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Gunning WT, Raghavan M, Calomeni EP, Turner JN, Roysam B, Roysam S, Smith MR, Kouides PA, Lachant NA. A Morphometric Analysis of Platelet Dense Granules of Patients with Unexplained Bleeding: A New Entity of Delta-Microgranular Storage Pool Deficiency. J Clin Med 2020; 9:E1734. [PMID: 32512725 PMCID: PMC7356033 DOI: 10.3390/jcm9061734] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/22/2020] [Accepted: 06/01/2020] [Indexed: 12/14/2022] Open
Abstract
One thousand and eighty patients, having prolonged bleeding times, frequent epistaxis, menorrhagia or easy bruising or other bleeding manifestations, and excluding those with von Willebrand's disease, were evaluated for platelet dense granule deficiency. The mean diameter of platelet dense granules was determined for all patients using image analysis. Four hundred and ninety-nine had "classic" dense (delta) granule storage pool deficiency (δ-SPD). Five hundred and eighty-one individuals (53.8%) were found to have a normal mean number of dense granules, but for some of these patients, the dense granules were smaller than for the controls. Of the patients having a normal number of dense granules, 165 (28.4%) were found to have significantly smaller granules than the platelets obtained from the control subjects. Their average granule diameter was 123.35 ± 0.86 nm, that is more than three standard deviations below the mean of the control data. Total δ-granule storage pool volumes (TDGV)/platelet were calculated using these measurements. Individuals with δ-SPD had half the number of granules (2.25 ± 0.04 DG/PL) and storage pool volume (3.88 ± 1.06 × 106 nm3) when compared to our control data (4.64 ± 0.11 DG/PL; 10.79 × 106 nm3 ± 0.42). Individuals having a bleeding history but a normal average of small dense granules had a calculated storage pool volume statistically different than controls and essentially the same storage pool volume as patients with δ-SPD. We have identified a sub-classification of δ-SPD that we have defined as micro-granular storage pool deficiency (δ-MGSPD).
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Affiliation(s)
| | - Meera Raghavan
- Kansas City University of Medicine and Biosciences, Kansas City, MO 64106, USA;
| | | | | | - Bodri Roysam
- Department of Electrical and Computer Engineering, University of Houston, Houston, TX 77204, USA;
| | | | - Mary R. Smith
- Department of Medicine, University of Toledo, Toledo, OH 43614, USA;
| | - Peter A. Kouides
- Mary Gooley Hemophilia Center, Rochester General Hospital, Rochester, NY 14621, USA;
| | - Neil A. Lachant
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA;
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Padmakumar M, Van Raes E, Van Geet C, Freson K. Blood platelet research in autism spectrum disorders: In search of biomarkers. Res Pract Thromb Haemost 2019; 3:566-577. [PMID: 31624776 PMCID: PMC6781926 DOI: 10.1002/rth2.12239] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/03/2019] [Indexed: 12/15/2022] Open
Abstract
Autism spectrum disorder (ASD) is a clinically heterogeneous neurodevelopmental disorder that is caused by gene-environment interactions. To improve its diagnosis and treatment, numerous efforts have been undertaken to identify reliable biomarkers for autism. None of them have delivered the holy grail that represents a reproducible, quantifiable, and sensitive biomarker. Though blood platelets are mainly known to prevent bleeding, they also play pivotal roles in cancer, inflammation, and neurological disorders. Platelets could serve as a peripheral biomarker or cellular model for autism as they share common biological and molecular characteristics with neurons. In particular, platelet-dense granules contain neurotransmitters such as serotonin and gamma-aminobutyric acid. Molecular players controlling granule formation and secretion are similarly regulated in platelets and neurons. The major platelet integrin receptor αIIbβ3 has recently been linked to ASD as a regulator of serotonin transport. Though many studies revealed associations between platelet markers and ASD, there is an important knowledge gap in linking these markers with autism and explaining the altered platelet phenotypes detected in autism patients. The present review enumerates studies of different biomarkers detected in ASD using platelets and highlights the future needs to bring this research to the next level and advance our understanding of this complex disorder.
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Affiliation(s)
- Manisha Padmakumar
- Department of Cardiovascular SciencesCenter for Molecular and Vascular BiologyKU LeuvenLeuvenBelgium
| | - Eveline Van Raes
- Department of Cardiovascular SciencesCenter for Molecular and Vascular BiologyKU LeuvenLeuvenBelgium
| | - Chris Van Geet
- Department of Cardiovascular SciencesCenter for Molecular and Vascular BiologyKU LeuvenLeuvenBelgium
| | - Kathleen Freson
- Department of Cardiovascular SciencesCenter for Molecular and Vascular BiologyKU LeuvenLeuvenBelgium
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Gkalea V, Tang S, Favier R, Kuadjovi C, Bégon E, Bugaut H, Bordet JC, Bachmeyer C, Blum L. Progressive pigmented purpuric dermatosis and platelet delta storage pool deficiency in a child. Pediatr Blood Cancer 2019; 66:e27748. [PMID: 30977588 DOI: 10.1002/pbc.27748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/07/2019] [Accepted: 03/13/2019] [Indexed: 01/15/2023]
Affiliation(s)
- Vasiliki Gkalea
- Laboratoire d'Hématologie, Hôpital Tenon (AP-HP), Paris, France
| | - Solange Tang
- Service de Dermatologie, Hôpital René Dubos, Pontoise, France
| | - Remi Favier
- Centre de Référence des Pathologies Plaquettaires, Hôpital Armand Trousseau (AP-HP), Paris, France
| | | | - Edouard Bégon
- Service de Dermatologie, Hôpital René Dubos, Pontoise, France
| | - Hélène Bugaut
- Service de Dermatologie, Hôpital René Dubos, Pontoise, France
| | | | - Claude Bachmeyer
- Service de Médecine Interne, Hôpital Tenon (AP-HP), Paris, France
| | - Laurent Blum
- Service de Dermatologie, Hôpital René Dubos, Pontoise, France
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Padmakumar M, Jaeken J, Ramaekers V, Lagae L, Greene D, Thys C, Van Geet C, BioResource NIHR, Stirrups K, Downes K, Turro E, Freson K. A novel missense variant in SLC18A2 causes recessive brain monoamine vesicular transport disease and absent serotonin in platelets. JIMD Rep 2019; 47:9-16. [PMID: 31240161 PMCID: PMC6498820 DOI: 10.1002/jmd2.12030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 01/24/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Brain monoamine vesicular transport disease is an infantile onset neurodevelopmental disorder caused by variants in SLC18A2, which codes for the vesicular monoamine transporter 2 (VMAT2) protein, involved in the transport of monoamines into synaptic vesicles and of serotonin into platelet dense granules. CASE PRESENTATION The presented case is of a child, born of healthy consanguineous parents, who exhibited hypotonia, mental disability, epilepsy, uncontrolled movements, and gastrointestinal problems. A trial treatment with L-DOPA proved unsuccessful and the exact neurological involvement could not be discerned due to normal metabolic and brain magnetic resonance imaging results.Platelet studies and whole genome sequencing were performed. At age 4, the child's platelets showed a mild aggregation and adenosine triphosphate secretion defect that could be explained by dysmorphic dense granules observed by electron microscopy. Interestingly, the dense granules were almost completely depleted of serotonin. A novel homozygous p.P316A missense variant in VMAT2 was detected in the patient and the consanguineous parents were found to be heterozygous for this variant. Although the presence of VMAT2 on platelet dense granules has been demonstrated before, this is the first report of defective platelet dense granule function related to absent serotonin storage in a patient with VMAT2 deficiency but without obvious clinical bleeding problems. CONCLUSIONS This study illustrates the homology between serotonin metabolism in brain and platelets, suggesting that these blood cells can be model cells for some pathways relevant for neurological diseases. The literature on VMAT2 deficiency is reviewed.
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Affiliation(s)
- Manisha Padmakumar
- Department of Cardiovascular SciencesCentre for Molecular and Vascular Biology, KU LeuvenLeuvenBelgium
| | - Jaak Jaeken
- Department of Development and Regeneration, PediatricsKU LeuvenLeuvenBelgium
| | - Vincent Ramaekers
- Department of NeuropediatricsCentre Hospitalier Universitaire Notre‐Dame des BruyèresLiégeBelgium
| | - Lieven Lagae
- Department of Development and Regeneration, PediatricsKU LeuvenLeuvenBelgium
| | - Daniel Greene
- NIHR BioResource – Rare Diseases, Cambridge University Hospitals, Cambridge Biomedical CampusCambridgeUK
- Department of HematologyUniversity of Cambridge, Cambridge Biomedical CampusCambridgeUK
- Department of Haematology, Medical Research Council Biostatistics Unit, Cambridge Institute of Public Health, Cambridge Biomedical CampusCambridgeUK
| | - Chantal Thys
- Department of Cardiovascular SciencesCentre for Molecular and Vascular Biology, KU LeuvenLeuvenBelgium
| | - Chris Van Geet
- Department of Cardiovascular SciencesCentre for Molecular and Vascular Biology, KU LeuvenLeuvenBelgium
| | - NIHR BioResource
- NIHR BioResource – Rare Diseases, Cambridge University Hospitals, Cambridge Biomedical CampusCambridgeUK
| | - Kathleen Stirrups
- NIHR BioResource – Rare Diseases, Cambridge University Hospitals, Cambridge Biomedical CampusCambridgeUK
- Department of HematologyUniversity of Cambridge, Cambridge Biomedical CampusCambridgeUK
| | - Kate Downes
- Department of Haematology, NHS Blood and Transplant, Cambridge Biomedical CampusCambridgeUK
- NIHR BioResource – Rare Diseases, Cambridge University Hospitals, Cambridge Biomedical CampusCambridgeUK
- Department of HematologyUniversity of Cambridge, Cambridge Biomedical CampusCambridgeUK
| | - Ernest Turro
- Department of Haematology, NHS Blood and Transplant, Cambridge Biomedical CampusCambridgeUK
- NIHR BioResource – Rare Diseases, Cambridge University Hospitals, Cambridge Biomedical CampusCambridgeUK
- Department of HematologyUniversity of Cambridge, Cambridge Biomedical CampusCambridgeUK
- Department of Haematology, Medical Research Council Biostatistics Unit, Cambridge Institute of Public Health, Cambridge Biomedical CampusCambridgeUK
| | - Kathleen Freson
- Department of Cardiovascular SciencesCentre for Molecular and Vascular Biology, KU LeuvenLeuvenBelgium
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Loredana Asztalos M, Schafernak KT, Gray J, Berry A, Paller AS, Mancini AJ. Hermansky-Pudlak syndrome: Report of two patients with updated genetic classification and management recommendations. Pediatr Dermatol 2017; 34:638-646. [PMID: 29044644 DOI: 10.1111/pde.13266] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hermansky-Pudlak syndrome (HPS) is a rare autosomal recessive disorder caused by mutations in one of nine genes involved in the packaging and formation of specialized lysosomes, including melanosomes and platelet-dense granules. The cardinal features are pigmentary dilution, bleeding diathesis, and accumulation of ceroid-like material in reticuloendothelial cells. Pulmonary fibrosis induced by tissue damage is seen in the most severe forms, and one subtype is characterized by immunodeficiency. We describe two patients with HPS type 1 and review the updated gene-based classification, clinical features, and recommendations for evaluation and follow-up.
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Affiliation(s)
- Manuela Loredana Asztalos
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Pathology and Laboratory Medicine , Northwestern University, Chicago, IL, USA.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kristian T Schafernak
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Pathology and Laboratory Medicine , Northwestern University, Chicago, IL, USA.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jayla Gray
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Pathology and Laboratory Medicine , Northwestern University, Chicago, IL, USA.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Adam Berry
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Pathology and Laboratory Medicine , Northwestern University, Chicago, IL, USA.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Amy S Paller
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Pathology and Laboratory Medicine , Northwestern University, Chicago, IL, USA.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anthony J Mancini
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Pathology and Laboratory Medicine , Northwestern University, Chicago, IL, USA.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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