Circadian rhythm in platelet: an emerging therapeutic target in human diseases

Platelet function and count display robust circadian oscillations with a period of approximately 24 hours, governed by the core molecular clock and modulated by environmental factors such as light, diet, and stress. This review elaborates on three key aspects. First, platelet surface markers peak around 8-9 AM, whereas platelet count, ATP release, and aggregability reach their maximum between 3-8 PM. Mechanistically, the nuclear receptor Rev-erbα drives the morning surge in platelet reactivity and thrombosis via the OPHN-1/RhoA/ERM signaling pathway. Second, through their circadian rhythm, platelets actively participate in the pathogenesis of cardiovascular diseases, neurological disorders, and metabolic diseases. Third, circadian-targeting drugs including tasimelteon, ramelteon, agomelatine, SR9009, VTP-43742, and PF-670462 offer novel therapeutic strategies for rhythm-related disorders. This review highlights the circadian regulation of platelets as an emerging therapeutic target in human diseases.