Role of platelet plasma membrane Ca-ATPase in health and disease.

Platelets have essential roles in both health and disease. Normal platelet function is required for hemostasis. Inhibition of platelet function in disease or by pharmacological treatment results in bleeding disorders. On the other hand, hyperactive platelets lead to heart attack and stroke. Calcium is a major second messenger in platelet activation, and elevated intracellular calcium leads to hyperactive platelets. Elevated platelet calcium has been documented in hypertension and diabetes; both conditions increase the likelihood of heart attack and stroke. Thus, proper regulation of calcium metabolism in the platelet is extremely important. Plasma membrane Ca(2+)-ATPase (PMCA) is a major player in platelet calcium metabolism since it provides the only significant route for calcium efflux. In keeping with the important role of calcium in platelet function, PMCA is a highly regulated transporter. In human platelets, PMCA is activated by Ca(2+)/calmodulin, by cAMP-dependent phosphorylation and by calpain-dependent removal of the inhibitory peptide. It is inhibited by tyrosine phosphorylation and calpain-dependent proteolysis. In addition, the cellular location of PMCA is regulated by a PDZ-domain-dependent interaction with the cytoskeleton during platelet activation. Rapid regulation by phosphorylation results in changes in the rate of platelet activation, whereas calpain-dependent proteolysis and interaction with the cytoskeleton appears to regulate later events such as clot retraction. In hypertension and diabetes, PMCA expression is upregulated while activity is decreased, presumably due to tyrosine phosphorylation. Clearly, a more complete understanding of PMCA function in human platelets could result in the identification of new ways to control platelet function in disease states.