Platelet function alterations in dengue are associated with plasma leakage

Area of Science:

• Immunology
• Hematology
• Infectious Diseases

Background:

• Severe dengue is characterized by thrombocytopenia, plasma leakage, and bleeding.
• Platelets play a crucial role in maintaining endothelial integrity.
• The hypothesis is that platelet activation and subsequent dysfunction contribute to plasma leakage in dengue.

Purpose of the Study:

• To investigate platelet activation status and function in adult Indonesian patients with acute dengue.
• To determine the association between platelet activation markers and plasma leakage.
• To explore the role of platelet-derived serotonin in dengue pathogenesis.

Main Methods:

• Flow cytometry-based assays were used to measure platelet activation markers (αIIbβ3, CD63, CD62P) and response to TRAP.
• Platelet function was assessed by measuring maximal expression of αIIbβ3 and CD63 after TRAP stimulation.
• Plasma leakage was monitored daily using ultrasonography, and intra-platelet serotonin concentrations were measured.

Main Results:

• Acute dengue patients exhibited increased platelet activation, indicated by elevated expression of CD63 and CD62P (P-selectin).
• Platelet function defects were observed, with reduced maximal αIIbβ3 and CD63 expression upon TRAP activation.
• Lower expression of activated αIIbβ3 and CD63 was significantly associated with an increased risk of plasma leakage.

Conclusions:

• Platelet activation and functional alterations are present in acute dengue patients.
• These platelet changes may play a significant role in the development of dengue-associated plasma leakage.
• Increased intra-platelet serotonin concentrations were observed, potentially linking to plasma leakage.