Chapter
Platelets
18
INTRODUCTION
LSTRUCTURE AND COMPOsITION
INORMAL COUNT AND VARIATIONS
I PROPERTIES
FUNCTIONS
ACTIVATORS AND INHIBITORS
I DEVELOPMENT
I LIFESPAN AND FATE
APPLIED PHYSIOLOGY- PLATELET DISORDERS
INTRODUCTION CELL MEMBRANE
Platelets or thrombocytes are the formed elements of Cell membrane of platelet is 6 nm thick. Extensive
blood. Platelets are small colorless, non-nucleated and invagination of cell membrane forms an open canalicular
moderately refractive bodies. These formed elements of system (Fig. 18.1). This canalicular system is a delicate
blood are considered to be the fragments of cytoplasm. tunnel system through which the platelet granules
extrude their contents.
Size of Platelets Cell membrane of platelet contains lipids in the form
Diameter : 25 u(2 to 4 ) of phospholipids, cholesterol and glycolipids, carbo
Volume :7.5 cup(7to 8 cu u). hydrates as glycocalyx and glycoproteins and proteins.
Of these substances, glycoproteins and phospholipids
Shape of Platelets are functionally important.
Normally. platelets are of several shapes, viz. spherical
or rod-shaped and become oval or disk-shaped when Glycoproteins
inactivated. Sometimes, the platelets have dumbbell Glvcoproteins prevent the adherence of platelets to nor
a ynsu malendothelium, butaccelerate the adherence of platelets
filopodia and the activated platelets develop processes to collagen and damaged endothelium in ruptured blood
or filopodia (see below). vessels. Glycoproteins also form the receptors for
adenosine diphosphate (ADP) and thrombin.
STRUCTURE AND COMPOSITION
Phospholipids
Platelet is constituted by:
2. Microthubueeane or surtace membrane Phospholipids accelerate the clotting reactions. The
phospholipids form the precursors of thromboxane A,
3. Cytoplasm. and other prostaglandin-related substances.
Chapter 18 Platelets 123
MICROTUBULES 3. Inorganic substances such as calcium, copper,
magnesium and iron.
Microtubules form a ring around cytoplasm below the cell
proteins called tubulin. These tubules nroide stnucturnl Platelet Granules
support for the inactivated platelets to maintain the disk Granules present in cytoplasm of platelets are of two
like shape. types:
1. Alpha granules
CYTOPLASM 2. Dense granules.
Cytoplasm of platelets contains the cellular organelles, Substances present in these granules are given in
Table 18.1.
Golgi apparatus, endoplasmic reticulum, mitochondria,
Alpha granules
teneontains some chemical substances
Alpha granules contain:
suchoe
asnroteins. enzymes. hormonal substances, etc.
1. Clotting factors - fibrinogen, Vand XIll
Proteins 2. Platelet-derived growth factor
3. Vascular endothelial growth factor (VEGF)
1. Contractile proteins 4. Basic fibroblast growth factor (FGF)
L Actin and myosin: Contractile protens
oteins, which 5. Endostatin
are responsibie or contaon o pa 6. Thrombospondin.
actile protein, which
onsible for dlot retraction Dense granules
2. von Willebrand factor: Responsible for adherence Dense granules contain:
of platelets and regulation of plasma level of factor 1. Nucleotides
ViIl. 2. Serotonin
3. Fibrin-stabilizing factor: Aciotting factor. 3. Phospholipid
4. Platelet-derived growth factor (PDGF): Responsible 4. Calcium
for repair of damaged blood vessels and wound 5. Lysosomes.
healing. It is a potent mytogen (chemical agent that
promotes mitosis) for smooth muscie fibers of blood NORMAL COUNT AND VARIATIONS
vessels.
5. Platelet-activating factor (PAF): Causes aggregation Normal platelet count is 2,50,000/cu mm of blood. It ran
ges between 2,00,000 and 4,00,000/cu mm of blood.
of platelets during the injury of blood vessels,
resulting in prevention of excess loss of blood. PHYSIOLOGICAL VARIATIONS
6. Vitronectin (serum spreading factor): Promotes
adhesion of platelets and spreading of tissue cells in 1. Age: Platelets are less in infants (1,50,000 to
2,00,000/cu mm) and reaches normal level at 3rd
7. Thrombospondin: Inhibits angiogenesis (formation
of new biood vessels from pre-existing vessels). 2. Cev: There is no difference in the platelet count
between males and females. In females, it is reduced
Enzymes during menstruation.
3. High altitude: Platelet count increases.
1. Adensosine triphosphatase (ATPase) 4. Afier meals: After taking food, the platelet count
2. Enzymes necessary for synthesis of prostaglandins.
increases.
Hormonal Substances TABLE 18.1: Substances present in platelet granules
1. Adrenaline Alpha granules Dense granules
2. 5-hydroxytryptamine (5-HT; serotonin) Clotting factors: fibrinogen, V and Xi
3. Histamine. Platelet-derived growth factor
Vascular endothelial growth factor
Other Chemical Substances Basic fibroblast growth factor
Calcium
Endostatin
1. Glycogen Thrombospondin Lysosomes
2. Substances like blood group antigens
124 Section 2 Blood and Body Fluids
with During
eloctva
activation, thee platelets nange their shape
piaseudopodia which
are called processes or filopodia (Fig. 18.2).
Alpha granule Filopodia help the platelets aggregate toget
Activation and aggregation of platelets is acceler
by ADP, thromboxane A, and platelet-activating fa
Open canalicular (PTA: cytokine secreted by neutrophils and monoc
system Chapter 16).
AGGLUTINATION
Dense granule
Agglutination is the clumping together of platelets
Glycogen Aggregated platelets are agglutinated by the actions of
some platelet agglutinins and platelet-activating factor.
Microtubule FUNCTIONS OF PLATELETS
Normally, platelets are inactive and execute their actions
only when activated. Activated platelets immediately
Mitochondrion Teiease many substancesS. This process is known as
ctions of platelets are
carried out by these substances.
Functions of platelets are:
FIGURE 18.1: Platelet under electron microscope
1. ROLE IN BLOOD CLOTTING
PATHOLOGICAL VARIATIONS Platelets are responsible for the formation of intrinsic
Refer applied physiology of this chapter. prothrombin activator. This substance is responsible for
the onset of blood clotting (Chapter 20).
I PROPERTIES OF PLATELETS
2. ROLE IN CLOT RETRACTION
Platelets have three important properties (three 'A's):
1. Adhesiveness In the blood clot, blood cells including platelets are
2. Aggregation entrapped in between the fibrin threads. Cytoplasm of
3. Agglutination. platelets contains the contractile proteins, namely actin,
myosin and thrombosthenin, which are responsible for
ADHESIVENESS clot retraction (Chapter 20).
Adhesiveness is the property of sticking to a rough 3. ROLE IN PREVENTION OF
surface. During injury of blood vessel, endothelium is BLOOD LOSS (HEMOSTASIS)
damaged and the subendothelial collagen is exposed.
While coming in contact with collagen, platelets are Platelets accelerate the hemostasis by three ways:
activated and adhere to collagen. Adhesion of platelets i. Platelets secrete 5-HT, which causes the cons
involves interaction between von Willebrand factor triction of blood vessels.
secreted by damaged endothelium and a receptor protein ii. Due to the adhesive property, the platelets seal
called glycoprotein Ib situated on the surface of platelet the damage in blood vessels like capillaries.
membrane. Other factors which accelerate adhesiveness ii. By formation of temporary plug. the platelets
are collagen, thrombin, ADP, Thromboxane A., calcium seal the damage in blood vessels (Chapter 19).
ions, P-selectin and vitronectin.
4. ROLE IN REPAIR OF RUPTURED
AGGREGATION (GROUPING OF PLATELETS) BLOOD VESSEL
Aggregation is the grouping of platelets. Adhesion is Platelet-derived growth factor (PDGF) formed in cyto
followed by activation of more number of platelets by plasmof platelets is useful for the repair of the endothelium
substances released from dense granules of platelets. and other structures of the ruptured blood vessels.
Chapter 18 Platelets 125
LIFESPAN AND FATE OF PLATELETS
Average ifespan of platelets is 10 days. It varies
between 8 and 11 days. Platelets are destroyed by
Filopodia tissue macrophage system in spleen. So, splenomegaly
(enlargement of spleen) decreases platelet count and
splenectomy (removal of spleen) increases platelet
count
A B
APPLIED PHYSIOLOGY -
FIGURE 18.2: A. Inactive platelets. B. Activated platelets PLATELET DISORDERS
Platelet disorders occur because of pathological variation
5. ROLE IN DEFENSE MECHANISM nplatelet count and dystunction of platelets.
Platelet disorders are:
By the property of agglutination, platelets encircle the
foreign bodies and destroy them. 1. Thrombocytopenia
2. Thrombocytosis
ACTIVATORS AND INHIBITORS 3. Thrombocythemia
OF PLATELETS 4. Glanzmann's thrombasthenia.
ACTIVATORS OF PLATELETS 1. Thrombocytopenia
1. Collagen, which is exposed during damage of blood Decrease in platelet count is called thrombocytopenia. It
vessels leads to thrombocytopenic purpura (Chapter 20).
2. von Willebrand factor romoocytopenia OCcurs in the following
Thromboxane A, Condi
4, Platelet-activating factor Acute infections
5. Thrombin
Acute leukemia
ADP
7. Calcium ions ii. Aplastic and pernicious anemia
iv. Chickenpox
8. P-selectin: Cell adhesion molecule secreted from
endothelial cells V. Smallpox
9. Convulxin: Purified protein from snake venom. vi. Splenomegaly
vii. Scarlet fever
INHIBITORS OF PLATELETS vii. Typhoid
1. Nitric oxide ix. Tuberculosis
2. Clotting factors: l1, IX, X, XI and X x. Purpura
3. Prostacyclin xi. Gaucher's disease.
4. Nucleotidases which breakdown the ADP.
2. Thrombocytosis
IDEVELOPMENT OF PLATELETS
Increase in platelet count is called thrombocytosis.
Platelets are formed from bone marrow. Pluripotent stem Thrombocvtosis occurs in the following n conditions:
cell gives rise to the colony forming unit-megakaryocyte L Allergic conditifitions
(CFU-M). This develops into megakaryocyte. Cytoplasm
of megakaryocyte form pseudopodium. A portion of
pseudopodium is detached to form platelet, which enters iv. Bone fractures
the circulation (Fig. 10.2). V. Surgical operations
Production of platelets is influenced by colony-stimu
vi. Splenectomy
lating factors and thrombopoietin. Colony-stimulating
factors are secreted by monocytes and T lymphocytes. vii. Rheumatic fever
Thrombopoietin is a glycoprotein like erythropoietin. It is vii. Trauma (wound or injury or damage caused by
secreted by liver and kidneys. external force).
126 Section 2 Blood and Body Fluids
3. Thrombocythemia 4. Glanzmann's Thrombasthenia
Thrombocythemia is the condition with persistent and Glanzmann's thrombasthenia is an inherited hemorrha
abnormal increase in platelet count. Thrombocythemia gic disorder, caused by structural or functional abnorma
occurs in the following conditions: lity of platelets. It leads to thrombasthenic purpura
i. Carcinoma (Chapter 20). However, the platelet count is nomal.
ii. Chronic leukemia It is characterized by normal clotting time, normal or
ii. Hodgkin's disease. prolonged bleeding time but defective clot retraction.