Journal
JOURNAL OF CLINICAL INVESTIGATION
Volume 127, Issue 12, Pages 4338-4351Publisher
AMER SOC CLINICAL INVESTIGATION INC
DOI: 10.1172/JCI95109
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Funding
- National Natural Science Foundation of China [81130008, 81570102, 81500093]
- National Key Basic Research Program of China [2012CB526600]
- NIH [R35GM122457]
- Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD)
- Jiangsu Provincial Special Program of Medical Science [BL2012005]
- Jiangsu Province's Key Medical Center [ZX201102]
- Jiangsu Province's Outstanding Medical Academic Leader Program
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Apoptosis delimits platelet life span in the circulation and leads to storage lesion, which severely limits the shelf life of stored platelets. Moreover, accumulating evidence indicates that platelet apoptosis provoked by various pathological stimuli results in thrombocytopenia in many common diseases. However, little is known about how platelet apoptosis is initiated or regulated. Here, we show that PKA activity is markedly reduced in platelets aged in vitro, stored platelets, and platelets from patients with immune thrombocytopenia (ITP), diabetes, and bacterial infections. Inhibition or genetic ablation of PKA provoked intrinsic programmed platelet apoptosis in vitro and rapid platelet clearance in vivo. PKA inhibition resulted in dephosphorylation of the proapoptotic protein BAD at Ser155, resulting in sequestration of prosurvival protein BCL-XL in mitochondria and subsequent apoptosis. Notably, PKA activation protected platelets from apoptosis induced by storage or pathological stimuli and elevated peripheral platelet levels in normal mice and in a murine model of ITP. Therefore, these findings identify PKA as a homeostatic regulator of platelet apoptosis that determines platelet life span and survival. Furthermore, these results suggest that regulation of PKA activity represents a promising strategy for extending platelet shelf life and has profound implications for the treatment of platelet number-related diseases and disorders.
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