Diagnostic Value of Platelet Transcriptome in Myeloproliferative Neoplasms

Besides their key role in hemostasis, platelets are functionally involved in a variety of other processes (angiogenesis, vascular remodeling, inflammatory reactions, and immune responses) and, accordingly, contribute to numerous pathologic events. This review summarizes the current data on the profile of platelet matrix and regulatory, protein non-coding RNAs in some pathologic processes. Many publications focus on platelet transcriptome in oncologic diseases regarding it as a specific marker of ‘tumor educated platelets’ (TEP) and deal with promising diagnostic tests, such as liquid biopsy. The identification of RNA transfer from platelets to tumor cells gave rise to developing modified platelets and their microvesicles as potential therapeutics, also using small interfering RNAs. In this paper, special attention is given to diagnostic value of the platelet RNA profile in chronic myeloproliferative neoplasms because platelets subsequently show pathologically altered megakaryocyte transcriptome. In particular, it independently confirms the diagnostic value of the platelet mRNA of CREB3L1 gene being a highly sensitive and specific marker of Ph-negative myeloproliferative neoplasms. The evaluation of mRNA level with the V617F mutation in the JAK2 gene can be chosen as an alternative to the assessment of mutant allele load in leukocyte DNA. This review also discusses the existing methodological issues in performing analytical procedures which appear to be the main disincentive to the widespread use of laboratory tests for RNA determination in platelets.