Platelets reprogram monocyte functions by secreting MMP-9 to benefit postoperative outcomes following acute aortic dissection

• Published in: iScience Vol. 26; no. 6; p. 106805
• Main Authors: Shen, Wei-Yun, Li, Hui, Zha, An-Hui, Luo, Ru-Yi, Zhang, Yan-Ling, Luo, Cong, Dai, Ru-Ping
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 16-06-2023; Elsevier
• Subjects: Cardiovascular medicine; Immunology; Specialized functions of cells; Cardiovascular medicine; Immunology; Specialized functions of cells
• ISSN: 2589-0042; 2589-0042
• DOI: 10.1016/j.isci.2023.106805

Platelets have a great ability to modulate immune responses. Monocyte-platelet aggregates (MPAs) are associated with the pathogenesis of cardiac disease. Notably, a low preoperative platelet count often indicates poor postoperative recovery following acute aortic dissection (AAD). The functions of platelets and MPAs in AAD, however, remain poorly understood. We found that, despite decreased platelet counts, platelets were also activated in AAD patients, with significant alterations in immune-modulating mediators. Of interest, monocytes in AAD patients had a suppressed immune status, which was correlated with poor outcomes following surgery. Interestingly, platelets preferentially aggregated with monocytes, and the levels of MPAs were related to recovery after surgical repair in AAD patients. Platelets restored suppressed monocyte functions in AAD patients by forming aggregates and partly by secreting matrix metalloproteinase-9 (MMP-9). Thus, the results point to a previously unknown mechanism for platelets involving monocyte reprogramming, which may improve postoperative outcomes following complex cardiovascular surgery.
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•Platelets were activated, and thrombocytopenia predicts surgical prognosis in AAD•AAD patients displayed reduced pro-inflammatory phenotypes in monocytes•Platelets-monocyte aggregates benefit postoperative recovery in AAD•Platelets restore monocyte function partly in an MMP-9-dependent way in AAD
Cardiovascular medicine; Immunology; Specialized functions of cells