Flow cytometry immunophenotyping of healthy platelets and hospitalized patients with suspected platelet dysfunction: Challenges for establishing a cutoff value.

Daiane Keller Cecconello, Fabiane Spagnol, Ana Paula Alegretti, Diogo Andr�� Pilger, Mariela Granero Farias
Author Information
  1. Daiane Keller Cecconello: Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Hospital de Cl��nicas de Porto Alegre, Porto Alegre, RS, Brazil. Electronic address: daia_cecconello@hotmail.com.
  2. Fabiane Spagnol: Hospital de Cl��nicas de Porto Alegre, Porto Alegre, RS, Brazil.
  3. Ana Paula Alegretti: Hospital de Cl��nicas de Porto Alegre, Porto Alegre, RS, Brazil.
  4. Diogo Andr�� Pilger: Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
  5. Mariela Granero Farias: Hospital de Cl��nicas de Porto Alegre, Porto Alegre, RS, Brazil.

Abstract

INTRODUCTION AND OBJECTIVE: Flow Cytometry (FC) is one of the techniques, which allows the identification and characterization of platelets. The detection of absent or reduced expression of the glycoproteins is the main objective of this technique. Abnormalities of glycoproteins lead to hemorrhagic syndromes. Among the main diseases, the Bernard-Soulier syndrome (BSS) and Glanzmann thrombasthenia (GT) stand out. We aimed to show a FC-based platelet assessment test for diagnostic use, which measures the expression of markers in normal patients, and evaluate these markers in patients with platelet disorders.
METHODS: We examined a control group of 41 healthy adults to establish reference values and assess the variability of the relative expression of platelet markers and subsequently compared these findings to those of 30 patients with suspected platelet dysfunctions. We determined the mean fluorescent intensity (MFI) of the expressed parameters by FC using CD41, CD42a, CD42b and CD61 and SSC/FSC platelet-gated cells.
RESULTS: We determined our baseline panel of markers and compared them to suspected platelet dysfunctions. Patients with suspected BSS presented increased levels of the MFI for the GPIIIa (CD61) and GPIIb (CD41). They showed significantly reduced levels of the GPIb (CD42b) and GPIX (CD42a). Patients with suspected GT showed normal expression of the GPIX (CD42a), increased expression of the GPIb (CD42b) and reduced levels of the GPIIIa (CD61). In this case, with reduced levels of only one marker, the GPIIb (CD41), values showed normal expression.
CONCLUSIONS: We describe the FC assay to support the diagnosis of different platelet disorders. Our study made it possible to implement a technique that brought benefits to care.

Keywords

References

  1. Platelets. 2018 Nov;29(7):670-676 [PMID: 29799301]
  2. Platelets. 2009 Jun;20(4):229-34 [PMID: 19459130]
  3. Cytometry B Clin Cytom. 2020 Nov;98(6):464-475 [PMID: 32516490]
  4. Int J Mol Sci. 2021 Sep 22;22(19): [PMID: 34638529]
  5. Platelets. 2018 Jun;29(4):347-356 [PMID: 29227167]
  6. Thromb Res. 1994 Dec 1;76(5):441-50 [PMID: 7900092]
  7. Pathophysiol Haemost Thromb. 2006;35(1-2):67-82 [PMID: 16855350]
  8. Blood. 1996 Jun 15;87(12):4925-36 [PMID: 8652804]
  9. PLoS One. 2018 Feb 1;13(2):e0192079 [PMID: 29389990]
  10. Platelets. 2016;27(1):66-74 [PMID: 25901600]
  11. Thromb Res. 2012 Jul;130(1):92-8 [PMID: 22424855]
  12. Development. 2002 Apr;129(8):2003-13 [PMID: 11934866]
  13. J Thromb Haemost. 2015 Feb;13(2):314-22 [PMID: 25403439]
  14. Turk J Med Sci. 2021 May 7;51(4):2135-2141 [PMID: 33957723]
  15. Indian J Med Res. 2017 May;145(5):629-634 [PMID: 28948953]
  16. Semin Thromb Hemost. 2004 Oct;30(5):501-11 [PMID: 15497093]
  17. Platelets. 2020 Oct 2;31(7):845-852 [PMID: 31906818]
  18. Anesth Analg. 2000 Jan;90(1):12-6 [PMID: 10624968]
  19. J Thromb Haemost. 2018 Apr;16(4):689-698 [PMID: 29337406]
  20. Hum Mutat. 2014 Sep;35(9):1033-45 [PMID: 24934643]
  21. Int J Mol Sci. 2020 Dec 14;21(24): [PMID: 33327658]

Word Cloud

Created with Highcharts 10.0.0plateletexpressionsuspectedreducedmarkerspatientslevelsFlowFCnormalCD41CD42aCD42bCD61showedoneplateletsglycoproteinsmaintechniqueBernard-SouliersyndromeBSSGlanzmannthrombastheniaGTdisordershealthyvaluescompareddysfunctionsdeterminedMFIPatientsincreasedGPIIIaGPIIbGPIbGPIXcytometryINTRODUCTIONANDOBJECTIVE:CytometrytechniquesallowsidentificationcharacterizationdetectionabsentobjectiveAbnormalitiesleadhemorrhagicsyndromesAmongdiseasesstandaimedshowFC-basedassessmenttestdiagnosticusemeasuresevaluateMETHODS:examinedcontrolgroup41adultsestablishreferenceassessvariabilityrelativesubsequentlyfindings30meanfluorescentintensityexpressedparametersusingSSC/FSCplatelet-gatedcellsRESULTS:baselinepanelpresentedsignificantlycasemarkerCONCLUSIONS:describeassaysupportdiagnosisdifferentstudymadepossibleimplementbroughtbenefitscareimmunophenotypinghospitalizeddysfunction:ChallengesestablishingcutoffvalueGlycoproteinsPlatelets

Similar Articles

Cited By