PLATELETS

INTRODUCTION

Platelets (thrombocytes) are circulating cells that are important mediators of hemostasis. Platelets
are small colorless, non-nucleated formed elements of blood considered to be the fragments of
cytoplasm. Each cell has a diameter of 1-4 µm and the total platelet count in the blood is between
150,000 and 300,000/µl. Normally, platelets are of several shapes, viz. spherical or rod-shaped
and become oval or disk-shaped when inactivated. Sometimes, the platelets have dumbbell
shape, comma shape, cigar shape or any other unusual shape. Inactivated platelets are without
processes or filopodia and the activated platelets develop processes or filopodia.

STRUCTURE AND COMPOSITION

Platelet is constituted by:
1. Cell membrane or surface membrane
2. Microtubules
3. Cytoplasm.

CELL MEMBRANE

The platelet cell membrane has a thickness of 6 nm. The cell membrane invaginates extensively
to form an open tunnel system known as the canalicular system. This system facilitates the
platelets’ uptake of several factors from plasma. Also, platelet granules are able to extrude their
contents into plasma through this system. Cell membrane of platelet contains lipids in the form
of phospholipids, cholesterol and glycolipids, carbohydrates as glycocalyx and glycoproteins and
proteins. Of these substances, glycoproteins and phospholipids are functionally important.

Glycoproteins
The glycoproteins serve as membrane receptors for collagen, exogenous activators, von
willebrand factor of the blood vessel , thereby promoting the adherence of platelets to collagen
and damaged endothelium in ruptured vessels and to one another. Glycoproteins prevent the
adherence of platelets to normal endothelium.
Phospholipids
Phospholipids accelerate the clotting reactions. The phospholipids form the precursors of
thromboxane A2 and other prostaglandin-related substances.
MICROTUBULES
Microtubules form a ring around cytoplasm below the cell membrane. Microtubules are made up
of polymerized proteins called tubulin. These tubules provide structural support for the
inactivated platelets to maintain the disk-like shape.
CYTOPLASM
Cytoplasm of platelets contains the cellular organelles, Golgi apparatus, endoplasmic reticulum,
mitochondria, microtubule, microvessels, filaments and granules. Cytoplasm also contains some
chemical substances such as proteins, enzymes, hormonal substances, etc.
Proteins
1. Contractile proteins
i. Actin and myosin: Contractile proteins, which are responsible for contraction of platelets.
ii. Thrombosthenin: Third contractile protein, which is responsible for clot retraction.
2. von Willebrand factor: Responsible for adherence of platelets and regulation of plasma level
of factor VIII.
3. Fibrin-stabilizing factor: A clotting factor.
4. Platelet-derived growth factor (PDGF): Responsible for repair of damaged blood vessels and
wound healing. It is a potent mytogen (chemical agent that promotes mitosis) for smooth muscle
fibers of blood vessels.
5. Platelet-activating factor (PAF): Causes aggregation of platelets during the injury of blood
vessels, resulting in prevention of excess loss of blood.
6. Vitronectin (serum spreading factor): Promotes adhesion of platelets and spreading of tissue
cells in culture.
7. Thrombospondin: Inhibits angiogenesis (formation of new blood vessels from pre-existing
vessels).
Enzymes
1. Adensosine triphosphatase (ATPase)
2. Enzymes necessary for synthesis of prostaglandins.
Hormonal Substances
1. Adrenaline
2. 5-hydroxytryptamine (5-HT; serotonin)
3. Histamine.
Other Chemical Substances
1. Glycogen
2. Substances like blood group antigens
3. Inorganic substances such as calcium, copper, magnesium and iron.

Platelet Granules

Platelets contain many granules which when secreted, play an important role in all phases of
hemostasis: vasoconstriction, platelet plug formation, coagulation and healing of the wound in
the blood vessel. The storage granules are classified into 3 types:
1. Alpha granules: these contain factor V and fibrinogen (coagulation factors), thrombospondin
(for platelet aggregation), von Willebrand factor (for platelet adhesion), and platelet-derived
growth factor which stimulates the growth of fibroblast and smooth muscle and therefore
healing.
2. Dense granules: they contain ADP, serotonin and calcium
3. Lysosomes: these contain hydrolytic enzymes active at low pH

ORIGIN AND DEVELOPMENT OF PLATELETS

Platelets originate from fragmentation of megakaryocytes, which in turn originate from the
pluripotential stem cells in the marrow that give rise to all blood cells.
Platelets are formed from megakaryocytes by either of two processes:
1. through cytoplasmic pseudopodia which penetrate the wall of the marrow sinusoids and are
broken off into the blood stream
2. by vesicle formation throughout the cytoplasm which fuse and fragment the cytoplasm into
platelets, leaving the nucleus to degenerate.
LIFESPAN AND FATE OF PLATELETS
Average lifespan of platelets is 10 days. It varies between 8 and 11 days. Platelets are destroyed by
tissue macrophage system in spleen. So, splenomegaly (enlargement of spleen) decreases platelet count
and splenectomy (removal of spleen) increases platelet count.

PHYSIOLOGICAL VARIATIONS
1. Age: Platelets are less in infants (1,50,000 to 2,00,000/cu mm) and reaches normal level at 3rd
month after birth.
2. Sex: There is no difference in the platelet count between males and females. In females, it is
reduced during menstruation.
3. High altitude: Platelet count increases.
4. After meals: After taking food, the platelet count increases.

PROPERTIES OF PLATELETS
Platelets have three important properties (three ‘A’s):
1. Adhesiveness
2. Aggregation
3. Agglutination.
ADHESIVENESS
Adhesiveness is the property of sticking to a rough surface. During injury of blood vessel,
endothelium is damaged and the subendothelial collagen is exposed. While coming in contact
with collagen, platelets are activated and adhere to collagen. Adhesion of platelets involves
interaction between von Willebrand factor secreted by damaged endothelium and a receptor
protein called glycoprotein Ib situated on the surface of platelet membrane. Other factors which
accelerate adhesiveness are collagen, thrombin, ADP, Thromboxane A2, calcium ions, P-selectin
and vitronectin.
AGGREGATION (GROUPING OF PLATELETS)
Aggregation is the grouping of platelets. Adhesion is followed by activation of more number of
platelets by substances released from dense granules of platelets. During activation, the platelets
change their shape with elongation of long filamentous pseudopodia which are called processes
or filopodia.
Filopodia help the platelets aggregate together. Activation and aggregation of platelets is
accelerated by ADP, thromboxane A2 and platelet-activating factor (PTA: cytokine secreted by
neutrophils and monocytes;
„ AGGLUTINATION
Agglutination is the clumping together of platelets. Aggregated platelets are agglutinated by the
actions of some platelet agglutinins and platelet-activating factor.

FUNCTIONS OF PLATELETS
Normally, platelets are inactive and execute their actions only when activated. Activated platelets
immediately release many substances. This process is known as platelet release reaction.
Functions of platelets are carried out by these substances.
Functions of platelets are:
1. ROLE IN BLOOD CLOTTING
Platelets are responsible for the formation of intrinsic prothrombin activator. This substance is
responsible for the onset of blood clotting .
2. ROLE IN CLOT RETRACTION
In the blood clot, blood cells including platelets are entrapped in between the fibrin threads.
Cytoplasm of platelets contains the contractile proteins, namely actin, myosin and
thrombosthenin, which are responsible for clot retraction
3. ROLE IN PREVENTION OF BLOOD LOSS (HEMOSTASIS)
Platelets accelerate the hemostasis by three ways:
i. Platelets secrete 5-HT, which causes the constriction of blood vessels.
ii. Due to the adhesive property, the platelets seal the damage in blood vessels like capillaries.
iii. By formation of temporary plug, the platelets seal the damage in blood vessels.
4. ROLE IN REPAIR OF RUPTURED BLOOD VESSEL
Platelet-derived growth factor (PDGF) formed in cytoplasm of platelets is useful for the repair of
the endothelium and other structures of the ruptured blood vessels.
5. ROLE IN DEFENSE MECHANISM
By the property of agglutination, platelets encircle the foreign bodies and destroy them.

„
APPLIED PHYSIOLOGY – PLATELET DISORDERS
Platelet disorders occur because of pathological variation in platelet count and dysfunction of
platelets.
Platelet disorders are:
1. Thrombocytopenia
2. Thrombocytosis
3. Thrombocythemia
4. Glanzmann’s thrombasthenia.

1. Thrombocytopenia
Decrease in platelet count is called thrombocytopenia. It leads to thrombocytopenic purpura.
Thrombocytopenia occurs in the following conditions:
i. Acute infections
ii. Acute leukemia
iii. Aplastic and pernicious anemia
iv. Chickenpox
v. Smallpox
vi. Splenomegaly
vii. Scarlet fever
viii. Typhoid
ix. Tuberculosis
x. Purpura
xi. Gaucher’s disease.
2. Thrombocytosis
Increase in platelet count is called thrombocytosis. Thrombocytosis occurs in the following
conditions:
i. Allergic conditions
ii. Asphyxia
iii. Hemorrhage
iv. Bone fractures
v. Surgical operations
vi. Splenectomy
vii. Rheumatic fever
viii. Trauma (wound or injury or damage caused by external force).

3. Thrombocythemia
Thrombocythemia is the condition with persistent and abnormal increase in platelet count.
Thrombocythemia occurs in the following conditions:
i. Carcinoma
ii. Chronic leukemia
iii. Hodgkin’s disease

4. Glanzmann’s Thrombasthenia
Glanzmann’s thrombasthenia is an inherited hemorrhagic disorder, caused by structural or
functional abnormality of platelets. It leads to thrombasthenic purpura. However, the platelet
count is normal. It is characterized by normal clotting time, normal or prolonged bleeding time
but defective clot retraction