Olfactory Receptor Activation Reduces Platelet Reactivity and Arterial Thrombosis Through Actin Cytoskeleton Remodeling

A Anu Aggarwal (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) V Vara Prasad V.N. Josyula (Center for Therapeutics Discovery, Cleveland Clinic Research , Cleveland Clinic Foundation, OH (V.P.V.N.J., N.W., S.S.).) N Nancy Wang (Department of Neurology, Massachusetts General Hospital, Boston) M Moua Yang (Division of Hematology and Oncology, Department of Medicine, University of Washington School of Medicine and Bloodworks Northwest Research Institute, Seattle (M.Y., Q.P.K.).) Y Young Jun Shim (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) Q Quinn P. Kennedy (Division of Hematology and Oncology, Department of Medicine, University of Washington School of Medicine and Bloodworks Northwest Research Institute, Seattle (M.Y., Q.P.K.).) R Reina Samuel (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) N Naseer Sangwan (Center for Microbiome and Human Health, Cleveland Clinic Research) S Suman Guntupalli (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) M Matthew Godwin (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) H Huijun Edelyn Park (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) M Mariya Ali (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) C Courtney Jennings (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) B Bhairavi Rajasekar (Section of Vascular Medicine, Department of Cardiovascular Medine, Heart Vascular and Thoracic Institute, Cleveland Clinic Foundation, OH (B.R., A. S, S.J.C.).) A Alliefair Scalise (Section of Vascular Medicine, Department of Cardiovascular Medine, Heart Vascular and Thoracic Institute, Cleveland Clinic Foundation, OH (B.R., A. S, S.J.C.).) A Anthony R. Sloan (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) J Justin D. Lathia J Jessica Grondolsky (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) S Sarah M. Schumacher (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) S Shaun Stauffer (Center for Therapeutics Discovery, Cleveland Clinic Research , Cleveland Clinic Foundation, OH (V.P.V.N.J., N.W., S.S.).) K Keith R. McCrae (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) T Thomas M. McIntyre (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).) S Scott J. Cameron (Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).)

Abstract

BACKGROUND: Despite antiplatelet therapy, some patients remain at high ischemic risk because of drug nonresponsiveness or high residual platelet reactivity. We aimed to target an orphan platelet GPCR (G protein–coupled receptor) from the OR (olfactory receptor) family as a novel antithrombotic strategy. METHODS: Using an engineered reporter cell line expressing human OR2L13 , an orphan GPCR implicated in limiting platelet reactivity, we conducted a high-throughput screen of 8000 nonodorant bioactive compounds with counterscreen validation. Subsequent studies assessed platelet function in healthy subjects and patients with coronary artery and peripheral artery disease. Phospho-proteomics revealed key signaling pathways, whereas ex vivo and in vivo studies evaluated the impact of a lead compound on platelet signaling, biomechanics, and thrombosis in both arterial and venous vasculature. RESULTS: We identified 6 OR2L13 (olfactory receptor family 2 subfamily L member 13)-specific agonists that suppressed platelet aggregation and α-granule exocytosis through multiple receptors, suggesting a shared downstream mediator. The lead agonist (CCF0054500) phosphorylated platelet HSP27 (heat shock protein 27), disrupting the actin cytoskeleton and reducing clot retraction (clot area, 70.6 versus 5.2; P <0.0001), an effect reversed by HSP27 inhibition. In a murine arterial injury model, CCF0054500 decreased platelet accumulation by 88.9% ( P <0.0003) without affecting fibrin generation or hemostasis. In a myocardial infarction model with high residual platelet reactivity, CCF0054500 lowered platelet reactivity ( P <0.0001) and improved left ventricular function ( P =0.007). CONCLUSIONS: We describe and characterize the first nonolfactory probe for the purpose of inhibiting platelet activation and thrombosis through downstream HSP27 in a comprehensive investigation using a first-of-its-kind platelet inhibitor targeting an orphan platelet GPCR.

Article Details

Journal Circulation
Volume / Issue Vol. 153, Issue 23
Published June 09, 2026
Pages 1827-1844
ISSN 0009-7322
Publisher Lippincott Williams & Wilkins

Journal Info

Circulation

Lippincott Williams & Wilkins

ISSN: 0009-7322 Health Sciences

Authors (23)

A

Anu Aggarwal

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

V

Vara Prasad V.N. Josyula

Center for Therapeutics Discovery, Cleveland Clinic Research , Cleveland Clinic Foundation, OH (V.P.V.N.J., N.W., S.S.).

N

Nancy Wang

Department of Neurology, Massachusetts General Hospital, Boston

M

Moua Yang

Division of Hematology and Oncology, Department of Medicine, University of Washington School of Medicine and Bloodworks Northwest Research Institute, Seattle (M.Y., Q.P.K.).

Y

Young Jun Shim

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

Q

Quinn P. Kennedy

Division of Hematology and Oncology, Department of Medicine, University of Washington School of Medicine and Bloodworks Northwest Research Institute, Seattle (M.Y., Q.P.K.).

R

Reina Samuel

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

N

Naseer Sangwan

Center for Microbiome and Human Health, Cleveland Clinic Research

S

Suman Guntupalli

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

M

Matthew Godwin

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

H

Huijun Edelyn Park

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

M

Mariya Ali

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

C

Courtney Jennings

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

B

Bhairavi Rajasekar

Section of Vascular Medicine, Department of Cardiovascular Medine, Heart Vascular and Thoracic Institute, Cleveland Clinic Foundation, OH (B.R., A. S, S.J.C.).

A

Alliefair Scalise

Section of Vascular Medicine, Department of Cardiovascular Medine, Heart Vascular and Thoracic Institute, Cleveland Clinic Foundation, OH (B.R., A. S, S.J.C.).

A

Anthony R. Sloan

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

J

Justin D. Lathia

J

Jessica Grondolsky

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

S

Sarah M. Schumacher

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

S

Shaun Stauffer

Center for Therapeutics Discovery, Cleveland Clinic Research , Cleveland Clinic Foundation, OH (V.P.V.N.J., N.W., S.S.).

K

Keith R. McCrae

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

T

Thomas M. McIntyre

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).

S

Scott J. Cameron

Department of Heart, Blood and Kidney Research, Cleveland Clinic Research, Cleveland Clinic Foundation, OH (A.A., Y.J.S., R.S., N.S., S.G., M.G., H.E.P., M.A., C.J., A.R.S., J.D.L., J.G., S.M.S., K.R.M., T.M.M., S.J.C.).