Synergistic Inhibition of Both P2Y1 and P2Y12 Adenosine Diphosphate Receptors As Novel Approach to Rapidly Attenuate Platelet-Mediated Thrombosis

Arterioscler Thromb Vasc Biol. 2016 Mar;36(3):501-9. doi: 10.1161/ATVBAHA.115.306885. Epub 2016 Jan 7.

Abstract

Objective: Unlike currently approved adenosine diphosphate receptor antagonists, the new diadenosine tetraphosphate derivative GLS-409 targets not only P2Y12 but also the second human platelet adenosine diphosphate receptor P2Y1 and may, therefore, be a promising antiplatelet drug candidate. The current study is the first to investigate the in vivo antithrombotic effects of GLS-409.

Approach and results: We studied (1) the in vivo effects of GLS-409 on agonist-stimulated platelet aggregation in anesthetized rats, (2) the antithrombotic activity of GLS-409 and the associated effect on the bleeding time in a canine model of platelet-mediated coronary artery thrombosis, and (3) the inhibition of agonist-stimulated platelet aggregation by GLS-409 versus selective P2Y1 and P2Y12 inhibition in vitro in samples from healthy human subjects before and 2 hours after aspirin intake. In vivo treatment with GLS-409 significantly inhibited adenosine diphosphate- and collagen-stimulated platelet aggregation in rats. Further, GLS-409 attenuated cyclic flow variation, that is, platelet-mediated thrombosis, in vivo in our canine model of unstable angina. The improvement in coronary patency was accompanied by a nonsignificant 30% increase in bleeding time. Of note, GLS-409 exerted its effects without affecting rat and canine hemodynamics. Finally, in vitro treatment with GLS-409 showed effects similar to that of cangrelor and the combination of cangrelor with the selective P2Y1 inhibitor MRS 2179 on agonist-stimulated platelet aggregation in human platelet-rich plasma and whole blood before and 2 hours after aspirin intake.

Conclusions: Synergistic inhibition of both P2Y1 and P2Y12 adenosine diphosphate receptors by GLS-409 immediately attenuates platelet-mediated thrombosis and effectively blocks agonist-stimulated platelet aggregation irrespective of concomitant aspirin therapy.

Keywords: P2Y1; P2Y12; adenosine diphosphate; antiplatelet therapy; aspirin.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adenosine Diphosphate / analogs & derivatives
  • Adenosine Diphosphate / pharmacology
  • Adenosine Monophosphate / analogs & derivatives
  • Adenosine Monophosphate / pharmacology
  • Adult
  • Animals
  • Aspirin / pharmacology
  • Blood Coagulation / drug effects
  • Blood Platelets / drug effects*
  • Blood Platelets / metabolism
  • Coronary Thrombosis / blood
  • Coronary Thrombosis / drug therapy*
  • Dinucleoside Phosphates / pharmacology*
  • Disease Models, Animal
  • Dogs
  • Dose-Response Relationship, Drug
  • Female
  • Fibrinolytic Agents / pharmacology*
  • Humans
  • Male
  • Platelet Aggregation / drug effects*
  • Platelet Aggregation Inhibitors / pharmacology*
  • Platelet Function Tests
  • Purinergic P2Y Receptor Antagonists / pharmacology*
  • Rats, Sprague-Dawley
  • Receptors, Purinergic P2Y1 / blood
  • Receptors, Purinergic P2Y1 / drug effects*
  • Receptors, Purinergic P2Y12 / blood
  • Receptors, Purinergic P2Y12 / drug effects*
  • Time Factors
  • Young Adult

Substances

  • Dinucleoside Phosphates
  • Fibrinolytic Agents
  • N(6)-methyl-2'-deoxyadenosine 3',5'-diphosphate
  • P2RY1 protein, human
  • P2RY12 protein, human
  • P2ry1 protein, rat
  • P2ry12 protein, rat
  • Platelet Aggregation Inhibitors
  • Purinergic P2Y Receptor Antagonists
  • Receptors, Purinergic P2Y1
  • Receptors, Purinergic P2Y12
  • Adenosine Monophosphate
  • Adenosine Diphosphate
  • cangrelor
  • Aspirin