Platelet response heterogeneity in thrombus formation

ICA Munnix, JMEM Cosemans, Jocelyn Auger, JWM Heemskerk

Research output: Contribution to journalReview article

104 Citations (Scopus)


Vascular injury leads to formation of a structured thrombus as a consequence of platelet activation and aggregation, thrombin and fibrin formation, and trapping of leukocytes and red cells. This review summarises current evidence for heterogeneity of platelet responses and functions in the thrombus-forming process. Environmental factors contribute to response heterogeneity, as the platelets in a thrombus adhere to different substrates, and sense specific (ant)agonists and rheological conditions. Contraction of platelets and interaction with fibrin and other blood cells cause further response variation. On the other hand, response heterogeneity can also be due to intrinsic differences between platelets in age and in receptor and signalling proteins. As a result, at least three subpopulations of platelets are formed in a thrombus: aggregating platelets with (reversible) integrin activation, procoagulant (coated) platelets exposing phosphatidylserine and binding coagulation factors, and contracting platelets with cell-cell contacts. This recognition of thrombus heterogeneity has implications for the use and development of antiplatelet medication.
Original languageEnglish
Pages (from-to)1149-1156
Number of pages8
JournalThrombosis and Haemostasis
Issue number6
Publication statusPublished - 1 Dec 2009


  • platelets
  • Aggregation
  • heterogeneity
  • thrombus formation
  • coagulation


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