Proteomic perspectives on platelet reactivity: towards precision thrombosis research

PURPOSE OF REVIEW: Advances in proteomics continue to expand our understanding of how protein systems regulate platelet function in hemostasis, thrombosis, and inflammation. However, clinical translation of platelet proteomics findings remains limited. This review highlights recent studies of platelet proteomes and platelet function in development, aging, and disease. RECENT FINDINGS: Studies have defined platelet proteomes associated with hypoactivity and hyperactivity across embryonic, neonatal, adult, and aging states. Phosphoproteomics has revealed signaling pathways linked to platelet dysregulation in aging, nutrient states, and specific diseases. Analyses of platelet secretomes and extracellular vesicles show agonist, therapy, and disease-associated signatures in diabetes, neurodegeneration, cancer, and myeloproliferative neoplasms. Proteomic profiling of thrombi in myocardial infarction, stroke, and sepsis has uncovered distinct signatures implicating platelets in clot architecture, fibrinolysis resistance, and immune crosstalk. SUMMARY: Proteomics continues to define alterations in platelet composition shaped by development, aging, and disease, identifying molecular effectors of platelet function and pointing to biomarkers and therapeutic targets. Platelet proteomics is increasingly positioned to inform precision strategies in thrombotic and inflammatory disorders and to refine models of vascular biology and medicine.