Since automated hematology analyzers use staining with nucleic acid specific dyes to detect immature platelets I am curious to learn whether these dyes would also detect nucleic acids from pathogens associated with platelets. I know of a case where Babesiosis was originally overlooked due to a high reticulocyte count and assume that what can happen for red blood cells could potentially happen for platelets as well. Differentiation between immature platelets and "pathogen-associated" platelets might be of particular importance in diseases like autoimmune thrombocytopenic purpura. It could help our understanding of platelets as innate immune cells if immature platelets could also represent "pathogen-associated" platelets.
Dear Elisabeth
as you know, the presence of Babesia into RBC adds to these cells a variable amount of nucleic acid by simulating an increase of reticulocytes. Theoretically, due to similar mechanisms, could also be likely an overestimation of the IPF in case of presence of bacteria associated with plt. Anyway, we must consider that in this hypotesis, additional informations can be acquired not only by the number of immature platelets but by observing even the morphologies of the specific cytographic images provided by each haematological analyzer. These cytographic images instrument-specific are the graphic representation of platelets distribution in a cartesian system. In the attached images you can compare a normal number of IPF with a normal cytographic morphology (on the left) and a falsely increased IPF (by cytoplasmic fragments, in this case) on the right with a very modified cytographic morphology.
Dear Elizabeth
Very interesting and thought-provoking question indeed. Once upon a time, I did some experiments using thiazole orange that stains mRNA to differentiate between essential thrombocythaemia and reactive thrombocytosis (RT) on the basis that one would expect to see more mRNA in RT. The results did support this assumption. Of course, lots of technological advances have happened since. But, I think, one could use nucleic acid stains to differentiate between reticulated platelets and pathogen-infected ones. It will be very interesting to study. Since we have more advanced dyes for flow cytometry, you could run some experiments with a combination of RNA specific and DNA specific dyes using platelets from known cases of RT. You may find that RT platelets express more RNA rather than DNA. Once you have established the expression profile, you can then study platelets from patients with confirmed bacterial septicaemia, viraemia (HIV, CMV (allo-BMT), acute glandular fever...) and parasitaemia (malaria, babesiosis...) to look at any difference(s) in the profile. The results may give you some useful clues for further research. Good luck with the experiments and please keep me in the loop. I would be very interested to know what you find.
Best wishes
Siva
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