Neonatal Platelets Induce Monocytes to a Myeloid-Derived Suppressor Cell Phenotype.
Preeti Maurya1, Daniel O'Reilly2, Zachary Hilt3
1University of Rochester School of Medicine, Rochester, New York, United States.
Blood
|April 14, 2026
Summary
Neonatal platelets, unlike adult platelets, promote monocytes to become myeloid-derived suppressor cells (MDSCs) that limit T-cell activation. This immune-suppressing role of neonatal platelets may explain adverse outcomes from platelet transfusions in newborns.
Area of Science:
- Immunology
- Neonatal Medicine
- Hematology
Background:
- Adult and neonatal platelets differ in immune molecule expression.
- Predicting platelet-immune cell interactions in neonates is complex due to varying factors.
- Previous studies showed adult, but not neonatal, platelet transfusions increased monocyte trafficking in neonatal mice.
Purpose of the Study:
- To investigate the distinct immune effects of neonatal versus adult platelets on monocytes.
- To determine the mechanism by which neonatal platelets influence T-cell activation.
- To explore the implications of these findings for neonatal platelet transfusions.
Main Methods:
- Incubation of monocytes with neonatal or adult platelets/releasates.
- Assessment of monocyte phenotype (e.g., PD-L1 expression) and T-cell activation in vitro.
- In vivo studies using a neonatal mouse model and an asthma-like model.
- Analysis of prostaglandin E2 (PGE2) and EP4 signaling pathways.
Main Results:
- Neonatal platelets, but not adult platelets, induced a myeloid-derived suppressor cell (MDSC) phenotype in monocytes.
- MDSCs generated by neonatal platelets exhibited increased PD-L1 expression.
- Monocytes pre-incubated with neonatal platelets or releasates suppressed T-cell activation both in vitro and in vivo.
- Neonatal platelet-induced immune suppression was mediated by increased PGE2 production signaling through monocyte EP4 receptors.
Conclusions:
- Neonatal platelets possess immune-limiting functions in the neonatal period by suppressing T-cell responses indirectly.
- These findings suggest a mechanism contributing to adverse outcomes observed with neonatal platelet transfusions.
- Understanding these distinct platelet functions is crucial for optimizing neonatal care.
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