Pharmacological Modulation of Microparticle Release: New Strategies for the Management of Atherothrombotic Vascular Disorders

Microparticles (MPs) are submicron vesicles (0.1-1 mu m) shed from the membrane of platelets, monocytes, endothelial cells and other cell types. Abundant clinical evidence relates increased plasma levels of MPs with several cardiovascular and inflammatory diseases, being a topic of tremendous interest in recent years. MPs have been proposed as potential effectors in thrombosis, inflammation, vascular injury or angiogenesis. Although MPs were traditionally considered noxious actors, recent scientific advances revealed another layer of complexity with their diverse roles in the pathophysiology of thrombotic disorders. Therefore, whilst their impact on the evolution of the disease is indisputable, the milieu of factors regulating MP release is still an intriguing field. Since MPs have been shown to be involved in thrombosis and inflammatory diseases, modulation of their release might have important therapeutic applications and provide further insights into their (patho)physiological roles. In this regard, increasing clinical attention has been devoted to the effects of pharmacological agents on MP circulating levels and antigenic composition. This trend led to many recent studies with special focus on the pharmaceutical options to inhibit formation of procoagulant MPs. Thus, this review aims to summarize available clinical and in vitro literature on mechanisms triggering MP release and modulating their activity.