Therapeutic drug-induced platelet apoptosis: an overlooked issue in pharmacotoxicology

• Published in: Archives of toxicology Vol. 88; no. 2; pp. 185 - 198
• Main Authors: Thushara, R. M., Hemshekhar, M., Kemparaju, K., Rangappa, K. S., Devaraja, S., Girish, K. S.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2014; Springer Nature B.V
• Subjects: Apoptosis; Apoptosis - drug effects; Aspirin - adverse effects; Biomedical and Life Sciences; Biomedicine; Blood Platelets - drug effects; Blood Platelets - ultrastructure; Cisplatin - adverse effects; Drug therapy; Drug-Related Side Effects and Adverse Reactions; Environmental Health; Humans; Occupational Medicine/Industrial Medicine; Pharmacology; Pharmacology/Toxicology; Pharmacovigilance; Review Article; Thrombocytopenia - chemically induced; Thrombocytopenia - pathology; Toxicity; Vancomycin - adverse effects; Vancomycin - analogs & derivatives; Aspirin; Biodrugs; Balhimycin; Vancomycin; Platelet apoptosis; Microparticles; Cisplatin
• ISSN: 0340-5761; 1432-0738
• DOI: 10.1007/s00204-013-1185-3

The surfacing of the applied fields of biology such as, biotechnology, pharmacology and drug discovery was a boon to the modern man. However, it had its share of disadvantages too. The indiscriminate use of antibiotics and other biological drugs resulted in numerous adverse reactions including thrombocytopenia. One of the reasons for drug-induced thrombocytopenia could be attributed to an enhanced rate of platelet apoptosis, which is a less investigated aspect. The present essay sheds light on the adverse (pro-apoptotic) effects of some of the commonly used drugs and antibiotics on platelets viz. cisplatin, aspirin, vancomycin and balhimycin. Furthermore, the undesirable reactions resulting from chemotherapy could be attributed at least to some extent to the systemic stress induced by microparticles, which in turn are the byproducts of platelet apoptosis. Thereby, the essay aims to highlight the challenges in the emerging trend of cross-disciplinary implications, i.e., drug-induced platelet apoptosis, which is a nascent field. Thus, the different mechanisms through which drugs induce platelet apoptosis are discussed, which also opens up a new perspective through which the adverse effects of commonly used drugs could be dealt. The drug-associated platelet toxicity is of grave concern and demands immediate attention. Besides, it would also be appealing to examine the platelet pro-apoptotic effects of other commonly used therapeutic drugs.