Specific Impairment of Human Platelet P2YAC ADP Receptor–Mediated Signaling by the Antiplatelet Drug Clopidogrel

J Geiger, J Brich, P Honig-Liedl… - … , and vascular biology, 1999 - Am Heart Assoc
J Geiger, J Brich, P Honig-Liedl, M Eigenthaler, P Schanzenbacher, JM Herbert, U Walter
Arteriosclerosis, thrombosis, and vascular biology, 1999Am Heart Assoc
Clopidogrel is an effective new antiplatelet agent useful for the treatment of ischemic
cerebrovascular, cardiac, and peripheral arterial disease. However, the mechanism of
clopidogrel action is not well understood, although it is known to inhibit ADP-evoked platelet
aggregation. In the current study, the effect of clopidogrel on recently identified human
platelet ADP receptors and their signaling pathways was investigated by using platelets from
clopidogrel-treated subjects, 6 healthy volunteers (2 females and 4 males) who received 75 …
Abstract
—Clopidogrel is an effective new antiplatelet agent useful for the treatment of ischemic cerebrovascular, cardiac, and peripheral arterial disease. However, the mechanism of clopidogrel action is not well understood, although it is known to inhibit ADP-evoked platelet aggregation. In the current study, the effect of clopidogrel on recently identified human platelet ADP receptors and their signaling pathways was investigated by using platelets from clopidogrel-treated subjects, 6 healthy volunteers (2 females and 4 males) who received 75 mg of clopidogrel daily for 7 days. Blood was taken and various platelet receptor signaling pathways were analyzed before treatment, after 7 days of medication, and 4 weeks after treatment had ceased. Platelet tests included the analysis of aggregation, rapid calcium influx, calcium mobilization from intracellular stores, adenylyl cyclase, and phosphorylation of vasodilator-stimulated phosphoprotein (VASP). The data indicate that clopidogrel does not affect those platelet ADP receptors coupled to cation influx (P2X1 ADP receptors) or calcium mobilization (P2Y1 ADP receptors). In contrast, clopidogrel treatment specifically impairs the ADP receptor coupled to Gi/adenylyl cyclase (P2YAC ADP receptors). Clopidogrel abolishes the inhibitory P2YAC receptor–mediated ADP effects on prostaglandin E1–stimulated, cAMP-dependent phosphorylation of VASP without affecting epinephrine, thrombin, and thromboxane signaling. VASP phosphorylation is known to be closely correlated with the inhibition of platelet and fibrinogen receptor (glycoprotein IIb/IIIa) activation. Therefore, inhibition of the platelet P2YAC ADP receptor and its intracellular signaling, including decreased VASP phosphorylation, is suggested as a molecular mechanism of clopidogrel action.
Am Heart Assoc