Platelet GPIbα is a mediator and potential interventional target for NASH and subsequent liver cancer

Mohsen Malehmir, Dominik Pfister, Suchira Gallage, Marta Szydlowska, Donato Inverso, Elena Kotsiliti, Valentina Leone, Moritz Peiseler, Bas G J Surewaard, Dominik Rath, Adnan Ali, Monika Julia Wolf, Hannah Drescher, Marc E Healy, Daniel Dauch, Daniela Kroy, Oliver Krenkel, Marlene Kohlhepp, Thomas Engleitner, Alexander OlkusTjeerd Sijmonsma, Julia Volz, Carsten Deppermann, David Stegner, Patrick Helbling, César Nombela-Arrieta, Anahita Rafiei, Martina Hinterleitner, Marcel Rall, Florian Baku, Oliver Borst, Caroline L Wilson, Jack Leslie, Tracy O'Connor, Christopher J Weston, David H Adams, Lozan Sheriff, Ana Teijeiro, Marco Prinz, Ruzhica Bogeska, Natasha Anstee, Malte N Bongers, Mike Notohamiprodjo, Tobias Geisler, Dominic J Withers, Jerry Ware, Derek A Mann, Hellmut G Augustin, Alexandros Vegiopoulos, Michael D Milsom, Adam J. Rose, Patricia F. Lalor, Josep M Llovet, Roser Pinyol, Frank Tacke, Roland Rad, Matthias Matter, Nabil Djouder, Paul Kubes, Percy A Knolle, Kristian Unger, Lars Zender, Bernhard Nieswandt, Meinrad Gawaz, Achim Weber, Mathias Heikenwalder

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Non-alcoholic fatty liver disease ranges from steatosis to non-alcoholic steatohepatitis (NASH), potentially progressing to cirrhosis and hepatocellular carcinoma (HCC). Here, we show that platelet number, platelet activation and platelet aggregation are increased in NASH but not in steatosis or insulin resistance. Antiplatelet therapy (APT; aspirin/clopidogrel, ticagrelor) but not nonsteroidal anti-inflammatory drug (NSAID) treatment with sulindac prevented NASH and subsequent HCC development. Intravital microscopy showed that liver colonization by platelets depended primarily on Kupffer cells at early and late stages of NASH, involving hyaluronan-CD44 binding. APT reduced intrahepatic platelet accumulation and the frequency of platelet-immune cell interaction, thereby limiting hepatic immune cell trafficking. Consequently, intrahepatic cytokine and chemokine release, macrovesicular steatosis and liver damage were attenuated. Platelet cargo, platelet adhesion and platelet activation but not platelet aggregation were identified as pivotal for NASH and subsequent hepatocarcinogenesis. In particular, platelet-derived GPIbα proved critical for development of NASH and subsequent HCC, independent of its reported cognate ligands vWF, P-selectin or Mac-1, offering a potential target against NASH.

Original languageEnglish
Pages (from-to)641-655
Number of pages15
JournalNature Medicine
Issue number4
Publication statusPublished - 1 Apr 2019


  • Animals
  • Blood Platelets/drug effects
  • Body Weight/drug effects
  • Cytokines/metabolism
  • Cytoplasmic Granules/drug effects
  • Endothelium/drug effects
  • Hepatocytes/drug effects
  • Humans
  • Hyaluronan Receptors/metabolism
  • Hyaluronic Acid/metabolism
  • Kupffer Cells/drug effects
  • Liver/drug effects
  • Liver Neoplasms/blood
  • Mice, Transgenic
  • Non-alcoholic Fatty Liver Disease/blood
  • Platelet Aggregation/drug effects
  • Platelet Aggregation Inhibitors/pharmacology
  • Platelet Count
  • Platelet Glycoprotein GPIb-IX Complex/metabolism

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology


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