Role of CD61+ cells in thrombocytopenia of dengue patients
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Although hematological disorders with salient features of thrombocytopenia have been well documented in dengue patients, the role of CD61-expressing platelets and the megakaryocytic cell lineage in the pathogenesis of dengue virus (DENV) infection remains largely unexplored. A prospective observational study was performed using blood samples and PBMCs from dengue-confirmed patients, as well as from rhesus monkeys (RM) experimentally infected with DENV. Immunohistochemical staining and FACS techniques were applied to evaluate the frequencies of CD61+ cells that contained DENV antigen. Highly enriched population of CD61+ cells was also isolated from acute DENV-infected RM and assayed for DENV RNA by quantitative RT-PCR. Results revealed that DENV antigen was found in small vesicles of varying size, and more frequently in anucleated cells associated with platelets in dengue patients. The DENV antigen-containing cells were CD61+ and appeared to share characteristics of megakaryocytes. Kinetic profiles of CD61+ cells from DENV-infected RM revealed a transient increase in CD61+CD62P+ cells early after DENV infection. DENV RNA in a highly enriched population of CD61+ cells from the infected RM was observed during acute stage. Our results indicate that virus containing CD61+ cells may be directly linked to the platelet dysfunction and low platelet count characteristics of dengue patients.
KeywordsDengue Viremia Thrombocytopenia Fever Megakaryocytes DF DHF
We would like to thank Korakot Polsrila at the Center of Excellence for Flow Cytometry and clinical staffs at the Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, for sample collections and laboratory confirmation of dengue. The research was supported in part by Emory SOM start-up fund, Thailand Research Fund for Senior Research Scholar, Robert E. Shop International Fellowship, the U19 Pilot Project Funds U19 AI057266 (RFA-AI-02-042), NIH/SERCEB, Emory URC grants, and the NCRR p51 support to the Yerkes National Primate Research Center DRR000165.
Conflict of interest
The authors declare no competing financial interests.
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