Abstract
Platelets have been recognized to be an integral part of human immune system. Hematologic disfunction, such as thrombocytopenia, is one of the most salient clinical features in dengue patients. Understanding the parameters released from activated platelets, involving in maintaining the delicate network, can provide a better picture of pathogenic cause of dengue. Ninety four dengue confirmed patients, 24 other febrile patients, and 12 healthy controls were enrolled to study. The parameters including the levels of polyphosphates, bradykinin, thyroxine, nitrite/ nitrate, platelet factor 4 (PF4), and serotonin, from the circulation of dengue patients were quantified by commercial ELISA kits and then compared to that from patients with other febrile illnesses, follow-up samples, and healthy controls. The following results were documented. Results 1. The levels of polyphosphates were on average 30% higher in acute dengue samples than healthy controls. 2. The levels of thyroxine, and nitrite/nitrate were significantly higher in acute dengue samples compared to that of other febrile, follow-up and healthy samples, while bradykinin was significantly lower. 3. The levels of PF4 were not different among samples of acute dengue, other febrile illness and follow-up, but were all significantly higher than the healthy controls. 4. The levels of serotonin were significantly higher in acute febrile stage compared to convalescent stage; while significantly lower than healthy subjects. The dynamic network of biochemical programs that coordinate to maintain hemostasis become unbalanced during and following dengue virus infection. Factors released from activated platelets may influence the vascular permeability
Highlights
Inflammation resulting from immune responses and hemostasis are interrelated pathophysiologic processes; changes in one system can considerably affect the other
Results indicated that the amounts of platelet factor 4 (PF4) were not different in acute serum samples compared to other febrile illnesses and convalescent samples, they were significantly higher than healthy controls (Figure 5). These results suggest that activated platelets may persist for a long period of time in dengue patients, even though it is possible that this platelet hyperactivation may indicate an undiagnosed secondary infection
Inflammation caused by many conditions, including infections, leads to activation of biochemical pathways in the hemostatic system that in turn back talks, influencing the inflammatory activity
Summary
Inflammation resulting from immune responses and hemostasis are interrelated pathophysiologic processes; changes in one system can considerably affect the other They act as a Yin and Yang within the body’s intricate circulatory network to maintain a constant normal physiological state, especially under disease conditions. In some situations, one or more programs may deviate from the assigned tasks, resulting in abnormal activation of particular biochemical feedback loops, which likely cause a domino effect leading to minor, moderate, or total failure of the system. This scenario likely occurs during infections with pathogens, since they are equipped with evasion programs that disturb the balance of the hosts’ hemostasis and/
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