Abstract
Platelet activation has been reported to play a major role in inflammatory response and thrombocytopenia during dengue viral infection. Cells expressing FcϒR2Aand DC-SIGN receptors are reported to be involved in dengue virulence. The present study is designed to assess the expression level of these two receptors on platelet surface collected from dengue patients and to study its association in patients with platelet RNA positive for dengue virus. This was an analytical cross-sectional study carried out in JIPMER hospital, Puducherry. Forty-four patients with dengue infection as cases and 44 patients with non dengue acute other febrile illness(OFI) as controls were recruited. Peripheral venous blood was withdrawn on day of admission, day 3 post admission and day of discharge and serological tests for NS1 dengue antigen and anti IgM antibody were analyzed for diagnosis of dengue infection. Platelet rich plasma was assessed for DC SIGN, FcϒR2A levels and platelets separated from dengue patients were subjected to RNA extraction and detection of presence of viral RNA. The study observed a decreased expression of DC-SIGN and FcϒR2A on platelets in dengue patients compared to OFI group on all the time points. Further, cells expressing DC-SIGN and FcϒR2A were found to be decreased on platelets in dengue patients who were positive for NS1 antigen. DC-SIGN and FcϒR2A expression was also found to be notably decreased in patients positive for platelet DENV RNA when compared with patients negative for platelet DENV RNA. Our results suggest that DC-SIGN and FcϒR2A, which are receptors for viral capture and immune mediated clearance respectively, might be down regulated on platelets in patients with dengue infection. The decreased receptor expression diminishes platelet activation and subsequently has protective action on the host from the ongoing conflict between immune system and dengue virus.
Highlights
Dengue viral infection causes self-limiting mild dengue fever to life threatening severe dengue
In order to understand the role of above mentioned receptors on surface of platelets in dengue patients, we evaluated the expression of DC-SIGN and FcƳR2A on platelets in dengue and other febrile illness throughout the course of infection and its association in patients with platelet RNA positive for dengue virus
Mean fluorescence intensity (MFI) of DC-SIGN was found to be decreased in Dengue Patients when compared with Other Febrile Illness and Non Febrile Illness
Summary
Dengue viral infection causes self-limiting mild dengue fever to life threatening severe dengue. The actual mechanism that regulates the disease virulence is not completely understood. DC-SIGN and FcYR2A receptors on platelets in dengue
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