---
title: "Platelet P‑selectin Differences Drive Neonatal Monocyte Migration After Adult Platelet Exposure"
id: "pubmed-42769001"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42769001"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42769001/"
doi: "10.1080/09537104.2026.2726287"
published_at: "2026-09-22T09:36:32.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Platelet P‑selectin Differences Drive Neonatal Monocyte Migration After Adult Platelet Exposure
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42769001
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42769001/)
- **DOI:** [10.1080/09537104.2026.2726287](https://doi.org/10.1080%2F09537104.2026.2726287)
- **Published At:** 2026-09-22T09:36:32.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Neonatal platelets (from cord blood) are functionally distinct from **adult platelets**, being comparatively hyporeactive to multiple agonists; transfusing adult platelets into neonates creates a developmental cellular mismatch. - The study used an **in vitro** model exposing neonatal (cord blood) monocytes to either neonatal or adult platelets to simulate transfusion-related mismatch. - **Adult platelets** showed higher surface **P‑selectin** expression and released more beta‑2‑microglobulin (B2M) after activation than neonatal platelets. - Both neonatal and adult platelets increased release of **IL‑8** and **MCP‑1** from neonatal monocytes to a similar extent; cytokine release was not dependent on platelet developmental stage. - Exposure to adult platelets induced significantly greater monocyte surface expression of **CCR2** and **CCR5**, indicating a shift toward a pro‑migratory monocyte phenotype compared with neonatal platelets. - Blocking **P‑selectin/PSGL‑1** interactions had no effect on platelet‑induced monocyte cytokine release but completely prevented the upregulation of monocyte **CCR2** and **CCR5**. - These results suggest that platelet **P‑selectin** exposure—higher on adult platelets—selectively regulates monocyte migration potential via **PSGL‑1**, while cytokine induction is mediated by other platelet factors. - Clinical relevance: developmental differences in platelet immune function may contribute to harmful inflammation after platelet transfusion in neonates; matching transfusion products by developmental stage may reduce pro‑migratory priming and improve outcomes. - The study emphasizes the need for further research into age‑matched platelet products and how platelet immune functions change with development.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 22. # Developmental differences in platelet P-selectin expression modulate neonatal monocyte inflammatory responses [Erin Soule-Albridge](https://pubmed.ncbi.nlm.nih.gov/?term=Soule-Albridge+E&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Emily Flahardy](https://pubmed.ncbi.nlm.nih.gov/?term=Flahardy+E&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Henry A Feldman](https://pubmed.ncbi.nlm.nih.gov/?term=Feldman+HA&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-2 "Department of Pediatrics, Harvard Medical School, Boston, MA, USA.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-3 "Biostatistics and Research Design Center, Boston Children's Hospital, Boston, MA, USA."), [Natalie Kane](https://pubmed.ncbi.nlm.nih.gov/?term=Kane+N&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Kimberley Banfield](https://pubmed.ncbi.nlm.nih.gov/?term=Banfield+K&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Amalia El Nems](https://pubmed.ncbi.nlm.nih.gov/?term=El+Nems+A&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Jesselin Romero Escobar](https://pubmed.ncbi.nlm.nih.gov/?term=Romero+Escobar+J&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Martha Sola-Visner](https://pubmed.ncbi.nlm.nih.gov/?term=Sola-Visner+M&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-2 "Department of Pediatrics, Harvard Medical School, Boston, MA, USA."), [Patricia Davenport](https://pubmed.ncbi.nlm.nih.gov/?term=Davenport+P&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#full-view-affiliation-2 "Department of Pediatrics, Harvard Medical School, Boston, MA, USA.") Affiliations Expand ### Affiliations * 1 Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA. * 2 Department of Pediatrics, Harvard Medical School, Boston, MA, USA. * 3 Biostatistics and Research Design Center, Boston Children's Hospital, Boston, MA, USA. * PMID: **42769001** * DOI: [ 10.1080/09537104.2026.2726287 ](https://doi.org/10.1080/09537104.2026.2726287) Item in Clipboard # Developmental differences in platelet P-selectin expression modulate neonatal monocyte inflammatory responses Erin Soule-Albridge et al. Platelets. 2026 Dec. Show details Display options Display options Format Abstract PubMed PMID Platelets Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Platelets%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Platelets%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42769001/) . 2026 Dec;37(1):2726287. doi: 10.1080/09537104.2026.2726287. Epub 2026 Sep 22. ### Authors [Erin Soule-Albridge](https://pubmed.ncbi.nlm.nih.gov/?term=Soule-Albridge+E&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Emily Flahardy](https://pubmed.ncbi.nlm.nih.gov/?term=Flahardy+E&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Henry A Feldman](https://pubmed.ncbi.nlm.nih.gov/?term=Feldman+HA&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-2 "Department of Pediatrics, Harvard Medical School, Boston, MA, USA.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-3 "Biostatistics and Research Design Center, Boston Children's Hospital, Boston, MA, USA."), [Natalie Kane](https://pubmed.ncbi.nlm.nih.gov/?term=Kane+N&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Kimberley Banfield](https://pubmed.ncbi.nlm.nih.gov/?term=Banfield+K&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Amalia El Nems](https://pubmed.ncbi.nlm.nih.gov/?term=El+Nems+A&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Jesselin Romero Escobar](https://pubmed.ncbi.nlm.nih.gov/?term=Romero+Escobar+J&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA."), [Martha Sola-Visner](https://pubmed.ncbi.nlm.nih.gov/?term=Sola-Visner+M&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-2 "Department of Pediatrics, Harvard Medical School, Boston, MA, USA."), [Patricia Davenport](https://pubmed.ncbi.nlm.nih.gov/?term=Davenport+P&cauthor_id=42769001)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-1 "Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42769001/#short-view-affiliation-2 "Department of Pediatrics, Harvard Medical School, Boston, MA, USA.") ### Affiliations * 1 Boston Children's Hospital, Division of Newborn Medicine, Boston, MA, USA. * 2 Department of Pediatrics, Harvard Medical School, Boston, MA, USA. * 3 Biostatistics and Research Design Center, Boston Children's Hospital, Boston, MA, USA. * PMID: **42769001** * DOI: [ 10.1080/09537104.2026.2726287 ](https://doi.org/10.1080/09537104.2026.2726287) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract Neonatal and adult platelets are functionally different, with neonatal platelets being comparatively hypo-reactive to multiple platelet agonists. When transfused, neonates receive platelets from adult donors, resulting in a cellular developmental mismatch. Platelets are key regulators of the monocyte inflammatory response, yet how the developmental stage of the platelet affects this response is unknown. In this study, we modeled this developmental mismatch _in vitro_ to investigate the neonatal (cord blood) monocyte inflammatory response and migratory phenotype after exposure to either neonatal (cord blood) or adult platelets. Adult platelets expressed more P-selectin on the surface and released more beta-2-microglobulin (B2M) after activation compared to neonatal platelets. While exposure to platelets of either developmental stage increased the release of IL-8 and MCP-1 from neonatal monocytes to a similar degree, exposure to adult platelets induced significantly greater monocyte CCR2 and CCR5 surface expression, consistent with a pro-migratory monocyte phenotype. Blocking P-selectin/PSGL-1 interactions had no effect on platelet induced monocyte cytokine release but completely abrogated monocyte CCR2 and CCR5 surface upregulation. These findings suggest that the monocyte pro-migratory phenotype is regulated by P-selectin exposure, which is influenced by the platelet developmental stage, while monocyte cytokine release is independent of platelet P-selectin expression or developmental stage. **Keywords:** Monocyte; neonate; transfusion. ## Plain language summary **What is the context?** Premature neonates in the neonatal intensive care unit (NICU) often receive platelet transfusions to prevent bleeding, but use of higher transfusion thresholds has been linked to increased death, bleeding, lung disease, and developmental delays.This may be due to a “mismatch” between the neonate’s platelets and the transfused platelets from adult donors. Compared to neonatal platelets, adult platelets are more active and potentially more inflammatory.Platelets help regulate inflammation through interactions with immune cells like monocytes, but how exposure to neonatal vs. adult platelets affects the monocyte inflammatory response is unknown.**What is new?** In this study, we found that monocytes isolated from neonates responded differently after exposure to adult vs. neonatal platelets.Exposure to adult platelets increased CCR2 and CCR5 on monocytes, priming them to migrate from blood into tissue – an effect driven by platelet P-selectin binding to the monocyte receptor PSGL-1.**What is the Impact?** These findings show the need to better understand how platelet immune function changes with development, so transfusion products can be better matched to a patient’s age – reducing harmful inflammation and improving outcomes. 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