Inhibitory effects of Paeonia suffruticosa extract and paeoniflorin on shear stress-induced platelet aggregation (SIPA). (A) Effects of herbal extracts (100 µg/mL) on SIPA in human platelet-rich-plasma (PRP) (n = 3). (B) Concentration-dependent effects of Paeonia suffruticosa extract on SIPA (n = 3). (C) Effects of the active ingredients of Paeonia suffruticosa (25 µM) on SIPA in PRP (n = 3). Insert, the molecular structure of paeoniflorin. Protocatechuic acid (PCA, 25 µM) was used as positive control. (D) Molecular structure (upper) and fluorescent observation inhibitory effect of paeoniflorin platelet aggregation in pathological shear stress (lower). Green: Calcein-loaded platelets. (E–F), Inhibitory effects of paeoniflorin on SIPA in human PRP, in a concentration- (10 min treatment) (n = 5) (E) and time-dependent manner (n = 3) (F). (G) Effects of paeoniflorin on SIPA at different levels of shear rate (n = 3), (H). SIPA inhibition by paeoniflorin in human washed platelets (n = 4). Values are mean ± standard error of the mean (SEM; expressed as the error bar) of the independent experiments from different blood donors. *, significant differences from control group (p < 0.05). Arrowhead indicated platelet aggregates (D). Scale bar: 50 μm.