title: Higher platelet reactivity and platelet-monocyte complex formation in Gram-positive sepsis compared to Gram-negative sepsis.
abstract: Platelets may play a role in the high risk for vascular complications in Gram-positive sepsis. We compared the platelet reactivity of 15 patients with Gram-positive sepsis, 17 with Gram-negative sepsis and 20 healthy controls using a whole blood flow cytometry-based assay. Patients with Gram-positive sepsis had the highest median fluorescence intensity (MFI) of the platelet membrane expression of P-selectin upon stimulation with high dose adenosine diphosphate (ADP; P = 0.002 vs. Gram-negative and P = 0.005 vs. control groups) and cross-linked collagen-related peptide (CRP-XL; P = 0.02 vs. Gram-negative and P = 0.0001 vs. control groups). The Gram-positive group also demonstrated significantly higher ADP-induced fibrinogen binding (P = 0.001), as wll as platelet-monocyte complex formation (P = 0.02), compared to the Gram-negative group and had the highest plasma levels of platelet factor 4, β-thromboglobulin and soluble P-selectin. In contrast, thrombin-antithrombin complex and C-reactive protein levels were comparable in both patient groups. In conclusion, common Gram-positive pathogens induce platelet hyperreactivity, which may contribute to a higher risk for vascular complications.
authors.affiliation: a Department of Internal Medicine , Radboud University Medical Center , Nijmegen , The Netherlands.|b Radboud Center for Infectious Diseases , Radboud University Nijmegen Medical Center , Nijmegen , The Netherlands.|c Center for Tropical and Infectious Diseases (CENTRID) , Faculty of Medicine Diponegoro University - Dr. Kariadi Hospital , Semarang , Indonesia.
authors.forename: Rahajeng N
authors.identifier: http://orcid.org/0000-0001-6168-4758
authors.initials: RN
authors.lastname: Tunjungputri
authors.affiliation: a Department of Internal Medicine , Radboud University Medical Center , Nijmegen , The Netherlands.|b Radboud Center for Infectious Diseases , Radboud University Nijmegen Medical Center , Nijmegen , The Netherlands.
authors.forename: Wouter
authors.initials: W
authors.lastname: van de Heijden
authors.affiliation: c Center for Tropical and Infectious Diseases (CENTRID) , Faculty of Medicine Diponegoro University - Dr. Kariadi Hospital , Semarang , Indonesia.
authors.forename: Rolf T
authors.initials: RT
authors.lastname: Urbanus
authors.affiliation: c Center for Tropical and Infectious Diseases (CENTRID) , Faculty of Medicine Diponegoro University - Dr. Kariadi Hospital , Semarang , Indonesia.
authors.forename: Philip G
authors.initials: PG
authors.lastname: de Groot
authors.affiliation: a Department of Internal Medicine , Radboud University Medical Center , Nijmegen , The Netherlands.|b Radboud Center for Infectious Diseases , Radboud University Nijmegen Medical Center , Nijmegen , The Netherlands.|d Department of Clinical Chemistry and Haematology , University Medical Centre , Utrecht , The Netherlands.
authors.forename: Andre
authors.initials: A
authors.lastname: van der Ven
authors.affiliation: a Department of Internal Medicine , Radboud University Medical Center , Nijmegen , The Netherlands.|b Radboud Center for Infectious Diseases , Radboud University Nijmegen Medical Center , Nijmegen , The Netherlands.
authors.forename: Quirijn
authors.initials: Q
authors.lastname: de Mast
mesh_terms: D000244:Adenosine Diphosphate / Q000494:pharmacology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000378:metabolism* / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000097:blood* / Q000473:pathology; D016908:Gram-Positive Bacterial Infections / Q000097:blood* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism* / Q000473:pathology; D019007:P-Selectin / Q000097:blood; D015539:Platelet Activation; D010978:Platelet Factor 4 / Q000097:blood; D018805:Sepsis / Q000097:blood* / Q000473:pathology; D001620:beta-Thromboglobulin / Q000378:metabolism
chemical_list: D019007:P-Selectin; C061615:PPBP protein, human; D001620:beta-Thromboglobulin; D010978:Platelet Factor 4; D000244:Adenosine Diphosphate; D002097:C-Reactive Protein
keywords: Gram-positive; gram-negative; infection; platelet activation; sepsis