis of sepsis is poorly understood. Here we
report a protective role of platelets in septic shock. We show that experimental
thrombocytopenia induced by intraperitoneal injection of an anti-glycoprotein Ibα
monoclonal antibody increases mortality and aggravates organ failure, whereas transfusion …
Abstract
Although it has long been known that patients with sepsis often have thrombocytopenia and that septic patients with severe thrombocytopenia have a poor prognosis and higher mortality, the role of platelets in the pathogenesis of sepsis is poorly understood. Here we report a protective role of platelets in septic shock. We show that experimental thrombocytopenia induced by intraperitoneal injection of an anti-glycoprotein Ibα monoclonal antibody increases mortality and aggravates organ failure, whereas transfusion of platelets reduces mortality in lipopolysaccharide-induced endotoxemia and a bacterial infusion mouse sepsis model. Plasma concentrations of proinflammatory cytokines TNF-α and IL-6 are elevated by thrombocytopenia and decreased by platelet transfusion in septic mice. Furthermore, we identify that platelets protect from septic shock by inhibiting macrophage-dependent inflammation via the COX1/PGE2/EP4-dependent pathway. Thus, these findings demonstrate a previously unappreciated role for platelets in septic shock and suggest that platelet transfusion may be effective in treating severely septic patients.
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