Platelet-Bacterial Interactions as Therapeutic Targets in Infective Endocarditis

Endocarditis is an inflammation of the lining of the heart and valves. It can be due to a noninfectious cause (Asopa et al., 2007) but when the inflammation is associated with an infection, usually bacterial, it is known as infective endocarditis (IE) and is characterized by the development of a large septic thrombus on one of the cardiac valves (Beynon et al., 2006; Moreillon and Que, 2004). As this thrombus grows, it can lead to valve failure or may fragment forming a septic embolus that is associated with high mortality if the target of the embolus is the brain, heart or lung (Homma and Grahame-Clarke, 2003). Untreated the mortality is very high and even with aggressive therapy with antibiotics and valve replacement surgery there is a significant mortality. Primarily the disease is due to the formation of a platelet-bacteria thrombus on a cardiac valve and this review will look at the interaction between bacteria and platelets within the context of endocarditis.