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Amicus or Adversary

Platelets in Lung Biology, Acute Injury, and Inflammation

¹ Fudação Oswaldo Cruz, Rio de Janeiro, Brazil; ² Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, and ³ Program in Human Molecular Biology and Genetics, University of Utah, Salt Lake City, Utah

Correspondence and requests for reprints should be addressed to Guy A. Zimmerman, M.D., University of Utah, Program in Human Molecular Biology and Genetics, 15 North 2030 East, Room 4220, Salt Lake City, UT 84112-5330. E-mail: guy.zimmerman{at}hmbg.utah.edu

Platelets are the chief effector cells in hemostasis and have additional major functions in inflammation, vascular integrity, and tissue repair. Platelets and the lungs have interrelated activities. Previous studies provide evidence that platelets contribute to pulmonary vascular barrier function and are required for defense against pulmonary hemorrhage, and that the lungs can influence platelet number and distribution. There is also evidence that platelets contribute to pathologic syndromes of pulmonary inflammation and thrombosis. Thus, platelets have an "amicus or adversary" relationship with the lung. Recent observations and discoveries have established new paradigms relevant to influences of platelets on lung cell and molecular biology. These new findings are in a variety of areas including thrombopoieis, nontraditional activities of platelets, new synthetic capabilities and mechanisms of post-translational gene expression, interactions of platelets with endothelial cells and contributions to alveolar capillary barrier permeability, interactions of platelets with myeloid leukocytes, and platelet involvement in stem cell signaling and vascular repair. These issues are considered in a translational approach, with an emphasis on acute lung injury and the acute respiratory distress syndrome.

Key Words: platelets • inflammation • thrombosis • lung injury

CLINICAL RELEVANCE The studies reviewed here will alter paradigms regarding the contributions and activites of platelets in acute lung injury and other syndromes of pulmonary inflammation and thrombosis.

 

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