Effects of the 5-Hydroxytryptamine 3 Receptor Antagonist Palonosetron on Hemostasis: An In Vitro Study Using Thromboelastography

<i>Background and Objectives</i>: Serotonin modulates platelet aggregation and secretion, but its role in hemostasis remains controversial. This study hypothesized that the 5-HT<sub>3</sub> receptor antagonist palonosetron may inhibit platelet function and aimed to evaluate i...

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Main Authors: Hyun-Jung Shin, Bon-Wook Koo, Ji-Na Kim, Ji-In Park, Hyo-Seok Na
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/4/682
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author Hyun-Jung Shin
Bon-Wook Koo
Ji-Na Kim
Ji-In Park
Hyo-Seok Na
author_facet Hyun-Jung Shin
Bon-Wook Koo
Ji-Na Kim
Ji-In Park
Hyo-Seok Na
author_sort Hyun-Jung Shin
collection DOAJ
description <i>Background and Objectives</i>: Serotonin modulates platelet aggregation and secretion, but its role in hemostasis remains controversial. This study hypothesized that the 5-HT<sub>3</sub> receptor antagonist palonosetron may inhibit platelet function and aimed to evaluate its effects on blood coagulation using thromboelastography (TEG). <i>Materials and Methods</i>: Blood samples from 11 healthy volunteers were treated with palonosetron at concentrations of 25, 250, and 2500 ng/mL. Untreated samples served as controls. Coagulation parameters were assessed using global hemostasis (citrated kaolin, citrated rapid TEG, citrated kaolin with heparinase, and citrated functional fibrinogen) and PlateletMapping (adenosine diphosphate [ADP], arachidonic acid, and others) assays. <i>Results</i>: In the global hemostasis assay, maximum amplitude values, reflecting clot strength, decreased with increasing palonosetron concentrations in all tests, including citrated kaolin (<i>p</i> = 0.031), citrated rapid TEG (<i>p</i> = 0.001), citrated kaolin with heparinase (<i>p</i> = 0.033), and citrated functional fibrinogen (<i>p</i> = 0.011). The PlateletMapping assay showed significant reductions in ADP-induced platelet aggregation (<i>p</i> = 0.001), with the largest inhibition observed at 2500 ng/mL (<i>p</i> = 0.007). Despite these changes, all values remained within normal reference ranges. <i>Conclusions</i>: Palonosetron induces hypocoagulable trends in vitro by inhibiting platelet function and fibrinogen-mediated clot strength. However, these changes are unlikely to result in clinically significant hemostatic impairment when used within therapeutic doses. Further research is warranted to confirm these findings and explore their clinical relevance.
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spelling doaj-art-b543d86bf9f940458bb0437047be37392025-08-20T02:18:09ZengMDPI AGMedicina1010-660X1648-91442025-04-0161468210.3390/medicina61040682Effects of the 5-Hydroxytryptamine 3 Receptor Antagonist Palonosetron on Hemostasis: An In Vitro Study Using ThromboelastographyHyun-Jung Shin0Bon-Wook Koo1Ji-Na Kim2Ji-In Park3Hyo-Seok Na4Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea<i>Background and Objectives</i>: Serotonin modulates platelet aggregation and secretion, but its role in hemostasis remains controversial. This study hypothesized that the 5-HT<sub>3</sub> receptor antagonist palonosetron may inhibit platelet function and aimed to evaluate its effects on blood coagulation using thromboelastography (TEG). <i>Materials and Methods</i>: Blood samples from 11 healthy volunteers were treated with palonosetron at concentrations of 25, 250, and 2500 ng/mL. Untreated samples served as controls. Coagulation parameters were assessed using global hemostasis (citrated kaolin, citrated rapid TEG, citrated kaolin with heparinase, and citrated functional fibrinogen) and PlateletMapping (adenosine diphosphate [ADP], arachidonic acid, and others) assays. <i>Results</i>: In the global hemostasis assay, maximum amplitude values, reflecting clot strength, decreased with increasing palonosetron concentrations in all tests, including citrated kaolin (<i>p</i> = 0.031), citrated rapid TEG (<i>p</i> = 0.001), citrated kaolin with heparinase (<i>p</i> = 0.033), and citrated functional fibrinogen (<i>p</i> = 0.011). The PlateletMapping assay showed significant reductions in ADP-induced platelet aggregation (<i>p</i> = 0.001), with the largest inhibition observed at 2500 ng/mL (<i>p</i> = 0.007). Despite these changes, all values remained within normal reference ranges. <i>Conclusions</i>: Palonosetron induces hypocoagulable trends in vitro by inhibiting platelet function and fibrinogen-mediated clot strength. However, these changes are unlikely to result in clinically significant hemostatic impairment when used within therapeutic doses. Further research is warranted to confirm these findings and explore their clinical relevance.https://www.mdpi.com/1648-9144/61/4/682palonosetronplatelet functionthromboelastographyhemostasis5-HT<sub>3</sub> receptor antagonistserotonin
spellingShingle Hyun-Jung Shin
Bon-Wook Koo
Ji-Na Kim
Ji-In Park
Hyo-Seok Na
Effects of the 5-Hydroxytryptamine 3 Receptor Antagonist Palonosetron on Hemostasis: An In Vitro Study Using Thromboelastography
Medicina
palonosetron
platelet function
thromboelastography
hemostasis
5-HT<sub>3</sub> receptor antagonist
serotonin
title Effects of the 5-Hydroxytryptamine 3 Receptor Antagonist Palonosetron on Hemostasis: An In Vitro Study Using Thromboelastography
title_full Effects of the 5-Hydroxytryptamine 3 Receptor Antagonist Palonosetron on Hemostasis: An In Vitro Study Using Thromboelastography
title_fullStr Effects of the 5-Hydroxytryptamine 3 Receptor Antagonist Palonosetron on Hemostasis: An In Vitro Study Using Thromboelastography
title_full_unstemmed Effects of the 5-Hydroxytryptamine 3 Receptor Antagonist Palonosetron on Hemostasis: An In Vitro Study Using Thromboelastography
title_short Effects of the 5-Hydroxytryptamine 3 Receptor Antagonist Palonosetron on Hemostasis: An In Vitro Study Using Thromboelastography
title_sort effects of the 5 hydroxytryptamine 3 receptor antagonist palonosetron on hemostasis an in vitro study using thromboelastography
topic palonosetron
platelet function
thromboelastography
hemostasis
5-HT<sub>3</sub> receptor antagonist
serotonin
url https://www.mdpi.com/1648-9144/61/4/682
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