The importance of hematopoietic progenitor cells in dengue

Abstract

Scientific investigations designed to better understand and assess the distinguishing clinical characteristics pave the way to a successful treatment for a disease. Since the peripheral blood is obtained easily, the most frequent type of investigation performed on infectious agents focuses on the hematological components of blood drawn from patients. Bone marrow aspirates, although somewhat more difficult to obtain, should be evaluated more frequently because they provide additional information, giving us a glimpse into the development of the disease. Understanding the distinct and unique changes in hematological components of the bone marrow induced by a particular pathogen or corresponding to a specific illness may be a valuable asset for the diagnosis and prognosis of disease. A good example of a pathogen that could be better evaluated with greater knowledge of the bone marrow is dengue, one of the most important public vector-borne human diseases. Owing to the multitude of clinical manifestations and the dynamic alterations of various blood components over time, this disease is one of the most difficult to prevent and treat in humans. Although large amounts of data have been generated in the literature, there remains a large gap between this information and its relevance for the purpose of patient care. While evaluating the cellular components in the circulated blood from ill patients provides us with valuable information about the pathogenesis of various pathogens, there are other players participating in the progression to disease. The goal of this review is to emphasize the importance of bone marrow hematopoietic progenitor cells in disease and to inspire other researchers to incorporate them into their investigations on dengue pathogenesis. It is anticipated that the knowledge derived from these investigations not only elicit original concepts on the pathogenesis of dengue but also foster a new way of thinking in terms of vaccine or therapeutic development to prevent and treat dengue.

Transient Monocytosis Subjugates Low Platelet Count in Adult Dengue Patients

“…With evidence suggesting platelets can be infected by DENV and become activated [17,18,31], an ex vivo study was carried out to verify the DENV-infected platelets, which could be aggregated with monocytes directly. Platelets were purified and infected with DENV as previously described [8]. After washing out unbound virus, the DENV platelets were mixed with allogeneic PBMCs for the indicated times specified in the online supplementary figure legends.…”

“…Many hypotheses have been implicated, including antibody-mediated enhancement on viral entry and replication in Fc-bearing phagocytic cells [3], individual genetic background [4], viral strain differences [5], a cascade of cytokine storm resulting from viral infection in immune cells [6], and hematological disorders [7,8]. …”

Dengue en el Perú: a un cuarto de siglo de su reemergencia

“…También puede provocar daños en las células endoteliales y de órganos como el hígado, el corazón, el riñón o el cerebro. La plaquetopenia es una manifestación de destrucción de estas por fenómeno inmunológico y por depleción temporal en su producción, aunque la intensidad del sangrado no está en relación con los niveles de plaquetopenia (42)(43)(44) . Las causas del sangrado es multifactorial e incluyen las alteraciones vasculares, alteraciones de los mecanismos de la coagulación y fibrinólisis (45) .…”

Role of Bone Marrow in Pathogenesis of Viral Infections

“…An example of one such viral infection is dengue. Although dengue virus infects people from a wide range of ages, the peak in incidence of severe dengue coincidentally occurs in the young adults, with individuals that have not completed their bone marrow conversion [16]. Thus, it is likely that the contents of the bone marrow could play a significant role in dengue pathogenesis.…”

“…Since in the case of dengue virus infection, the majority of dengue affected patients do not seek help until several days after onset of clinical symptoms, studying the kinetics of bone marrow changes in human disease will be very challenging [16,19,33]. This difficulty is further complicated by the concern of increased risk of bleeding in these patients, making it clinically impractical to acquire BM samples.…”