Platelet extracellular vesicles as biomarkers for arterial thrombosis

Arterial thrombosis is a major and global cause of human death and disability. Considering the socioeconomic costs of arterial thrombosis, identification of biomarkers to predict and detect arterial thrombosis at an early stage is an important public health goal. Platelet extracellular vesicles (PEV) are a new candidate biomarker of arterial thrombosis. PEV can be measured in biorepositories, thereby offering the possibility to validate PEV in multicenter clinical trials. PEV analysis has been hitherto hampered by lack of standardized methodology, but substantial technological improvements of PEV detection techniques have been achieved recently. However, before PEV emerge from research tools to clinical applications, a number of issues should be clarified. To facilitate validation of PEV as biomarkers of thrombosis, we discuss (i) whether PEV are useful as biomarkers of thrombosis, (ii) why previous conclusions on PEV concentrations, composition and functions require re-evaluation, and (iii) which questions have to be answered before PEV become clinically useful.