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The relative importance of platelet activation by PAMPs in sepsis is not well established.
The multiple facets of platelet involvement in sepsis therefore represent substantial challenges to the clinician and call for a deeper understanding of the relative importance of platelet contribution to determine their ultimate clinical significance.
Of course, the importance of platelet mitochondrial dysfunction per se has to be put in perspective.
This also highlights the potential importance of platelet function testing and monitoring of antiplatelet therapy.
Looney and colleagues [ 43] described the importance of platelet and neutrophil interaction as an essential component of the 'two-hit' model of TRALI.
They also have defects in tissue repair after injury, reflecting the importance of platelet α-granule secretome beyond the haemostasis/thrombosis context [53].
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The importance of platelets is exemplified by the disruption of the endothelium barrier associated with thrombocytopenia [109].
There is growing evidence demonstrating the importance of platelet-leucocyte aggregation in atherothrombosis and acute coronary syndromes.
The importance of platelet-derived VEGF in cancer may be due to VEGF released upon thrombin activation by platelets, with VEGF inducing vascular permeability and in doing so further promoting coagulation (Mohle et al, 1997; Verheul and Pinedo, 1998).
These findings broaden the importance of platelet-mediated cytoprotection and are significant as etoposide is a chemotherapeutic used to treat malignancies, including small cell lung carcinoma, germ-line cancers, sarcoma, lymphoma and leukaemia.
The importance of platelets in each of the steps varies in different vasculatures.
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