Novel mechanisms of platelet clearance and thrombopoietin regulationGrozovsky, Renata; Giannini, Silvia; Falet, Hervé; Hoffmeister, Karin M.Current Opinion in Hematology: September 2015 - Volume 22 - Issue 5 - p 445–451 doi: 10.1097/MOH.0000000000000170 HEMOSTASIS AND THROMBOSIS: Edited by Joseph E. Italiano and Jorge A. Di Paola Abstract Author Information Purpose of review The human body produces and removes 1011 platelets daily to maintain a normal steady-state platelet count. Platelet production must be tightly regulated to avoid spontaneous bleeding or arterial occlusion and organ damage. Multifaceted and complex mechanisms control platelet removal and production in physiological and pathological conditions. This review will focus on different mechanisms of platelet clearance, with focus on the biological significance of platelet glycans. Recent findings The Ashwell–Morrell receptor (AMR) recognizes senescent, desialylated platelets under steady state conditions. Desialylated platelets and the AMR are the physiological ligand–receptor pair regulating hepatic thrombopoietin (TPO) mRNA production, resolving the longstanding mystery of steady state TPO regulation. The AMR-mediated removal of desialylated platelets regulates TPO synthesis in the liver by recruiting JAK2 and STAT3 to increase thrombopoiesis. Summary Inhibition of TPO production downstream of the hepatic AMR–JAK2 signaling cascade could additionally contribute to the thrombocytopenia associated with JAK1/2 treatment, which is clinically used in myeloproliferative neoplasms. Division of Hematology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA Correspondence to Karin M. Hoffmeister, MD, Division of Hematology, Brigham and Women's Hospital, One Blackfan Circle, Karp 6, Boston, MA 02115, USA. E-mail: firstname.lastname@example.org Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.