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Abstract Or101: Targeting mitochondrial calcium uniporter attenuates platelet hyperactivation and procoagulant phenotype associated with obesity in humans and mice
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Abstract Or101: Targeting mitochondrial calcium uniporter attenuates platelet hyperactivation and procoagulant phenotype associated with obesity in humans and mice

Madankumar Ghatge, Gagan Flora, Mariia Kumskova, Manasa Nayak, Pedro Hsieh, Marcelo Correia and Anil Chauhan
Arteriosclerosis, thrombosis, and vascular biology, Vol.46(Suppl_1)
05/2026
DOI: 10.1161/atvb.46.suppl_1.Or101

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Abstract

Abstract only Background: Obesity and non-alcoholic fatty liver disease (NAFLD) is associated with platelet hyperactivity and thrombotic risk, yet its underlying mechanism remains poorly understood. Platelet function depends on spatiotemporal intracellular Ca 2+ signaling, where oscillations support aggregation and sustained rise drive induce procoagulant activity. The regulatory role of mitochondrial calcium uniporter (MCU), the primary route for mitochondrial Ca 2+ uptake, in regulating platelet hyperactivity in obesity and NAFLD remains unexplored. Aim: Determine whether MCU acts as a key regulator of platelet hyperactivity in obesity and NAFLD. Methods: Platelets from obese and NAFLD patients (BMI >30) and matched lean controls (BMI <25) were analyzed. WT and platelet-specific MCU knockout mice were fed chow or high-fat diet for 12–25 weeks. Aggregation and ATP secretion were assessed by aggregometry; αIIbβ3 activation and α-granule secretion by flow cytometry; Ca 2+ mobilization by fluorometry; and signaling pathways by immunoblotting. Results: In both early-onset obesity and obesity with NAFLD (in humans and mice), we observed increased PLC-γ activation, PKC substrate phosphorylation, and enhanced Ca 2+ mobilization, indicating platelet hyperactivity. Platelets from early obesity exhibited GPVI- and GPCR agonist induced hyperaggregation, increased granule secretion, and enhanced αIIbβ3-activation (P<0.05 vs. lean controls). In contrast, platelets from obesity with NAFLD displayed a state of functional exhaustion with a greater propensity toward a procoagulant phenotype, characterized by increased phosphatidyl serine exposure. Next, we assessed platelet function in both conditions using platelet-specific MCU knockout and pharmacological inhibition of MCU. In early obesity, MCU inhibition attenuated GPVI- and GPCR-mediated aggregation and secretion. Similarly, MCU modulation prevented mitochondrial depolarization and procoagulant transformation associated with the exhausted platelet state. These antiplatelet effects were mechanistically linked to the prevention of MCU-mediated Ca 2+ overload and preservation of mitochondrial membrane potential, supporting a central role for MCU in regulating cytosolic and mitochondrial Ca 2+ homeostasis that drives a bioenergetic shift toward metabolic regulated thrombosis. Conclusion: MCU functions a key regulator of platelet hyperactivity in obesity and NAFLD via coupling cytosolic Ca 2+ signaling to mitochondrial bioenergetics.

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