Adenosine diphosphate
metaboliteADP released from platelet dense granules activates P2Y receptors, sustaining platelet aggregation and thrombus propagation.
Pathway placement
Cascade stepPlatelet adhesion & activation
Confidencehigh
RationaleADP released from platelet dense granules; P2Y12 agonist driving platelet activation.
Also acts inCoagulation / thrombus
Druggability
Not assessed (no mapped human gene target).
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I67
C — confounder / Type-II67
A — assay feasibility42
E — evidence strength52
T1DI (composite)11
Specificity differential (R−C)0
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationn/a
4tachyarrhythmian/a
5hypoxemia / respiratory failuren/a
6hypertensive emergencyn/a
7high-demand / peri-operative stressn/a
Coverage: 1/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 4 supporting references. See the discrimination table for all markers.
Assay & specimen
Class-level default (no specific cleared assay)— generic method inferred from analyte class; confirm against a specific product insert before use.
Specimen
Serum, plasma or urine
Collection tube
Serum separator (gold/red-top, SST) · Lithium heparin (green-top) · Sterile urine container
Method / principle
LC-MS/MS (targeted metabolomics) or enzymatic colorimetric where available
Reagent / substrate
Stable-isotope-labeled internal standard (MS); or enzyme-coupled Trinder reagent
Platform
LC-MS/MS; some automated chemistry
Turnaround · availability
Send-out / research · Specialized / research
Literature evidence(11)
- CD39 polymorphism enables lung thrombosis in sickle cell disease.Nature communications · 2026 · PMID 41530145 · doi
- Neutrophil Cathepsin G Enhances Thrombogenicity of Mildly Injured Arteries via ADP-Mediated Platelet Sensitization.International journal of molecular sciences · 2022 · PMID 35054930 · doi
- Role of CD39 in COVID-19 Severity: Dysregulation of Purinergic Signaling and Thromboinflammation.Frontiers in immunology · 2022 · PMID 35173744 · doi
- The human platelet transcriptome and proteome is altered and pro-thrombotic functional responses are increased during prolonged hypoxia exposure at high altitude.Platelets · 2019 · PMID 30721642 · doi
- Mucor circinelloides induces platelet aggregation through integrin αIIbβ3 and FcγRIIA.Platelets · 2018 · PMID 29297721 · doi
- Extracellular ATP metabolism on vascular endothelial cells: A pathway with pro-thrombotic and anti-thrombotic molecules.Vascular pharmacology · 2015 · PMID 25989108 · doi
- Evidence of platelet activation at medically used hypothermia and mechanistic data indicating ADP as a key mediator and therapeutic target.Arteriosclerosis, thrombosis, and vascular biology · 2011 · PMID 21512161 · doi
- Human solCD39 inhibits injury-induced development of neointimal hyperplasia.Thrombosis and haemostasis · 2009 · PMID 20024507 · doi
- Ecto-nucleotidases of the CD39/NTPDase family modulate platelet activation and thrombus formation: Potential as therapeutic targets.Blood cells, molecules & diseases · 2006 · PMID 16476557 · doi
- Role of CD39 (NTPDase-1) in thromboregulation, cerebroprotection, and cardioprotection.Seminars in thrombosis and hemostasis · 2005 · PMID 15852226 · doi
- New developments in anti-platelet therapies: potential use of CD39/vascular ATP diphosphohydrolase in thrombotic disorders.Current drug targets · 2000 · PMID 11465076 · doi
Clinical trials(1)
- High On-treatment Platelet Reactivity to Adenosine Diphosphate Identified by Multiple Platelet Function Assay Guide to Modify Anti-platelet Strategy in Patients Undergoing Percutaneous Coronary InterventionNCT02699008 · NA · COMPLETED · Clopidogrel, Ticagrelor