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Surface markers of platelet function in idiopathic nephrotic syndrome in children
1Department of Nephrology and Dialysis, "Polish Mother's Memorial Hospital" Research Institute, 281/289 Rzgowska Street, 93-338 Lódz, Poland. mtkaczyk@krysia.uni.lodz.pl
Insights
Platelets show activation during childhood idiopathic nephrotic syndrome (INS) relapses, indicated by microparticles and aggregates. This suggests platelets may contribute to the prothrombotic state in early INS stages.
Area of Science:
- Pediatric Nephrology
- Hematology
- Thrombosis Research
Background:
- Idiopathic nephrotic syndrome (INS) in children can be associated with an increased risk of thrombotic events.
- Platelet activation plays a crucial role in hemostasis and thrombosis.
- Understanding platelet behavior during INS relapses is essential for risk stratification.
Purpose of the Study:
- To investigate platelet activation markers in whole blood during idiopathic nephrotic syndrome (INS) relapses in children.
- To compare platelet activation in children with active INS, in remission, and healthy controls.
Main Methods:
- Flow cytometry was used to measure platelet microparticles, platelet-platelet aggregates, and surface expression of CD62P (P-selectin) and CD42b.
- Study groups included children with active INS relapses, in long-term remission, and healthy controls.
Main Results:
- Children experiencing INS relapses showed increased platelet microparticles and aggregates, and decreased CD42b expression within the first two weeks.
- Elevated CD62P expression was observed at the onset of relapse compared to remission and control groups.
- No significant differences in platelet markers were found between children in long-term remission and healthy controls.
- Elevated serum F1+2 prothrombin fragment confirmed coagulation cascade activation during follow-up.
Conclusions:
- Platelet activation markers suggest platelets may independently contribute to the prothrombotic state in early stages of childhood INS.
- The precise role of platelets in triggering INS relapses requires further investigation.
Abstract:
The objective of the study was to investigate platelet activation markers in whole blood in idiopathic nephrotic syndrome (INS) in children. The study group consisted of 34 children with 45 relapses of INS, 35 children in long-term remission of INS, and 26 healthy controls. Using flow cytometry we measured the percentage of platelet microparticles, platelet-platelet aggregates, and surface expression of CD62P (P-selectin) and CD42b (a component of von Willebrand factor receptor). We found an increased percentage of microparticles and platelet-platelet aggregates, decreased expression of CD42b in the first 2 weeks of INS relapse. CD62P expression was elevated only at the onset of INS relapse when compared with the long-term remission group and healthy subjects. Children in long-term INS remission did not differ from healthy controls. There was no significant correlation between platelet activation markers and selected biochemical factors of blood in children with INS. Activation of the coagulation cascade was confirmed by an elevated serum concentration of F1+2 prothrombin fragment during follow-up. These findings suggest that platelets may contribute independently to the prothrombotic state in the early stages of INS, but their role in triggering relapses remains to be investigated.