Die Rolle von Thrombozyten bei Hämostase, Thrombose, Immunabwehr und Entzündung

Zusammenfassung

Unsere Vorstellung über die verschiedenen Rollen der Thrombozyten hat sich in den letzten Jahren deutlich verändert. Waren Thrombozyten bis vor wenigen Jahren den meisten nur als Akteure bei der primären Hämostase und als Lieferant für eine negativ geladene Phospholipidoberfläche bekannt, so musste dieses Bild spätestens mit der Entdeckung von spezifischen Proteinrezeptoren für Gerinnungsfaktoren auf der Plättchenoberfläche revidiert werden. Neben ihrer regulativen Rolle in der Hämostase können Thrombozyten auch als Abwehrzellen angesehen werden. Als solche interagieren sie direkt mit Mikroorganismen, wie Bakterien, pathogenen Pilzen und Protozoen. In Wechselwirkung mit Endothelzellen und Leukozyten nehmen sie direkten Einfluss auf unspezifische und spezifische Abwehr. Thrombozyten spielen zweifelsfrei eine wesentliche Rolle bei thromboembolischen Komplikationen der fortgeschrittenen arteriosklerotischen Läsion, sind aber auch schon an der initialen Entstehung der Arteriosklerose beteiligt und spielen eine wichtige Rolle bei dem Fortschreiten der Erkrankung.

Summary

The views on the role of platelets in physiology and in pathogenesis have considerably changed in the recent past. While platelets had previously been seen only as contributors in primary haemostasis and as donors of negatively charged phospholipids to support thrombin formation, this view has had to be revised, at least since the discovery of specific receptors for coagulation factors on the platelet surface. Platelets are part of the body's immune defence system. They can interact with bacteria, pathogenic fungi and protozoa. The interaction of platelets with endothelial cells and leukocytes is crucial in innate and adaptive immunity. Platelets participate in the pathogenesis of the initial lesions and in the progression of atherrosclerosis by inducing chronic inflammatory processes at the vascular wall, which result in the development of atherosclerotic lesions and atherothrombosis.

Schlüsselwörter

Thrombozyten - Thrombozytopathien - Blutungsneigung - Thrombose - Entzündung - Immunabwehr

Key words

platelets - platelet disorders - bleeding - thrombosis - inflammation - host defense

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