The present study investigated the role of Aβ in TRAP-induced human platelet activation. It was revealed that 7 µM Aβ markedly suppressed platelet aggregation induced by TRAP, but not collagen or ADP. In addition, the suppressive effect of Aβ on the TRAP-stimulated platelet aggregation was identified only for the platelets pretreated with Aβ for 15 min. Therefore, it is likely that the suppressive effect of Aβ on platelet aggregation is specific to TRAP-stimulated platelets, and that preceding the action of Aβ is required to exert its suppressive effect. It is probable that Aβ could interact with TRAP not extracellularly but directly affect platelets to exert its suppressive effect via a certain binding site on human platelets, although the specific receptor for Aβ has not yet been discovered. In addition, the dosage of 7 µM Aβ appears to be non-toxic, as platelets pretreated with Aβ aggregated when stimulated by ADP or collagen.
Regarding receptors of thrombin, it is well known that human platelets express PAR-1 and PAR-4 as thrombin receptors [17], and TRAP acts as a PAR agonist due to its identical amino acid sequence to the tethered ligand of PARs cleaved by thrombin [19]. Therefore, the present study then examined the effect of Aβ on human platelet aggregation induced by TRAP, SCP0237 or A3227, and revealed that Aβ markedly attenuated human platelet aggregation induced by all of them. It seems that the suppressive effect of Aβ on TRAP-induced platelet aggregation is not specific, but instead equal to PAR-1 and PAR-4, and that Aβ exerts its suppressive effect at a point, at least, downstream from PAR-1 and PAR-4.
It was recently revealed that activated human platelets by TRAP secret PDGF-AB and release phosphorylated-HSP27 into plasma [20]. Therefore, the present study further examined the Aβ effect on the TRAP-induced PDGF-AB secretion and phosphorylated-HSP27 release, and found that Aβ significantly attenuates both PDGF-AB secretion and phosphorylated-HSP27 release induced by TRAP. Therefore, it was suggested that Aβ attenuates TRAP-induced human platelet activation. With regard to the TRAP-activated intracellular signaling pathway, it has previously been reported that TRAP induces the phosphorylation of p38 MAP kinase and JNK. TRAP-induced phosphorylation of p38 MAP kinase, but not JNK, is followed by the phosphorylation of HSP27, leading to subsequent release of phosphorylated-HSP27 into the plasma. The present study revealed that Aβ significantly decreased TRAP-induced phosphorylation of p38 MAP kinase, HSP27 and JNK. Taking these findings into account, it is most likely that Aβ modulates PAR-elicited human platelet activation to reduce at a point at least downstream from PAR-1 and PAR-4 and upstream of p38 MAP kinase and JNK. The potential mechanism underlying the role of Aβ in the TRAP-stimulated human platelet activation is summarized in Fig. 7. To the best of our knowledge, this is the first report to demonstrate the suppressive effect of Aβ in the TRAP-stimulated human platelet activation.
Regarding the relationships between platelet functions and amyloid-related proteins, several studies indicated that Aβ itself promotes platelet aggregation, which is measured by light-transmittance [14,15]. Thus, the present study validated the Aβ-effect on human platelet aggregation using a laser scattering system measuring not only light-transmittance but also distribution of the size of platelet aggregates. In the present study, unlike previous reports, Aβ alone hardly affected the light-transmittance nor distribution of platelet particles. In addition, PDGF-AB, which is secreted from activated platelets, were not detected when platelets were stimulated by Aβ alone. Furthermore, p38 MAP kinase is reportedly involved in Aβ-induced platelet activation [14] but in the present study, Aβ by itself did not induce p38 MAP kinase phosphorylation. Therefore, it is likely that in the present study, Aβ did not initiate platelet activation, which is inconsistent with previous reports [14–16]. On the other hand, the difference in the platelet reactivity, such as the presence of micro-aggregation or not in the population categorized as ‘same’, was previously shown in diabetic patients [27]. Although in the present study, micro-aggregation was not observed and diabetic patients were not included, there is likely to be a difference in the reactivities of platelets among individuals. Therefore, these discrepancies could be caused by the difference in the reactivities of human platelets used in the experiments. In addition, the results of the present study were reproducible, therefore indicating another aspect of Aβ functions in platelet activation.
CAA is characterized by abnormal accumulation of Aβ in the cerebral vessel wall, which causes alterations in vascular functions, leading to hemorrhage and infarction [5,7]. Previous reports have indicated the role of Aβ as a potent stimulator for platelets [14–16], which could partially explain the CAA-related brain infarction. On the other hand, platelet activation induced by Aβ could not fully explain the CAA-related intracerebral hemorrhage. It has also been reported that at the site of the injured vessel wall, subendothelial collagen and tissue factors are key initiators of platelet activation, which comprise two distinct pathways and play crucial roles not only in hemostasis, but also thrombus formation [17]. In the present study, it was revealed that Aβ negatively regulates platelet aggregation induced by TRAP, but not collagen. In addition, Aβ alone did not initiate platelet activation in the present study. In amyloid-deposited vessel walls, therefore, it is probable that platelets contact deposited Aβ, which diminishes platelet aggregability induced by thrombin, leading to failed accomplishment of thrombin-initiated hemostasis at the injured vessel site. The proposed action of Aβ may at least partially explain the mechanism underlying CAA-related intracerebral hemorrhage and its tendency to recur.
The limitation of the present study is that the findings are based on the experiments ex vivo, in which in vivo disease situations, such as blood-brain barrier leakage, vessel wall damage or underling microbleeds, have not been considered. Thus, further investigations are necessary to clarify the exact mechanism underlying the alteration of platelet function caused by Aβ, which could be implicated in the clinical disease settings, including CAA.
In conclusion, the results of the present study strongly suggest that Aβ negatively regulates PAR-elicited human platelet activation. The results of the present study may suggest an underlying cause of intracerebral hemorrhage due to CAA.