Exploring bias in platelet P2Y 1 signalling: host defence versus haemostasis.

Platelets are necessary for maintaining haemostasis. Separately, platelets are important for the propagation of inflammation during the host immune response against infection. The activation of platelets also causes inappropriate inflammation in various disease pathologies, often in the absence of changes to haemostasis. The separate functions of platelets during inflammation compared to haemostasis are therefore varied and this will be reflected in distinct pathways of activation. The activation of platelets by the nucleotide adenosine diphosphate (ADP) acting on P2Y 1 and P2Y 12 receptors is important for the development of platelet thrombi during haemostasis. However, P2Y 1 stimulation of platelets is also important during the inflammatory response, and paradoxically in scenarios where no changes to haemostasis and platelet aggregation occur. In these events, Rho-GTPase signalling, rather than the canonical phospholipase Cβ (PLCβ) signalling pathway are necessary. We describe our current understanding of these differences, reflecting on recent advances in knowledge of P2Y 1 structure, and the possibility of biased agonism occurring from activation via other endogenous nucleotides, compared to ADP. Knowledge arising from these different pathways of P2Y 1 stimulation of platelets during inflammation compared to haemostasis may help therapeutic control of platelet function during inflammation or infection, whilst preserving essential haemostasis.