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. 2023 May;21(5):1336-1351.
doi: 10.1016/j.jtha.2023.02.006. Epub 2023 Feb 13.

Severe fever with thrombocytopenia syndrome virus replicates in platelets and enhances platelet activation

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Free article

Severe fever with thrombocytopenia syndrome virus replicates in platelets and enhances platelet activation

Lei Fang et al. J Thromb Haemost. 2023 May.
Free article

Abstract

Background: Severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) infection causes an emerging hemorrhagic fever in East Asia with a high mortality rate. Thrombocytopenia is a consistent feature of SFTS illness, but the mechanism remains elusive.

Objectives: We aimed to better understand the role of platelets in the pathophysiology of SFTSV infection, including the development of thrombocytopenia.

Methods: Using platelets from healthy volunteers and patients with SFTS, we evaluated the functional changes in platelets against SFTSV infection. We investigated the direct effect of glycoprotein VI on platelet-SFTSV interaction by quantitative real-time PCR, molecular docking, surface plasmon resonance spectrometry, flow cytometry, western blot, and platelet functional studies in vitro. Interactions of SFTSV and platelet-SFTSV complexes with macrophages were also determined by scanning electron microscope, quantitative real-time PCR, and flow cytometry.

Results: This study is the first to demonstrate that platelets are capable of harboring and producing SFTSV particles. Structural and functional studies found that SFTSVs bind platelet glycoprotein VI to potentiate platelet activation, including platelet aggregation, adenosine triphosphate release, spreading, clot retraction, coagulation, phosphatidylserine exposure, thrombus formation, and adherence. In vitro mechanistic studies highlighted that the interaction of platelets with human THP-1 cells promoted SFTSV clearance and suppressed cytokine production in macrophages. However, unwanted SFTSV replication in macrophages reciprocally aggravated SFTSV persistence in the circulation, which may contribute to thrombocytopenia and other complications during SFTSV infection.

Conclusion: These findings together highlighted the pathophysiological role of platelets in initial intrinsic defense against SFTSV infections, as well as intertwined processes with host immunity, which can also lead to thrombocytopenia and poor prognosis.

Keywords: GPVI; SFTSV; platelet activation; replication; thrombocytopenia.

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Conflict of interest statement

Declaration of competing interests There are no competing interests to disclose.

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