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Serum concentrations of soluble P-selectin is increased in patients infected with Puumala virus

Introduction: Puumala virus belongs to the genus of hantaviruses, family Bunyaviridae and cause mild to moderate clinical manifestations of hemorrhagic fever with renal syndrome (HFRS). P-selectin is an adhesion molecule constitutively expressed in the α -granules of platelets and the Weibel– Palade bodies of endothelial cells upon their activation. Although it has been shown that soluble (s)P-selectin correlates with the platelet count, recent studies suggest that during inflammatory states, in which soluble selectins are elevated, it may serve as a specific marker of leukocyte interactions with endothelial cells. We presumed that sP-selectin might be a useful marker in monitoring activity of HFRS. Methods: We obtained sera samples from 23 HFRS patients, (including 11 paired sera) and 20 controls (general population). Serology testing was done by ELISA test. Patients were hospitalized at the University Hospital of Infectious Diseases in Zagreb. Clinical and laboratory data were also collected. All sera were tested by ELISA tests for the presence of sP-selectin according to the manufacturer’ s protocol (R&D Systems, Minneapolis, MN, USA). Nonparametric statistical analysis was used. Results: In acute (p=0, 008) and paired (p=0, 019) sera of patients with HFRS significantly increased serum levels of sP-selectin were detected. sP-selectin levels correlated neither with the platelet counts nor serum urea nitrogen or creatinine. All HFRS patients were infected by Puumala virus (mild to moderate diseases). Conclusion: Serum concentration of sP selectin is elevated during the course of HFRS. The concentration of sP-selectin strongly correlates with the platelet count in the blood of healthy donors and patients with thrombocytosis/thrombocytopenia. In our study such a correlation was not observed. It is unlikely that the excess of sP-selectin originates solely from platelets but rather from endothelial cells as well. In summary, circulating levels of sP-selectin may reflect complex interaction of virus, its target – endothelial cells and cells involved in immune reaction to virus. sP-selectin might be a useful marker in monitoring activity of the disease caused by hantavirus infection.

P-selectin; Puumala virus; HFRS

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