A fundamental property of platelets is their ability to transmit cytoskeletal contractile forces to extracellular matrices. While the importance of the platelet contractile mechanism in regulating fibrin clot retraction is well established, its role in regulating the primary hemostatic response, independent of blood coagulation, remains ill defined. Realtime analysis of platelet adhesion and aggregation on a collagen substrate revealed a prominent contractile phase during thrombus development, associated with a 30% to 40% reduction in thrombus volume. Thrombus contraction developed independent of thrombin and fibrin and resulted in the tight packing of aggregated platelets. Inhibition of the platelet contractile mechanism, with the myosin IIA inhibitor blebbistatin or through Rho kinase antagonism, markedly inhibited thrombus contraction, preventing the tight packing of aggregated platelets and undermining thrombus stability in vitro. Using a new intravital hemostatic model, we demonstrate that the platelet contractile mechanism is critical for maintaining the integrity of the primary hemostatic plug, independent of thrombin and fibrin generation. These studies demonstrate an important role for the platelet contractile mechanism in regulating primary hemostasis and thrombus growth. Furthermore, they provide new insight into the underlying bleeding diathesis associated with platelet contractility defects.
IntroductionThe ability of platelets to adhere to subendothelial matrix proteins and with other platelets at sites of vascular injury is critical for hemostatic plug formation and for the development of arterial thrombi. 1,2 The hemostatic response can be divided into 2 temporally distinct phases: the primary hemostatic plug, composed of aggregated platelets that form independent of fibrin formation 1 ; and the secondary hemostatic response, wherein fibrin polymers enmeshed into the developing thrombus physically stabilize the platelet plug. 3 During hemostatic plug formation, platelets undergo a complex series of morphologic and functional responses that require extensive remodeling of the actin cytoskeleton. These cytoskeletal changes are indispensable for the normal hemostatic function of platelets and are controlled by complex network of signaling, structural, and regulatory proteins. 4 The actin-based cytoskeleton can be separated into 2 functionally distinct structures: (1) the spectrin-rich membrane skeleton, lining the inner plasma membrane, and (2) the cytoskeleton, consisting of long actin filaments that radiate from the cell center to the surface membrane. 4,5 The membrane skeleton is essential for maintaining the structure and integrity of the surface membrane, whereas the cytoskeleton, through its attachment to myosin, principally generates contractile forces within the cell. 6 The internal generation of contractile force has a well-defined role in regulating platelet shape change 7,8 and in promoting granule secretion, 9,10 whereas the extracellular transmission of cytoskeletal contractile force i...