Platelets Promote Macrophage Polarization toward Pro-inflammatory Phenotype and Increase Survival of Septic Mice

Cell Rep. 2019 Jul 23;28(4):896-908.e5. doi: 10.1016/j.celrep.2019.06.062.


We investigated the contribution of human platelets to macrophage effector properties in the presence of lipopolysaccharide (LPS), as well as the beneficial effects and time frame for platelet transfusion in septic animals. Our results show that platelets sequester both pro-(TNF-α/IL-6) and anti-(IL-10) inflammatory cytokines released by monocytes. Low LPS concentrations (0.01 ng/mL) induced M2 macrophage polarization by decreasing CD64 and augmenting CD206 and CD163 expression; yet, the presence of platelets skewed monocytes toward type 1 macrophage (M1) phenotype in a cell-contact-dependent manner by the glycoprotein Ib (GPIb)-CD11b axis. Accordingly, platelet-licensed macrophages showed increased TNF-α levels, bacterial phagocytic activity, and a reduced healing capability. Platelet transfusion increased inducible nitric oxide synthase (iNOS)+ macrophages, improving bacterial clearance and survival rates in septic mice up to 6 h post-infection, an effect that was abolished by CD11b and GPIb blockade. Our results demonstrate that platelets orchestrate macrophage effector responses, improving the clinical outcome of sepsis in a narrow but relevant time frame.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / metabolism
  • Blood Platelets / drug effects
  • Blood Platelets / metabolism*
  • CD11b Antigen / metabolism
  • Cell Communication / drug effects
  • Cell Polarity* / drug effects
  • Cytokines / metabolism
  • Inflammation / pathology*
  • Inflammation Mediators / metabolism
  • Lipopolysaccharides / pharmacology
  • Macrophages / drug effects
  • Macrophages / pathology*
  • Male
  • Mice, Inbred C57BL
  • Monocytes / drug effects
  • Monocytes / metabolism
  • Nitric Oxide Synthase Type II / metabolism
  • Phenotype
  • Platelet Glycoprotein GPIb-IX Complex / metabolism
  • Platelet Transfusion
  • Sepsis / blood*
  • Sepsis / pathology
  • Shock, Septic / pathology
  • Survival Analysis


  • Anti-Inflammatory Agents
  • CD11b Antigen
  • Cytokines
  • Inflammation Mediators
  • Lipopolysaccharides
  • Platelet Glycoprotein GPIb-IX Complex
  • adhesion receptor
  • Nitric Oxide Synthase Type II