The role of podoplanin in tumor-associated thrombosis

Venous thromboembolism (VTE) is highly consequential for patients with cancer, it is the second leading cause of death in these patients. The literature describes several mechanisms leading to these complications. One of these is the interaction of podoplanin (PDPN), which is the subject of this article, with its receptor on platelets CLEC-2 (C-type lectin-like type II transmembrane receptor). This interaction leads to platelet activation and promotes hematogenous metastasis and thrombosis associated with cancer. Podoplanin is expressed in gliomas, squamous cell carcinoma, osteosarcoma by cancer cells, and it is also normally expressed in podocytes and lymphatic endothelial cells, but not in vascular endothelium. Thrombus inflammation initiates ectopic expression of podoplanin in vascular endothelial cells, which promotes thrombosis. It has been shown that podoplanin expression correlates with the incidence of VTE, as well as with cancer metastasis. Violation of the PDPN-CLEC-2 interaction may become a new direction in the development of drugs for the prevention of thrombosis for patients with cancer.