Ethaninidothioic acid (R5421) is not a selective inhibitor of platelet phospholipid scramblase activity

Ethaninidothioic acid (R5421) has been used as a scramblase inhibitor to determine the role of phospholipid scrambling across a range of systems including platelet procoagulant activity. The selectivity of R5421 has not been thoroughly studied. Here, we characterised the effects of R5421 on platelet function and its suitability for use as a scramblase inhibitor.

Human platelet activation was measured following pretreatment with R5421 and stimulation with a range of agonists. Phosphatidylserine exposure was measured using annexin V binding. Integrin α_IIb β₃ activation and α-granule release were measured by flow cytometry. Cytosolic Ca²⁺ signals were measured using Cal520 fluorescence. An in silico ligand-based screen identified 16 compounds which were tested in these assays.

R5421 inhibited A23187-induced phosphatidylserine exposure in a time- and temperature-dependent manner. R5421 inhibited Ca²⁺ signalling from the PAR1, PAR4 and glycoprotein VI receptors as well as platelet α_IIb β₃ integrin activation and α-granule release. R5421 is therefore not a selective inhibitor of platelet scramblase activity. An in silico screen identified the pesticide thiodicarb as similar to R5421. It also inhibited platelet phosphatidylserine exposure, Ca²⁺ signalling from the PAR1 and glycoprotein VI, α_IIb β₃ activation and α-granule release. Thiodicarb additionally disrupted Ca²⁺ homeostasis in unstimulated platelets.

R5421 is not a selective inhibitor of platelet scramblase activity. We have identified the pesticide thiodicarb, which had similar effects on platelet function to R5421 as well as additional disruption of Ca²⁺ signalling which may underlie some of thiodicarb's toxicity.