Platelet activation is a key factor in the development of cardiovascular diseases. High-density lipoprotein (HDL) is known for its cardioprotective activities including antithrombotic actions. While HDL mimetics have been explored for their potential to regulate thrombosis, their influence on platelet activity remains unclear. This study explores the capacity of synthetic HDL (sHDL) to modulate platelet function and investigates the underlying mechanisms. We examined the effects of sHDL, formulated with various ApoA1 mimetic peptides (18A, 5A, and 22A) and full-length ApoA1 protein, all complexed with 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC), on platelet function. DMPC-based sHDL demonstrated pronounced antiplatelet effects across all formulations. Comparison with DMPC micelles showed that all sHDL molecules were more effective, highlighting the crucial role of the protein-phospholipid complex in reducing platelet reactivity. Further analysis revealed that DMPC sHDL dose-dependently inhibited various platelet functions, including aggregation, integrin activation, α-granule secretion, protein kinase C (PKC) activation, and platelet spreading. Mechanistic studies demonstrated that DMPC sHDL's antiplatelet effects are not entirely dependent on cholesterol efflux, despite effectively reducing total platelet cholesterol. Furthermore, sHDL's activity was found to be independent of scavenger receptor BI (SR-BI). Notably, inhibition of the CD36 receptor markedly attenuated sHDL's antiplatelet activity and uptake, suggesting a novel mechanism distinct from that of native HDL. In summary, DMPC sHDL modulates platelet function through a synergistic action between protein and phospholipid components, primarily via CD36 receptor engagement. These insights pave the way for novel antiplatelet therapies utilizing sHDL's distinct properties.
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