Though major causes of IPD have been discovered via this approach over the past decades, the genetic basis for IPD in many patients remains unknown. The recent application of novel large scale screening methods in proteomics and transcriptomics [31,32], genome-wide association studies (GWAS) [33] and epigenetics [34] plus unprecedented large-scale cooperative efforts, have led to novel insights in platelet biology and of IPD complexity. Next generation sequencing Afatinib clinical trial approaches are expected to unravel IPDs that are already well phenotyped but which still have no identified genetic basis. The identification

of NBEAL2 gene mutations as the causative factor for GPS via RNA or exome sequencing is the first such example. It is now clear that defective α-granule formation Autophagy Compound Library is caused by a

protein family member of LYST and NBEA, proteins that are defective in platelets from patients with abnormal dense granules and broad spectrum IPD [11–14,35]. Advances in our knowledge of both the platelet genome and proteome will lead to further discoveries in MK and platelet biology. The use of novel ‘Omics’ technology via arrays or chips will potentially revolutionize not only current diagnosis of ‘classical’ IPDs through functional platelet testing but will additionally identify individuals with increased risk of bleeding previously hidden by their association with other clinical phenotypes. Discussion of the future of novel DNA-based diagnostic approaches for IPDs is particularly relevant as whole exome sequencing is fast becoming readily available very and economically viable. These novel technologies will bring platelet function testing closer to the

field of medical DNA sequencing [36]. In the future, DNA sequencing will give clinicians important information regarding the IPD genotype of their patients and so improve early diagnosis and prognosis. IPDs are rare disorders manifested by mild to severe mucocutaneous bleeding; for affected patients, e.g. GT or BSS, platelet transfusion is frequently needed for controlling spontaneous bleeding manifestations such as menorrhagia, epistaxis, and gastrointestinal bleeding, and is always needed when trauma occurs or surgery is performed. Childbirth is also a high-risk period [37,38]. For the mild to moderate bleeding entities, e.g. SPD, P2Y12 or TXA2 receptor defects, platelet transfusion is usually unnecessary. Transfusion of platelets should be used selectively and sparingly because of the substantial risk of alloimmunization against HLA antigens and/or platelet αIIbβ3 in GT and GPIb-IX-V in BSS that may lead to refractoriness to therapy [1,39]. To reduce the risk, HLA-matched single donors of platelets are recommended. If such donors are unavailable, leukocyte-depleted blood components should be used. Additional risks of platelet transfusion and blood component therapy are allergic reactions and transmission of infectious agents.