Platelet and immune cell crosstalk in dementia with Lewy bodies: Is there a unique inflammatory profile?

Neurodegenerative diseases such as dementia with Lewy bodies (DLB), Alzheimer's disease (AD), and Parkinson's disease (PD) share overlapping clinical features, making diagnosis challenging. This study evaluated hematological data from blood tests of DLB, AD and PD patients and control individuals, 16 each. The interaction between platelets and immune cells was analyzed using flow cytometry to identify disease-specific differences. DLB patients exhibited a non-significant trend toward lower absolute platelet counts and reduced percentages of total monocytes especially compared to AD. Monocyte-platelet interactions were associated with a significant increase of CD68 expression, which was more pronounced in DLB than in AD and PD. The CD68 receptor, a marker of monocyte and microglial activation and receptor for low-density lipoproteins (LDL), was significantly increased in DLB compared to both AD and PD. Based on CD68 expression, platelet count and CD14⁺ monocyte percentage, we developed two multiparametric logistic models to classify DLB patients from AD (AUC: 0.8095) and PD (AUC: 0.8056). After further validation, these differences may help distinguish DLB from AD and PD.