title: Blocking the EP3 receptor for PGE2 with DG-041 decreases thrombosis without impairing haemostatic competence.
abstract: OBJECTIVE
  Haemostasis interrupts bleeding from disrupted blood vessels by activating platelet aggregation and coagulation. A similar mechanism termed thrombosis generates obstructive thrombi inside diseased arteries. As a consequence of this similarity, current anti-thrombotic agents increase the risk of bleeding. Atherosclerotic plaques produce significant amounts of prostaglandin E2 (PGE2), which activates its receptor EP3 on platelets and aggravates atherothrombosis. We investigated whether blocking EP3 could dissociate atherothrombosis from haemostasis.
  
  
  RESULTS
  Inhibiting in vivo the receptor EP3 for PGE2 with the blocking agent DG-041 reduced murine thrombosis triggered by local delivery of arachidonic acid or ferric chloride on healthy arteries. Importantly, it also reduced thrombosis triggered by scratching murine atherosclerotic plaques. PGE2 was not produced at the bleeding site after tail clipping. Consistently, blocking EP3 did not alter murine tail, liver, or cerebral haemostasis. Furthermore, blocking EP3 reduced murine pulmonary embolism and intensified platelet inhibition by clopidogrel leaving tail bleeding times unchanged. Human atherosclerotic plaques produced PGE2, which facilitated platelet aggregation in human blood and rescued the function of P2Y12-blocked platelets. Finally, in healthy patients, DG-041 reduced platelet aggregation, but did not significantly alter the cutaneous bleeding time at doses up to eight times the dose that inhibited the facilitating effect of PGE2 on platelets.
  
  
  CONCLUSIONS
  In mice, blocking EP3 inhibited atherothrombosis without affecting haemostasis and intensified efficiency of conventional anti-platelet treatment without aggravating the bleeding risk. In patients, blocking EP3 should improve the prevention of cardiovascular diseases, which is currently limited by the risk of bleeding.
authors: Institut de Génétique et de Biologie Moléculaire et Cellulaire, Institut National de la Santé et de la Recherche Médicale U596, Centre National de la Recherche Scientifique UMR7104, Université Louis Pasteur, 67400 Illkirch, France.
authors: Peggy
authors: P
authors: Tilly
authors: Anne-Laure
authors: AL
authors: Charles
authors: Sophie
authors: S
authors: Ludwig
authors: Farid
authors: F
authors: Slimani
authors: Sabrina
authors: S
authors: Gross
authors: Olivier
authors: O
authors: Meilhac
authors: Bernard
authors: B
authors: Geny
authors: Kari
authors: K
authors: Stefansson
authors: Mark E
authors: ME
authors: Gurney
authors: Jean-Etienne
authors: JE
authors: Fabre
mesh_terms: D000178:Acrylamides / Q000494:pharmacology*; D000818:Animals; D001792:Blood Platelets / Q000187:drug effects; D000077144:Clopidogrel; D015232:Dinoprostone / Q000378:metabolism*; D004195:Disease Models, Animal; D051379:Mice; D058226:Plaque, Atherosclerotic / Q000188:drug therapy / Q000378:metabolism; D010974:Platelet Aggregation / Q000187:drug effects / Q000502:physiology; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D058308:Receptors, Prostaglandin E, EP3 Subtype / Q000037:antagonists & inhibitors*; D013450:Sulfones / Q000494:pharmacology*; D013927:Thrombosis / Q000188:drug therapy* / Q000378:metabolism; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000494:pharmacology
chemical_list: C531572:3-(1-((2,4-dichlorophenyl)methyl)-5-fluoro-3-methyl-1H-indol-7-yl)-N-((4,5-dichloro-2-thienyl)sulfonyl)-2-propenamide; D000178:Acrylamides; D010975:Platelet Aggregation Inhibitors; D058308:Receptors, Prostaglandin E, EP3 Subtype; D013450:Sulfones; D000077144:Clopidogrel; D015232:Dinoprostone; D013988:Ticlopidine
keywords: Anti-platelet agents; Atherothrombosis; Haemostasis; Prostaglandins