Des Prez R M, Steckley S, Stroud R M, Hawiger J
J Infect Dis. 1980 Jul;142(1):32-9. doi: 10.1093/infdis/142.1.32.
Thrombocytopenia is a common accompaniment of disseminated histoplasmosis. The yeast form of Histoplasma capsulatum does not directly injure human platelets freed of plasma. Preincubation of H. capsulatum with plasma enabled it to induce prompt platelet aggregation and selective release of [3H]serotonin without release of lysosomal beta-glucuronidase and the cytoplasmic marker, lactate dehydrogenase. Platelet aggregation was mediated by adenosine diphosphate, as shown by the blocking of the reaction by apyrase. Indomethacin inhibited both aggregation and serotonin release, indicating their dependence on prostaglandin synthesis by platelets. Plasma IgG conferred [3H]serotonin-releasing activity after complexing with yeasts, and plasma fibrinogen was necessary for platelet aggregation; classical and alternative complement pathways were not involved. The interaction of H. capsulatum with human platelets, mediated by IgG and fibrinogen without complement, represents a new attribute of this fungal pathogen and may contribute to thrombocytopenia complicating disseminated histoplasmosis.
血小板减少是播散性组织胞浆菌病的常见伴随症状。荚膜组织胞浆菌的酵母形式不会直接损伤去除血浆后的人血小板。荚膜组织胞浆菌与血浆预孵育后,能够诱导血小板迅速聚集并选择性释放[3H]5-羟色胺,而不会释放溶酶体β-葡萄糖醛酸酶和细胞质标志物乳酸脱氢酶。如通过腺苷三磷酸双磷酸酶阻断反应所示,血小板聚集由二磷酸腺苷介导。吲哚美辛抑制聚集和5-羟色胺释放,表明它们依赖于血小板合成前列腺素。血浆IgG与酵母结合后赋予[3H]5-羟色胺释放活性,血浆纤维蛋白原是血小板聚集所必需的;经典和替代补体途径未参与其中。荚膜组织胞浆菌与人血小板的相互作用由IgG和纤维蛋白原介导且无补体参与,这代表了这种真菌病原体的一种新特性,可能导致播散性组织胞浆菌病并发血小板减少。