Oishi Kazunori, Inoue Shingo, Cinco Maria T D D, Dimaano Efren M, Alera Maria T P, Alfon Jhoe A R, Abanes Ferdinand, Cruz Deu J M, Matias Ronald R, Matsuura Hiromi, Hasebe Futoshi, Tanimura Susumu, Kumatori Atsushi, Morita Kouichi, Natividad Filipinas F, Nagatake Tsuyoshi
Department of Internal Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
J Med Virol. 2003 Oct;71(2):259-64. doi: 10.1002/jmv.10478.
Although the public health impact of dengue is increasing rapidly, the mechanism of thrombocytopenia in this disease remains unknown. To elucidate this mechanism, the relationship between platelet-associated IgG (PAIgG) and platelet count in 53 patients in the acute phase of secondary dengue virus infection was investigated in a prospective-hospital-based study. A significant inverse correlation between the two parameters was found in these patients, while no correlation was observed in healthy volunteers. The low baseline platelet counts during the acute phase in 12 patients with secondary dengue virus infection significantly increased during the convalescent phase, while the increased PAIgG levels during the acute phase in these patients significantly decreased during the convalescent phase. Anti-platelet IgG autoantibody was detected rarely in the plasma of 53 patients with secondary dengue infection. The involvement of anti-dengue virus IgG was also shown in platelets from all of 8 patients in the acute phase of secondary dengue virus infection. These findings suggest that PAIgG formation involving anti-dengue virus IgG plays a pivotal role in the induction of transient thrombocytopenia during the acute phase of secondary dengue virus infection.
尽管登革热对公共卫生的影响正在迅速增加，但该疾病中血小板减少的机制仍不清楚。为阐明这一机制，在一项基于医院的前瞻性研究中，对53例继发登革病毒感染急性期患者的血小板相关IgG（PAIgG）与血小板计数之间的关系进行了调查。在这些患者中发现这两个参数之间存在显著的负相关，而在健康志愿者中未观察到相关性。12例继发登革病毒感染患者急性期的低基线血小板计数在恢复期显著增加，而这些患者急性期升高的PAIgG水平在恢复期显著降低。在53例继发登革热感染患者的血浆中很少检测到抗血小板IgG自身抗体。在继发登革病毒感染急性期的所有8例患者的血小板中也显示出抗登革病毒IgG的参与。这些发现表明，涉及抗登革病毒IgG的PAIgG形成在继发登革病毒感染急性期短暂性血小板减少的诱导中起关键作用。
