Prospects for pharmacological validation of the use of platelets as a "peripheral model" of neurons

Introduction. Depressive disorders are often found in patients with pathology of the cardiovascular system and are a predictor of the development of thrombotic events, such as myocardial infarction, acute ischemic cerebrovascular accident, pulmonary embolism. There are reasons to believe that this is due to the structural and biochemical relationship of platelets and brain neurons, which allows us to consider platelets as a marker of the pathology of the central nervous system. The purpose of this review is to assess the relationship between the hemostasis system and the development of depressive disorders from the standpoint of using platelets as a peripheral model of neurons and evaluating the effectiveness of drugs for the treatment of depression. Materials and methods. The work was carried out in accordance with the recommendations of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). For this review, a systematic literature search was conducted using PubMed, Cochrane and CINAHL databases for the period from 2018 to 2023, according to the keywords, hemostasis, acute cerebrovascular accident, depression, depressive disorders, platelets, cardiovascular diseases". Results. The data obtained indicate both a clinical link between depressive disorders and vascular events, and the commonality of platelets and CNS cells due to the commonality of the following proteins: transporters and receptors of serotonin or 5-hydroxytryptamine (5-HT), amyloid precursor protein (APP) and brain neurotrophic factor (BDNF), which previously they were considered specific neural proteins. In addition, there is a relationship between the dynamics of hemostasis and drug therapy for depression. Conclusions. In this review, we critically analyzed changes in hemostasis in terms of platelet activation in depressed patients with vascular disease. The mechanisms of platelet induction presented in the literature are diverse and require further study. A rational study of the pathways of platelet activation in patients with depressive disorders will provide a comprehensive understanding of the essence of the molecular mechanisms underlying the relationship of hemostasis in patients with depression in various vascular pathologies. Platelet activation in patients with depression and the dynamics of changes in hemostasis system parameters during the treatment of depressive disorders allows us to consider hemostasis as a peripheral marker of the central nervous system and pharmacotherapy.