AABB2026: Comparing Neonatal and Adult Platelets, Researchers Identify Differences in Developmental Changes in Metabolic Activities

Platelets from neonates are more likely to show elevated metabolic potential compared with platelets from adults, according to new findings presented by Christopher Thom, MD, PhD, assistant professor of pediatrics at Children's Hospital of Philadelphia.

The findings, presented during the Sunday morning oral abstract spotlight session titled “Basic Science Insights Into Red Blood Cells and Platelets,” demonstrated that these differences remained, regardless of whether the platelets were at rest or following activation.

Thom said these findings were important because infants with thrombocytopenia are often transfused with platelets from adult donors in an effort to prevent bleeding. However, as Thom noted,, liberal transfusion of platelets from adult donors is associated with increased risks for neonatal bleeding, respiratory complications, neurocognitive impairment, and mortality in preterm neonates.

Thom and his colleagues assessed data comparing neonatal platelets with adult platelets in both humans and mice. They defined pathways that were consistently up- or down-regulated throughout development. An analysis showed that signaling pathways associated with greater platelet reactivity were increased in platelets from adults. At the same time, vascular growth factors and metabolic pathways were more active in platelets from neonates.

Thom said these findings could underlie functional differences between platelets from adults and those from neonates. Additionally, he said these findings show that “targeted metabolic manipulation could help create platelet transfusion products with functional profiles appropriate for neonatal physiology.”