Differential platelet receptor expression for viral capture (DC-SIGN) and plasma leakage in patients with dengue infection

Abstract

IntroductionPlatelet activation and cells expressing DC-SIGN receptors have been reported to play a major role in dengue infection. The role of DC-SIGN expression and dengue virulence is not completely understood. In the present study, we assessed the expression of the DC-SIGN receptor on the platelet surface in dengue patients and its association with hematocrit, an indicator of plasma leakage. Material and methodsThis was an analytical cross-sectional study carried out in JIPMER hospital, Puducherry. A total of 71 patients were recruited with 35 dengue (cases) and 36 patients with non-dengue acute febrile illness (controls). Platelet-rich plasma was assessed for expression of DC-SIGN using flow cytometry at admission, day 3 & at discharge and was correlated with hematocrit at admission. ResultsSubjects were divided into groups based on the gender-specific mean value of hematocrit. We observed a decreased expression of DC-SIGN in cases compared to controls on admission in both groups. An increasing trend was observed in cases, though not significant, in the expression of DC-SIGN in patients with normal as well as increased hematocrit. In patients with higher hematocrit, DC-SIGN expression remains suppressed along the course of the disease. ConclusionOur results suggest that DC-SIGN, which is a receptor for viral capture might be prolongedly suppressed in dengue patients with plasma leakage. This could be part of a protective response from the host to prevent platelet activation and subsequent endothelial damage.