Publication: Hemoglobin-bound platelets correlate with the increased platelet activity in hemoglobin E/β-thalassemia
Issued Date
2020-01-01
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ISSN
1751553X
17515521
17515521
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2-s2.0-85086436705
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Mahidol University
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SCOPUS
Bibliographic Citation
International Journal of Laboratory Hematology. (2020)
Suggested Citation
Attaphon Chamchoi, Sirada Srihirun, Kittiphong Paiboonsukwong, Thanaporn Sriwantana, Peerawich Kongkaew, Suthat Fucharoen, Kovit Pattanapanyasat, Nathawut Sibmooh Hemoglobin-bound platelets correlate with the increased platelet activity in hemoglobin E/β-thalassemia. International Journal of Laboratory Hematology. (2020). doi:10.1111/ijlh.13260 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/57751
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Title
Hemoglobin-bound platelets correlate with the increased platelet activity in hemoglobin E/β-thalassemia
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Abstract
© 2020 John Wiley & Sons Ltd Introduction: An increase in platelet activity is a contributing factor to vascular complications in hemoglobin E/β-thalassemia (HbE/β-thal). Plasma-free hemoglobin (Hb) increases in HbE/β-thal patients and correlates with platelet activation, but the levels of Hb-bound platelets have never been reported. In this study, we aimed to investigate the levels of Hb-bound platelets and its association with platelet activity in HbE/β-thal patients. Methods: Hb-bound platelets were measured by flow cytometry in 22 healthy subjects and 26 HbE/β-thal patients (16 nonsplenectomized and 10 splenectomized HbE/β-thal patients). Plasma Hb was measured by the chemiluminescence method based on the consumption of nitric oxide (NO) by Hb. Expression of P-selectin and activated glycoprotein (aGP) IIb/IIIa on platelets was measured by flow cytometry as a marker of platelet activity. Results: Both nonsplenectomized and splenectomized HbE/β-thal patients had higher levels of Hb-bound platelets and plasma Hb than healthy subjects. In vitro incubation of dialyzed Hb from patients with platelets of healthy subjects caused an increase in Hb-bound platelets, which was partially inhibited by anti-GPIbα antibody. Plasma Hb positively correlated with Hb-bound platelets. Platelet P-selectin expression at baseline and in response to adenosine diphosphate (ADP, 1 µM) stimulation was higher in nonsplenectomized and splenectomized HbE/β-thal patients than healthy subjects. The ADP-induced aGPIIb/IIIa expression on platelets was also higher in HbE/β-thal patients than healthy subjects. Hb-bound platelets correlated with baseline P-selectin expression and ADP-induced P-selectin expression. Conclusion: HbE/β-thal patients have increased Hb-bound platelets, which is associated with increased baseline platelet activation and reactivity.