Tropical Biomedicine  2018;35(3):678-683

A preliminary study of platelet hyperactivity in the chronic indeterminate phase of Chagas’ disease

Flavio Rojas Castillejos 1 ; Laura Perez-Campos Mayoral 2 ; Gabriel Mayoral Andrade 2 ; Maria Teresa Hernandez-Huerta 2 ; Socorro Pina-Canseco 2 ; Ruth Martinez Cruz 2 ; Efrain Herrera Colmenares 2 ; Eduardo Perez-Campos Mayoral 2 ; Paz Maria Salazar 3 ; Martha Bucio Torres 3 ; Margarita Cabrera Bravo 3 ; Margarito Martinez Cruz 4 ; Carlos Matí ; as Cervantes 4 ; Roxana Diaz Albarraz 1 ; Joel Lopez Matias 1 ; Gabriela Ines Rios Arias 1 ; Gema Hrnandez Bernardino 1 ; Ernesto Perez Matus 1 ; Rosalinda Mendez Trujillo 1 ; Luis Manuel Sanchez Navarro 2 ; Alma Dolores Perez Santiago 4 ; Eduardo Perez Campos 5

Affiliations

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Country

Malaysia

Language

English

Abstract

The chronic indeterminate phase of Chagas’ disease is asymptomatic despite positive test results for antibodies specific to Trypanosoma cruzi. CD62P-APC (P-selectin) and PAC-1 FITC (GpIIb/IIIa) may improve diagnosis as biomarkers of platelet activity. Nine asymptomatic seropositive subjects, previously untreated, were selected from a blood bank within a year of Chagas’ disease detection, in addition to a control group of four. All subjects were evaluated by flow cytometry for CD62P, PAC-1 and CD41, and in a complementary study, by Tissue Doppler Echocardiography for isovolumic relaxation times (IVRT) and E/A ratios. The subjects were classified as positive or negative for CD62P and PAC-1 by a cut off obtained from their mean±2SD. For IVRT and E/A ratios, cut offs were obtained from the American Society of Echocardiography and the European Association of Cardiovascular Imaging recommendations. Fisher’s exact test was used for associated findings. Pre-test and post-test probability, sensitivity, specificity, positive and negative predictive values and likelihood ratios were calculated. Abnormalities were expressed as platelet hyperactivity and ventricular dysfunction in CD62P, PAC-1, IVRT and E/A ratios. CD62P appears to have greater sensitivity (0.75) and PAC-1, more accurate specificity (0.75), which may explain thrombotic events in Chagas’ disease. We recommend the use of CD62P and PAC-1 as biomarkers of platelet hyperactivity in patients in the chronic indeterminate phase of Chagas’ disease.