Biologicals, platelet apoptosis and human diseases: An outlook

• Platelets play a major role in health and disease including heart diseases and cancer.
• Commonly used biologicals induce increased platelet apoptosis and thrombocytopenia.
• Increased platelet apoptosis causes excess microparticle formation which is dangerous.
• Side-effects of biologicals on platelets and the consequences are often neglected.
• There is a need to overcome side-effects of proapoptotic drugs via auxiliary therapy.

Platelets, once considered mediators of hemostasis and thrombosis, are now known to be involved in wound healing, inflammation, cardiovascular diseases, diabetes, arthritis, and cancer. Recent reports attest that platelets possess the cellular machinery to undergo apoptosis and that platelet apoptosis can be triggered by myriad stimuli including chemical and physical agonists, and pathophysiological conditions. Augmented rate of platelet apoptosis leads to thrombocytopenia, bleeding disorders and microparticle generation. Despite knowing the significant role of platelets in health and disease, and that any alterations in platelet functions can wreak havoc to the health, the offshoot reactions of therapeutic drugs on platelets and the far-reaching consequences are often neglected. The present review focuses on the impact of platelet apoptosis and the role of platelet-derived microparticles on different pathophysiological conditions. It also touches upon the effects of biologicals on platelets, and discusses the need to overcome the adverse effects of pro-apoptotic drugs through auxiliary therapy.