Prognostic Impact of Platelet-Large Cell Ratio In Myelodysplastic Syndromes

Development of a decellularized extracellular matrix-derived wet adhesive for sustained drug delivery and enhanced wound healing

Complete tissue recovery following traumatic injury remains a major clinical challenge. While tissue adhesives show promise for managing traumatic injuries, developing materials with robust wet adhesion and high biocompatibility remains difficult. Decellularized extracellular matrix (ECM)-derived materials are widely utilized in tissue engineering due to their superior biocompatibility and bioactivity. In this study, a wet adhesive is developed by functionalizing ECM with dopamine. The resulting ECM-dopamine exhibits strong wet adhesion and excellent biocompatibility. Furthermore, ECM-dopamine can be engineered into a drug delivery platform for small agents and macromolecules. Solid lipid nanoparticles (SLNs) are incorporated into ECM-dopamine to enable sustained release of small molecules. The ECM-dopamine-SLN system ensures sustained drug release for at least one week upon adhesion to target tissues. ECM-dopamine-SLN loaded with antimicrobials accelerates wound healing and promotes angiogenesis by modulating the inflammatory response in a mouse skin excision model. Additionally, ECM-dopamine can deliver bioactive macromolecules to injured tissue. ECM-dopamine loaded with insulin-like growth factor-1 promotes skeletal muscle regeneration in a mouse volumetric muscle loss model, likely through the modulation of M2-like macrophage polarization. The dual functionality of ECM-dopamine as both a wet adhesive and a drug delivery platform offers significant potential for regenerative medicine applications.

Analysis of Manifestations and Associated Factors of HIV-1 Associated Thrombocytopenia in a General Teaching Hospital in Western China

Background

Thrombocytopenia frequently occurs with HIV-1 infection and plays a vital role in the deterioration of the Blood-Brain Barrier (BBB) and the development of neuroinflammation. This study aims to assess the prevalence and risk factors for HIV-1 associated thrombocytopenia (HAT) and summarize the characteristics of HAT-related neuroinflammation.

Methods

A retrospective study of HAT patients was conducted in a general teaching hospital from January 2017 to December 2021. Clinical and laboratory data from HIS and LIS were analyzed to determine the prevalence and risk factors for HAT and manifestations of HAT with neuroinflammation.

Results

The prevalence of HAT was 11.06%, with a majority of male patients (76.92%), individuals aged 50 and older (55.21%), and 63.80% experiencing mild thrombocytopenia. Significant differences were observed in CD4+ T cell count, platelet crit (PCT), and the proportion of large platelets (P-LCR) between the HAT and control groups (P<0.001, P<0.001, P=0.002). A CD4+ T cell count <200 cells/μL (P=0.001) was identified as a significant risk factor for HAT, while advanced age and high viral load were closely associated with HAT occurrence. HAT Patients with neuroinflammation were predominantly male (X2=10.066, P=0.007), had higher viral loads (X2=12.297, P=0.006), advanced age (X2=11.721, P=0.02), neuropsychiatric symptoms, and elevated levels of inflammatory factors such as IL-6 and proteins in cerebrospinal fluid (CSF).

Conclusion

In HIV-1 infection, the activation of monocytes, macrophages, and microglia leads to thrombocytopenia and neuroinflammation, highlighting the importance of recognizing HAT and HAT with neuroinflammation. Advanced age, lower CD4+ T cell count, and high viral load are closely linked to their occurrence.

Correlation analysis of peripheral platelet markers and disease phenotypes in Alzheimer's disease

INTRODUCTION

Platelets serve as the primary peripheral reservoir of amyloid beta (Aβ). However, there is limited research on platelet markers in routine blood examinations, particularly with regard to the large platelet ratio (P-LCR) in Alzheimer's disease (AD).

METHODS

This study included 512 AD patients and 205 healthy controls (HCs). Platelet markers and apolipoprotein E (APOE) 4 status were assessed in all participants.

RESULTS

The study revealed that P-LCR was significantly elevated in AD patients compared to HCs. In AD patients carrying APOE4, P-LCR significantly negatively correlated with Montreal Cognitive Assessment scores. There was an observed increasing trend in the rate of change in P-LCR with disease progression. Binary logistic regression analysis indicated that P-LCR may constitute a risk factor for AD, after adjusting for age, sex, APOE4, and body mass index.

DISCUSSION

P-LCR is associated with disease severity in AD patients carrying APOE4. P-LCR may be a promising marker to reflect platelet activity in AD patients.

HIGHLIGHTS

P-LCR significantly negatively correlated with MoCA scores in AD patients with APOE4. The rate of change in P-LCR showed an increasing trend with disease progression. P-LCR may be a risk factor for AD.

The role of platelet large cell ratio in determining mortality in COVID-19 patients

Inflammatory mechanisms have been implicated and have been subject to research in the clinical course of COVID-19 patients. In this study, platelet large cell ratio (P-LCR) has been examined as a novel prognostic and inflammatory parameter. A total of 1992 COVID-19-positive patients admitted to COVID-19 unit of Infectious Diseases were included. In order to identify a potential relationship between P-LCR and mortality, surviving patients were compared with subjects who died as a result of the disease. Although P-LCR levels showed a steady increase in all COVID-19 patients after admission, they were significantly higher in those who eventually died (P < .001), indicating a positive correlation between mortality and P-LCR. The P-LCR levels of patients followed up in the intensive care unit were statistically significantly higher than those followed up in the ward (P < .001). P-LCR levels of patients intubated in intensive care unit were statistically significantly higher than those who were not intubated (P < .001). Also, P-LCR levels were subdivided into 3 categories as normal, low, and elevated. Elevated P-LCR was found to be positively correlated with leukocyte count, neutrophil count, D-dimer, troponin, ferritin, and C-Reactive Protein (CRP) and showed negative correlation with fibrinogen, lymphocyte count, and platelet count. As P-LCR was correlated with the severity of inflammation in all COVID-19 patients, it was significantly higher in those patients who died. Elevated P-LCR was considered to be associated with the risk of severe disease and death. This inexpensive, readily available test may be incorporated into our clinical practice as a novel marker of poor prognosis in addition to other valuable laboratory parameters.

The postpartum uterine ultrasonographic scale in assessment of uterine involution after cesarean section in treated thrombophilia pregnant patients at term

Background

Pregnancy is a prothrombotic condition which can be abnormally exaggerated in women with thrombophilia.

Methods

In a prospective study, patients who delivered at term, by cesarean section, between 1 October 2017 and 1 December 2021, who already had a diagnosis of thrombophilia before coming to our hospital, were included in the study group (n = 80). A similar number of nonthrombophilia patients (n = 80) without any history of thrombotic events, age‐ and para‐matched with the study group, were included in the control group. The postpartum uterine ultrasonographic scale (PUUS) values, in the first 24–48 h, were correlated with the patients' data.

Results

The P‐LCR (platelet large cell ratio), was significantly higher in the treated thrombophilia group (p = 0.042). There was no correlation between PUUS and complete blood count values, coagulation factors, maternal characteristics, or fetal outcomes, except for postpartum neutrophils (p = 0.047) and postpartum platelet count (p = 0.046).

Conclusions

Postpartum uterine involution was not significantly different, after cesarean section, between treated thrombophilia patients and nonthrombophilia patients. Involution correlated only with postpartum neutrophils and postpartum platelet count.

Automated Detection of Dysplasia: Data Mining from Our Hematology Analyzers

Myelodysplastic syndromes (MDSs) are clonal hematopoietic diseases of the elderly, characterized by chronic cytopenia, ineffective and dysplastic hematopoiesis, recurrent genetic abnormalities and increased risk of progression to acute myeloid leukemia. Diagnosis on a complete blood count (CBC) can be challenging due to numerous other non-neoplastic causes of cytopenias. New generations of hematology analyzers provide cell population data (CPD) that can be exploited to reliably detect MDSs from a routine CBC. In this review, we first describe the different technologies used to obtain CPD. We then give an overview of the currently available data regarding the performance of CPD for each lineage in the diagnostic workup of MDSs. Adequate exploitation of CPD can yield very strong diagnostic performances allowing for faster diagnosis and reduction of time-consuming slide reviews in the hematology laboratory.