DYNAMICS OF PLATELET GLYCOPROTEIN IIB-IIIA RECEPTOR EXPRESSION AND FIBRINOGEN BINDING .1. QUANTAL ACTIVATION OF PLATELET SUBPOPULATIONS VARIES WITH ADENOSINE-DIPHOSPHATE CONCENTRATION

We have previously reported that maximal platelet activation with adenosine diphosphate (100 mu M ADP) causes rapid expression of all GPIIb-IIIa receptors for fibrinogen (FgR) (<1-3 s), measured with FITC-labeled PAC1 by flow cytometry. We have extended these studies to examine the effects of ADP concentration on the graded expression and Fg occupancy of GPIIb-IIIa receptors. Human citrated platelet-rich plasma, diluted 10-fold with Walsh-albumin-Mg+2 (2 mM), was treated with ADP (0.1-100 mu M). The rates of GPIIb-IIIa receptor expression or Fg binding were measured in unstirred samples by flow cytometry, using FITC-labeled monoclonal antibodies (mAb) PAC1 and 9F9, respectively, from on-rates, using increasing times between mAb and ADP additions. Fibrinogen receptors were all expressed rapidly at low (1 mu M) or high (100 mu M) ADP (few seconds), whereas Fg occupancy was 50% of maximal by about 2 min. The maximal extent of GPIIb-IIIa receptor expression and Fg occupancy was determined from maximal binding (FImax) at 30 min incubation with PAC1 or 9F9. On-rates and maximal extents of binding for either PAC1 or 9F9 probes showed identical [ADP]-response profiles (''K-D'' similar to 1.4 +/- 0.1 mu M). However, FImax studies showed bimodal histograms consisting of ''resting'' (P-0) and maximally ''activated'' (P*) platelets for both PAC1 and 9F9 binding, with the fraction of ''activated'' platelets increasing with ADP concentration. The data best fit a model where platelet subpopulations are ''quantally'' transformed from P-0 to P*, expressing all GPIIb-IIIa receptors, rapidly filled by Fg, but ''triggered'' at critical ADP concentrations. Larger, but not the largest, platelets appear to be the most sensitive subpopulation. The implications for clinical studies are discussed, and the relationship to dynamics of aggregation are described in a companion paper.