Platelets in chronic liver disease, from bench to bedside

Pierluigi Ramadori; Thomas Klag; Nisar Peter Malek; Mathias Heikenwalder

doi:10.1016/j.jhepr.2019.10.001

Platelets in chronic liver disease, from bench to bedside

JHEP Rep. 2019 Oct 25;1(6):448-459. doi: 10.1016/j.jhepr.2019.10.001. eCollection 2019 Dec.

Authors

Pierluigi Ramadori¹, Thomas Klag², Nisar Peter Malek², Mathias Heikenwalder¹

Affiliations

¹ Division of Chronic Inflammation and Cancer, German Cancer Research Center Heidelberg (DKFZ), Heidelberg, Germany.
² Department of Internal Medicine I, University of Tuebingen, Tuebingen, Germany.

Abstract

In the last decade, numerous studies revealed physiologic and pathophysiologic roles of platelets beyond haemostasis, a process to prevent and stop bleeding. These include the activation of the immune system and the promotion of inflammation, infection and cancer. Hence, the emerging view on the role of platelets has shifted - platelets are now seen as alert "sentinels" of the immune compartment, rather than passive bystanders. Herein, we review well-established and newly discovered features of platelets that define their natural role in maintaining blood haemostasis, but also their functional relationship with other cells of the immune system. We focus on recent studies underlining functional involvement of platelets in chronic liver diseases and cancer, as well as the effects of anti-platelet therapy in these contexts. Finally, we illustrate the potential of platelets as possible diagnostic and therapeutic tools in liver disease based on recently developed methodologies.

Keywords: HCC; NAFLD; NASH; Platelets; cancer; cirrhosis; immune system; immunology.

Publication types

Review