Inhibitory effects of ethanol on pathological high shear stress-induced platelet adhesion and aggregation: a microfluidic chip model study.
Level 5 - mechanism / opinion, no new human data
In vitro bench/microfluidic laboratory experiment
PubMed 42210379 · doi:10.1186/s12959-026-00881-6
What was done
Whole blood incubated with ethanol at concentrations ranging from 0.125% to 1% was perfused through a microfluidic chip platform modeling normal venous shear (300 s⁻¹), arterial shear (1500 s⁻¹), and severe stenosis (80% stenosis, 8200 s⁻¹). Real-time fluorescence microscopy was used to quantify platelet adhesion and aggregation, while flow cytometry measured platelet activation via P-selectin (CD62P) expression under pathological shear. Coagulation cascade effects were evaluated using plasma recalcification assays, standard coagulation profiles (PT, APTT, TT), and thromboelastography (TEG parameters: R-value, MA-value, CI-value).
What was found
Ethanol produced concentration-dependent inhibition of platelet adhesion and aggregation across all shear conditions. This inhibitory effect was significantly enhanced under pathological high shear (8200 s⁻¹; p < 0.0001 compared to lower shear rates). Ethanol also suppressed shear-induced P-selectin expression. Across all tested concentrations, ethanol caused no changes in plasma recalcification kinetics, PT/APTT/TT parameters, or TEG metrics. Absolute quantitative values for platelet inhibition and coagulation metrics were not reported in the abstract.
Why it matters
These results provide a physical and cellular mechanism explaining the paradoxical cardiovascular effects of alcohol, suggesting ethanol selectively suppresses high-shear platelet activation in stenotic vessels without perturbing plasma coagulation pathways.
Limits
This was strictly an in vitro microfluidic model and does not account for in vivo vascular physiology, endothelial mediator release, blood flow pulsatility, or hepatic alcohol metabolism. The abstract does not disclose the sample size, donor demographics, or exact numerical effect sizes.
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