Platelet aggregation but not activation and degranulation during the acute post-ischemic reperfusion phase in livers with no underlying disease

Background: Platelets and P-selectin (CD62P) play an unequivocal role in the pathology of hepatic ischemia/reperfusion (I/R) injury. Inhibition or knock-out of P-selectin or immunodepletion of platelets results in amelioration of post-ischemic inflammation, reduced hepatocellular damage, and improved survival. However, P-selectin expression on platelets and endothelial cells, which concurs with platelet activation, has never been clearly demonstrated in I/R-subjected livers.
Aims: To determine whether platelets become activated and degranulate in the acute phase of liver I/R and whether the platelets interact with neutrophils.
Methods: Hepatic I/R was induced in male C57BL/6J mice (N = 12) using 37.5-min ischemia time. Platelets, endothelial cells, and neutrophils were fluorescently labeled by systemic administration of non-blocking antibodies. Cell kinetics were monitored by intravital spinning disk confocal mi-croscopy during 90 min of reperfusion. Image analysis and quantification was performed with dedicated software.
Results: Platelets adhered to sinusoids more extensively in post-ischemic livers compared to livers not subjected to I/R and formed aggregates, which occurred directly after ischemia. Platelets and endothelial cells did not express P-selectin in post-ischemic livers. There was no interaction between platelets and neutrophils.
Conclusions: Platelets aggregate but do not become activated and do not degranulate in post-ischemic livers. There is no platelet-neutrophil interplay during the early reperfusion phase in a moderate model of hepatic I/R injury. The mechanisms underlying the biological effects of platelets and P-selectin in this setting warrant further investigation.
Relevance for patients: I/R in surgical liver patients may compromise outcome due to post-ischemic oxidative stress and sterile inflammation. Both processes are mediated in part by platelets. Under-standing platelet function during I/R is key to developing effective interventions for I/R injury and improving clinical outcomes.
[1] van Golen RF, van Gulik TM, Heger M. Mechanistic overview of reactive species-induced degradation of the endothelial glycocalyx during hepatic ischemia/reperfusion injury. Free Radic Biol Med 2012; 52: 1382-1402.
[2] van Golen RF, van Gulik TM, Heger M. The sterile immune response during hepatic ischemia/reperfusion. Cytokine Growth Factor Rev 2012; 23: 69-84.
[3] Garcia-Criado FJ, Toledo-Pereyra LH, Lopez-Neblina F, Phillips ML, Paez-Rollys A, Misawa K. Role of P-selectin in total hepatic ischemia and reperfusion. J Am Coll Surg 1995; 181: 327-334.
[4] Dulkanchainun TS, Goss JA, Imagawa DK, Shaw GD, Anselmo DM, Kaldas F, Wang T, Zhao D, Busuttil AA, Kato H, Murray NG, Kupiec-Weglinski JW, Busuttil RW. Reduction of hepatic ischemia/reperfusion injury by a soluble P-selectin glycoprotein ligand-1. Ann Surg 1998; 227: 832-840.
[5] Zibari GB, Brown MF, Burney DL, Granger N, McDonald JC. Role of P-selectin in the recruitment of leukocytes in mouse liver exposed to ischemia and reperfusion. Transplant Proc 1998; 30: 2327-2330.
[6] Singh I, Zibari GB, Brown MF, Granger DN, Eppihimer M, Zizzi H, Cruz L, Meyer K, Gonzales E, McDonald JC. Role of P-selectin expression in hepatic ischemia and reperfusion injury. Clin Transplant 1999; 13: 76-82.
[7] Yadav SS, Howell DN, Steeber DA, Harland RC, Tedder TF, Clavien PA. P-selectin mediates reperfusion injury through neutrophil and platelet sequestration in the warm ischemic mouse liver. Hepatology 1999; 29: 1494-1502.
[8] Sawaya DE, Zibari GB, Minardi A, Bilton B, Burney D, Granger DN, McDonald JC, Brown M. P-selectin contributes to the initial recruitment of rolling and adherent leukocytes in hepatic venules after ischemia/reperfusion. Shock 1999; 12: 227-232.
[9] Martinez-Mier G, Toledo-Pereyra LH, McDuffie JE, Warner RL, Ward PA. P-selectin and chemokine response after liver ischemia and reperfusion. J Am Coll Surg 2000; 191: 395-402.
[10] Young CS, Palma JM, Mosher BD, Harkema J, Naylor DF, Dean RE, Crockett E. Hepatic ischemia/reperfusion injury in P-selectin and intercellular adhesion molecule-1 double-mutant mice. Am Surg 2001; 67: 737-744.
[11] Khandoga A, Biberthaler P, Enders G, Axmann S, Hutter J, Messmer K, Krombach F. Platelet adhesion mediated by fibrinogen-intercelllular adhesion molecule-1 binding induces tissue injury in the postischemic liver in vivo. Transplantation 2002; 74: 681-688.
[12] Khandoga A, Biberthaler P, Enders G, Teupser D, Axmann S, Luchting B, Hutter J, Messmer K, Krombach F. P-selectin mediates platelet-endothelial cell interactions and reperfusion injury in the mouse liver in vivo. Shock 2002; 18: 529-535.
[13] Khandoga A, Biberthaler P, Messmer K, Krombach F. Plateletendothelial cell interactions during hepatic ischemia-reperfusion in vivo: a systematic analysis. Microvasc Res 2003; 65: 71-77.
[14] Nocito A, Georgiev P, Dahm F, Jochum W, Bader M, Graf R, Clavien PA. Platelets and platelet-derived serotonin promote tissue repair after normothermic hepatic ischemia in mice. Hepatology 2007; 45: 369-376.
[15] Xue F, Wang G, Pang Z, Liu C, Liang T. Protective effect of glutathione against liver warm ischemia-reperfusion injury in rats is associated with regulation of P-selectin and neutrophil infiltration. Anat Rec 2008; 291: 1016-1022.
[16] Nakano Y, Kondo T, Matsuo R, Hashimoto I, Kawasaki T, Kohno K, Myronovych A, Tadano S, Hisakura K, Ikeda O, Watanabe M, Murata S, Fukunaga K, Ohkohchi N. Platelet dynamics in the early phase of postischemic liver in vivo. J Surg Res 2008; 149: 192-198.
[17] Pak S, Kondo T, Nakano Y, Murata S, Fukunaga K, Oda T, Sasaki R, Ohkohchi N. Platelet adhesion in the sinusoid caused hepatic injury by neutrophils after hepatic ischemia reperfusion. Platelets 2010; 21: 282-288.
[18] Tamura T, Kondo T, Pak S, Nakano Y, Murata S, Fukunaga K, Ohkohchi N. Interaction between Kupffer cells and platelets in the early period of hepatic ischemia-reperfusion injury − an in vivo study. J Surg Res 2012; 178: 443-451.
[19] Tamura T, Kondo T, Ogawa K, Fukunaga K, Ohkohchi N. Protective effect of heme oxygenase-1 on hepatic ischemiareperfusion injury through inhibition of platelet adhesion to the sinusoids. J Gastroenterol Hepatol 2013; 28: 700-706.
[20] Mende K, Reifart J, Rosentreter D, Manukyan D, Mayr D, Krombach F, Rentsch M, Khandoga A. Targeting platelet migration in the postischemic liver by blocking protease-activated receptor 4. Transplantation 2014; 97: 154-160.
[21] Vretenbrant K, Ramstrom S, Bjerke M, Lindahl TL. Platelet activation via PAR4 is involved in the initiation of thrombin generation and in clot elasticity development. Thromb Haemost 2007; 97: 417-424.
[22] Woolbright BL, Jaeschke H. Heme oxygenase-1 and platelets in hepatic ischemia reperfusion injury. J Gastroenterol Hepatol 2013; 28: 756-757.
[23] Jenne CN, Wong CH, Petri B, Kubes P. The use of spinning-disk confocal microscopy for the intravital analysis of platelet dynamics in response to systemic and local inflammation. PLoS One 2011; 6: e25109.
[24] van Golen RF, Reiniers MJ, Heger M, Verheij J. Solutions to the discrepancies in the extent of liver damage following ischemia/reperfusion in standard mouse models. J Hepatol 2015; 62: 975- 977.
[25] Kloek JJ, Marechal X, Roelofsen J, Houtkooper RH, van Kuilenburg AB, Kulik W, Bezemer R, Neviere R, van Gulik TM, Heger M. Cholestasis is associated with hepatic microvascular dysfunction and aberrant energy metabolism before and during ischemia-reperfusion. Antioxid Redox Signal 2012; 17: 1109-1123.
[26] von Bruhl ML, Stark K, Steinhart A, Chandraratne S, Konrad I, Lorenz M, Khandoga A, Tirniceriu A, Coletti R, Kollnberger M, Byrne RA, Laitinen I, Walch A, Brill A, Pfeiler S, Manukyan D, Braun S, Lange P, Riegger J, Ware J, Eckart A, Haidari S, Rudelius M, Schulz C, Echtler K, Brinkmann V, Schwaiger M, Preissner KT, Wagner DD, Mackman N, Engelmann B, Massberg S. Monocytes, neutrophils, and platelets cooperate to initiate and propagate venous thrombosis in mice in vivo. J Exp Med 2012; 209: 819-835.
[27] Kamata T, Takada Y. Direct binding of collagen to the I domain of integrin alpha 2 beta 1 (VLA-2, CD49b/CD29) in a divalent cation-independent manner. J Biol Chem 1994; 269: 26006-26010.
[28] Berger G, Hartwell DW, Wagner DD. P-Selectin and platelet clearance. Blood 1998; 92: 4446-4452.
[29] Okajima K, Harada N, Kushimoto S, Uchiba M. Role of microthrombus formation in the development of ischemia/reperfusioninduced liver injury in rats. Thromb Haemost 2002; 88: 473-480.
[30] Essani NA, Fisher MA, Simmons CA, Hoover JL, Farhood A, Jaeschke H. Increased P-selectin gene expression in the liver vasculature and its role in the pathophysiology of neutrophilinduced liver injury in murine endotoxin shock. J Leukoc Biol 1998; 63: 288-296.
[31] Geng JG, Bevilacqua MP, Moore KL, McIntyre TM, Prescott SM, Kim JM, Bliss GA, Zimmerman GA, McEver RP. Rapid neutrophil adhesion to activated endothelium mediated by GMP-140. Nature 1990; 343: 757-760.
[32] Kubes P, Payne D, Woodman RC. Molecular mechanisms of leukocyte recruitment in postischemic liver microcirculation. Am J Physiol Gastrointest Liver Physiol 2002; 283: G139-G147.
[33] Smedsrod B, De Bleser PJ, Braet F, Lovisetti P, Vanderkerken K, Wisse E, Geerts A. Cell biology of liver endothelial and Kupffer cells. Gut 1994; 35: 1509-1516.
[34] Lalor PF, Lai WK, Curbishley SM, Shetty S, Adams DH. Human hepatic sinusoidal endothelial cells can be distinguished by expression of phenotypic markers related to their specialised functions in vivo. World J Gastroenterol 2006;12: 5429-5439.
[35] Jackson SP. The growing complexity of platelet aggregation. Blood 2007; 109: 5087-5095.
[36] Broos K, Feys HB, De Meyer SF, Vanhoorelbeke K, Deckmyn H. Platelets at work in primary hemostasis. Blood Rev 2011; 25: 155- 167.
[37] Broos K, De Meyer SF, Feys HB, Vanhoorelbeke K, Deckmyn H. Blood platelet biochemistry. Thromb Res 2012; 129: 245-249.
[38] Versteeg HH, Heemskerk JW, Levi M, Reitsma PH. New fundamentals in hemostasis. Physiol Rev 2013; 93: 327-358.
[39] Wood JP, Ellery PE, Maroney SA, Mast AE. Biology of tissue factor pathway inhibitor. Blood 2014;123: 2934-2943.
[40] Maroney SA, Haberichter SL, Friese P, Collins ML, Ferrel JP, Dale GL, Mast AE. Active tissue factor pathway inhibitor is expressed on the surface of coated platelets. Blood 2007; 109: 1931-1937.
[41] Schwarz HP, Heeb MJ, Wencel-Drake JD, Griffin JH. Identification and quantitation of protein S in human platelets. Blood 1985; 66: 1452-1455.
[42] Novotny WF, Girard TJ, Miletich JP, Broze GJ. Platelets secrete a coagulation inhibitor functionally and antigenically similar to the lipoprotein associated coagulation inhibitor. Blood 1988; 72: 2020- 2025.
[43] Walker FJ. Protein S and the regulation of activated protein C. Semin Thromb Hemost 1984; 10: 131-138.
[44] Lindahl AK, Sandset PM, Abildgaard U. The present status of tissue factor pathway inhibitor. Blood Coagul Fibrinolysis 1992; 3: 439-449.
[45] Kloek JJ, Levi M, Heger M, van der Loos CM, Gouma DJ, van Gulik TM. Cholestasis enhances liver ischemia/reperfusion- induced coagulation activation in rats. Hepatol Res 2010; 40: 204- 215.
[46] Niewiarowski S, Regoeczi E, Stewart GJ, Senyl AF, Mustard JF. Platelet interaction with polymerizing fibrin. J Clin Invest 1972; 51: 685-699.
[47] Vollmar B, Menger MD. The hepatic microcirculation: mechanistic contributions and therapeutic targets in liver injury and repair. Physiol Rev 2009; 89: 1269-1339.
[48] Jaeschke H. Molecular mechanisms of hepatic ischemia-reperfusion injury and preconditioning. Am J Physiol Gastrointest Liver Physiol 2003; 284: G15-G26.
[49] Oberkofler CE, Limani P, Jang JH, Rickenbacher A, Lehmann K, Raptis DA, Ungethuem U, Tian Y, Grabliauskaite K, Humar R, Graf R, Humar B, Clavien PA. Systemic protection through remote ischemic preconditioning is spread by platelet-dependent signaling in mice. Hepatology 2014; 60: 1409-1417.
[50] Starlinger P, Assinger A, Haegele S, Wanek D, Zikeli S, Schauer D, Birner P, Fleischmann E, Gruenberger B, Brostjan C, Gruenberger T. Evidence for serotonin as a relevant inducer of liver regeneration after liver resection in humans. Hepatology 2014; 60: 257- 266.
[51] Lesurtel M, Graf R, Aleil B, Walther DJ, Tian Y, Jochum W, Gachet C, Bader M, Clavien PA. Platelet-derived serotonin mediates liver regeneration. Science 2006; 312: 104-107.
[52] Wong CH, Jenne CN, Petri B, Chrobok NL, Kubes P. Nucleation of platelets with blood-borne pathogens on Kupffer cells precedes other innate immunity and contributes to bacterial clearance. Nat Immunol 2013; 14: 785-792.