Determinants of platelet count in pediatric patients with congenital cyanotic heart disease: Role of immature platelet fraction

Matter, Randa M.; Ragab, Iman; Roushdy, Alaa; Ahmed, Ahmed G.; Aly, Hanan Hassan; Ismail, Eman Abdel Rahman

doi:10.1111/chd.12530

Cited by 11 publications

(11 citation statements)

References 19 publications

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“…Third, given that BMSCs and haematopoietic stem cells (HSCs) share the same microenvironment, it is conceivable that the accumulated d -galactose in CCHD patients likely influenced the function of HSCs and even other progenitor cells residing in the bone marrow. Recently, Randa et al 54 has suggested that the increased immature platelet fraction in CCHD patients may denote peripheral platelet destruction. Apparently, haematopoiesis is perturbed to some extent in CCHD patients.…”

Section: Discussionmentioning

confidence: 99%

Hypoxia induces senescence of bone marrow mesenchymal stem cells via altered gut microbiota

et al. 2018

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Systemic chronic hypoxia is a feature of many diseases and may influence the communication between bone marrow (BM) and gut microbiota. Here we analyse patients with cyanotic congenital heart disease (CCHD) who are experiencing chronic hypoxia and characterize the association between bone marrow mesenchymal stem cells (BMSCs) and gut microbiome under systemic hypoxia. We observe premature senescence of BMSCs and abnormal d-galactose accumulation in patients with CCHD. The hypoxia that these patients experience results in an altered diversity of gut microbial communities, with a remarkable decrease in the number of Lactobacilli and a noticeable reduction in the amount of enzyme-degraded d-galactose. Replenishing chronic hypoxic rats with Lactobacillus reduced the accumulation of d-galactose and restored the deficient BMSCs. Together, our findings show that chronic hypoxia predisposes BMSCs to premature senescence, which may be due to gut dysbiosis and thus induced d-galactose accumulation.

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Section: Discussionmentioning

confidence: 99%

Hypoxia induces senescence of bone marrow mesenchymal stem cells via altered gut microbiota

et al. 2018

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“…In the case of isolated thrombocytopenia, a high IPF indicates the increased clearance of circulating platelets as observed during idiopathic thrombocytopenic purpura (ITP), whereas a normal IPF, similar to that of healthy donors, reflects a deficit in platelet production, that is, a bone marrow failure . Thus, the measure of the IPF can represent a useful method to distinguish immunological peripheral platelet destruction from bone marrow failure, and a convenient alternative method to bone marrow aspiration . The assessment of young platelets can also provide meaningful information in other pathologies associated with an important platelet turnover.…”

Section: Introductionmentioning

confidence: 99%

Cell surface expression of HLA I molecules as a marker of young platelets

Angénieux

Dupuis

Gachet

et al. 2019

Journal of Thrombosis and Haemostasis

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Background Accurate identification of the proportion of young platelets is important to distinguish peripheral thrombocytopenia from a deficit in platelet production. Young platelets are defined by their higher RNA content and are often assessed as thiazole orange bright (TObright) by flow cytometry. In clinical practice, their proportion is estimated by automatic blood counter according to their greater RNA content, which identifies a so‐called immature platelet fraction (IPF). However, the detected IPFs are not strictly identical to the young TObright platelet population observed by flow cytometry. Objectives The aim of this study was to assess the reliability of HLA I/major histocompatibility I (MHC I) cell surface expression as a marker of young platelets. Methods The HLA I/MHC I expression was evaluated by flow cytometry after costaining blood with TO and antibodies directed against HLA I/MHC I molecules. Results We found that platelets with a higher expression of plasma membrane‐localized MHC I molecules displayed an increased TO staining and a higher content in ribosomal P‐antigen. Transfusion experiments in mice showed that the number of MHC I molecules expressed on the cell surface of young murine platelets decreased during platelet aging, reaching basal levels within 24 h. Finally, we demonstrated that for patients with thrombocytopenias, the identification of young platelets is better assessed by the flow cytometric determination of the level of HLA I expression than by TO staining or the use of hematological blood counter. Conclusion Overall, our results highlight the relevance of MHC I/HLA I expression as a valuable parameter to identify young platelets.

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“…Thus, further research is required to elucidate the complex interplay between immature and mature platelets on ductal closure and to assess their specific functions and association with bleeding risk and thromboembolic complications in preterm infants. 25,26…”

Section: Discussionmentioning

confidence: 99%

Mature and immature platelets during the first week after birth and incidence of patent ductus arteriosus

et al. 2020

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Background:Thrombocytopenia is a risk factor for patent ductus arteriosus. Immature and mature platelets exhibit distinct haemostatic properties; however, whether platelet maturity plays a role in postnatal, ductus arteriosus closure is unknown.Methods:In this observational study, counts of immature and mature platelets (=total platelet count − immature platelet count) were assessed on days 1, 3, and 7 of life in very low birth weight infants (<1500 g birth weight). We performed echocardiographic screening for haemodynamically significant patent ductus arteriosus on day 7.Results:Counts of mature platelets did not differ on day 1 in infants with (n = 24) and without (n = 45) haemodynamically significant patent ductus arteriosus, while infants with significant patent ductus arteriosus exhibited lower counts of mature platelet on postnatal days 3 and 7. Relative counts of immature platelets (fraction, in %) were higher in infants with patent ductus arteriosus on day 7 but not on days 1 and 3. Receiver operating characteristic curve analysis unraveled associations between both lower mature platelet counts and higher immature platelet fraction (percentage) values on days 3 and 7, with haemodynamically significant ductus arteriosus. Logistic regression analysis revealed that mature platelet counts, but not immature platelet fraction values, were independent predictors of haemodynamically significant patent ductus arteriosus.Conclusion:During the first week of postnatal life, lower counts of mature platelets and higher immature platelet fraction values are associated with haemodynamically significant patent ductus arteriosus. Lower counts of mature platelet were found to be independent predictors of haemodynamically significant patent ductus arteriosus.

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Determinants of platelet count in pediatric patients with congenital cyanotic heart disease: Role of immature platelet fraction

Abstract: We suggest that elevated IPF in CCHD patients with thrombocytopenia may denote peripheral platelets destruction as an underlying mechanism. Hemoglobin level, RBCs count, Hct, and RET-He were not significant determinants for platelet count in CCHD.

Cited by 11 publications

References 19 publications

Hypoxia induces senescence of bone marrow mesenchymal stem cells via altered gut microbiota

Hypoxia induces senescence of bone marrow mesenchymal stem cells via altered gut microbiota

Cell surface expression of HLA I molecules as a marker of young platelets

Mature and immature platelets during the first week after birth and incidence of patent ductus arteriosus

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