ArticleJournal of thrombosis and haemostasis : JTH2013
Mechanisms of hemolysis-associated platelet activation.
Article in Journal of thrombosis and haemostasis : JTH, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 1 of them a synthesis that pooled it.
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83 citing papers in PubMed, 1 synthesis or guideline pooled it, 182 citations in OpenAlex.
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- Novel compound heterozygousFrontiers in oncology · 2025Article
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- Differential Effects of Erythropoietin Administration and Overexpression on Venous Thrombosis in Mice.Thrombosis and haemostasis · 2024Article
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- Article
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundIntravascular hemolysis occurs after blood transfusion, in hemolytic anemias, and in other conditions, and is associated with hypercoagulable states. Hemolysis has been shown to potently activate platelets in vitro and in vivo, and several mechanisms have been suggested to account for this, including: (i) direct activation by hemoglobin (Hb); (ii) increase in reactive oxygen species (ROS); (iii) scavenging of nitric oxide (NO) by released Hb; and (iv) release of intraerythrocytic ADP.
objectiveTo elucidate the mechanism of hemolysis-mediated platelet activation.
methodsWe used flow cytometry to detect PAC-1 binding to activated platelets for in vitro experiments, and a Siemens' Advia 120 hematology system to assess platelet aggregation by using platelet counts from in vivo experiments in a rodent model.
resultsWe found that Hb did not directly activate platelets. However, ADP bound to Hb could cause platelet activation. Furthermore, platelet activation caused by shearing of red blood cells (RBCs) was reduced in the presence of apyrase, which metabolizes ADP to AMP. The use of ROS scavengers did not affect platelet activation. We also found that cell-free Hb enhanced platelet activation by abrogating the inhibitory effect of NO on platelet activation. In vivo infusions of ADP and purified (ADP-free) Hb, as well as hemolysate, resulted in platelet aggregation, as shown by decreased platelet counts.
conclusionTwo primary mechanisms account for RBC hemolysis-associated platelet activation: ADP release, which activates platelets; and cell-free Hb release, which enhances platelet activation by lowering NO bioavailability.
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