Previous reports of the inhibitory effects of trifluoperazine on platelet responses to different aggregating agents have been conflicting, and the mechanism of action remains unclear. We have found that aggregation by minimum concentrations of collagen and arachidonic acid, and second phase aggregation by minimum concentrations of ADP, thrombin, epinephrine and the calcium ionophore A23187 were inhibited by 40-60 microM trifluoperazine. The first phase of aggregation by a minimum concentration of epinephrine was completely inhibited by 100 microM trifluoperazine, and the first phase of aggregation induced by ADP, thrombin or A23187 was decreased by 300 microM trifluoperazine. The platelet shape change caused by collagen, but by no other aggregating agent examined, was inhibited by 300 microM trifluoperazine. Secretion of 3H-5 hydroxytryptamine by minimum concentrations of ADP, collagen, epinephrine and arachidonic acid was completely suppressed by 50 microM trifluoperazine. Secretion by thrombin and A23187 was incompletely inhibited by 300 microM trifluoperazine. Thromboxane B2 formation caused by all aggregating agents, except epinephrine, was incompletely suppressed by 50 microM trifluoperazine, and 300 microM trifluoperazine only caused complete inhibition of thromboxane B2 formation by ADP, collagen and epinephrine. The phorbol ester, TPA, which mimics diacylglycerol by activating protein kinase C, caused aggregation and secretion. Aggregation, but not secretion, by low concentrations of TPA was inhibited by concentrations of trifluoperazine as low as 50 microM. However, aggregation by a combination of TPA and A23187 was only inhibited by concentrations of trifluoperazine in excess of 100 microM. Secretion by TPA was inhibited by concentrations of trifluoperazine in excess of 200 microM. Our findings suggest that low concentrations of trifluoperazine inhibit platelet activation by inhibiting phospholipase A2, and that higher concentrations inhibit platelet responses by interfering with protein kinase C.

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