• 1 April 1987
    • journal article
    • research article
    • Vol. 109  (4) , 495-503
Abstract
Platelet adherence to subendothelium depends on binding of plasma von Willebrand factor (VWF) to the subendothelial surface and its subsequent interaction with platelet membrane glycoprotein Ib (GPIb) in the Baumgartner perfusion technique. To examine the role of the platelet glycoprotein IIb-IIIa (GPIIb-IIIa) complex in these processes, we performed studies in patients with platelets deficient in GPIIb-IIIa (thrombasthenia) or GPIb (Bernard-Soulier syndrome) in the Baumgartner system with human umbilical artery segments at a wall shear rate of 2600 sec-1. Morphometry specified the percentage of the subendothelial surface covered with contact (C) or spread (S) platelets or platelet thombi. Total platelet adherence was defined as C + S. In thrombasthenia, C showed a small but significant increase compared with controls, whereas C + S was reduced by .apprx. 40%; thrombi were totally absent. With Bernard-Soulier platelets, each parameter was reduced by 72% to 93%. To verify that these findings were related to the epitopes involved in VWF, fibronectin, and fibrinogen binding, we incubated normal blood with monoclonal antibodies to GPIIb-IIIa complex (10E5 and PLT-1) or GPIb (6D1), and these experiments yielded results similar to those observed with thrombasthenic and Bernard-Soulier platelets, respectively. By transmission electron microscopy, normal platelets preincubated with 10E5 or thrombasthenic platelets showed abormalitly short and blunt pseudopodia, suggesting that the platelet GPIIb-IIIa complex plays a role in platelet spreading on subendothelium. Our observations confirm that platelet spreading is mediated at least in part by the epitope(s) of the GPIIb-IIIa complex involved in adhesive protein binding. The congenital absence of this epitope, or its blockade by a monoclonal antibody, inhibits pseudopod formation on the subendothelial surface.