Humoral response to the BBIBP-CorV vaccine over time in healthcare workers with or without exposure to SARS-CoV-2.

SARS-CoV-2-specific humoral response was analyzed over time in a group of healthcare workers with or without exposure to SARS-CoV-2, who underwent vaccination with BBIBP-CorV (Sinopharm) vaccine in Argentina. Seroconversion rates in unexposed subjects after the first and second doses were 40 % and 100 %, respectively, showing a significant increase in antibody concentrations from dose 1 to dose 2 (p < 0.0001). The highest antibody concentrations were found in younger subjects and women, remaining significantly associated in a multivariable linear regression model (p = 0.005). A single dose of the BBIBP-CorV vaccine induced a strong antibody response in individuals with prior SARS-CoV-2infection, while a second dose did not increase this response. A sharp increase in antibody concentrations was observed following SARS-CoV-2 infection in those participants who became infected after the first and second doses (p = 0.008). Individuals with SARS-CoV-2 exposure prior to vaccination showed significantly higher anti-spike IgG antibody levels, at all-time points, than those not exposed (p < 0.001). Higher antibody titers were induced by a single dose in previously SARS-CoV-2 infected individuals than those induced in naïve subjects by two doses of the vaccine (p < 0.0001). Three months after the second dose both groups showed a decline in antibody levels, being more abrupt in unexposed subjects. Overall, our results showed a trend towards lower antibody concentrations over time following BBIBP-CorV vaccination. Sex and age seem to influence the magnitude of the humoral response in unexposed subjects while the combination of exposure to SARS-CoV-2 plus vaccination, whatever the sequence of the events was, produced a sharp increase in antibody levels. Evaluation of the humoral responses over time and the analysis of the induction and persistence of memory B and T cell responses, are needed to assess long-term immune protection induced by BBIBP-CorV vaccine.

Activation of toll-like receptors 2 and 4 on CD34+ cells increases human megakaryo/thrombopoiesis induced by thrombopoietin.

BACKGROUND: Platelet Toll-like receptor (TLR)2/4 are key players in amplifying the host immune response; however, their role in human megakaryo/thrombopoiesis has not yet been defined. OBJECTIVES: We evaluated whether Pam3CSK4 or lipopolysaccharide (LPS), TLR2/4 ligands respectively, modulate human megakaryocyte development and platelet production. METHODS: CD34+ cells from human umbilical cord were stimulated with LPS or Pam3CSK4 with or without thrombopoietin (TPO). RESULTS: CD34+ cells and megakaryocytes express TLR2 and TLR4 at both RNA and protein level; however, direct stimulation of CD34+ cells with LPS or Pam3CSK4 had no effect on cell growth. Interestingly, both TLR ligands markedly increased TPO-induced CD34+ cell proliferation, megakaryocyte number and maturity, proplatelet and platelet production when added at day 0. In contrast, this synergism was not observed when TLR agonists were added 7 days after TPO addition. Interleukin-6 (IL-6) release was observed upon CD34+ or megakaryocyte stimulation with LPS or Pam3CSK4 but not with TPO and this effect was potentiated in combination with TPO. The increased proliferation and IL-6 production induced by TPO + LPS or Pam3CSK4 were suppressed by TLR2/4 or IL-6 neutralizing antibodies, as well as by PI3K/AKT and nuclear factor-κB inhibitors. Additionally, increased proplatelet and platelet production were associated with enhanced nuclear translocation of nuclear factor-E2. Finally, the supernatants of CD34+ cells stimulated with TPO+LPS-induced CFU-M colonies. CONCLUSIONS: Our data suggest that the activation of TLR2 and TLR4 in CD34+ cells and megakaryocytes in the presence of TPO may contribute to warrant platelet provision during infection episodes by an autocrine IL-6 loop triggered by PI3K/NF-κB axes.

Así comienza la vida plaquetaria: un viaje desde los megacariocitos medulares a las plaquetas circulantes / The birth of a platelet: A trip from bone marrow megakaryocytes to circulating platelets / Começa assim a vida plaquetária: uma viagem desde os megacariócitos medulares às plaquetas circulantes

Tal vez por haber sido consideradas como simples restos citoplasmáticos de los megacariocitos encargadas únicamente de la reparación de heridas, las plaquetas han tenido un lugar secundario en cuanto a su estudio e interés en comparación con los otros componentes celulares de la sangre. Sin embargo, en los últimos 20 años se ha avanzado mucho en el conocimiento de estas fascinantes células que de a poco han recobrado un lugar destacado dentro de la hematología. A lo largo de este trabajo se han revisado los aportes más destacados y novedosos acerca del proceso de biogénesis plaquetaria, su regulación por el microambiente medular y factores humorales, recorriendo desde la generación de megacariocitos hasta la liberación de plaquetas libres.

Perhaps for being considered mere megakaryocyte cytoplasmic debris responsible for wound repair alone, platelets have had a secondary role when compared to other cellular blood components. However, in the last 20 years we have learned much more about these fascinating cells, which have slowly regained a prominent place in hematology. This review discusses the most outstanding and novel contributions on platelet biogenesis, its regulation by the bone marrow microenvironment and humoral factors, analyzing from megakaryocyte generation to platelet release.

Talvez por ter sido considerados simples restos citoplasmáticos dos megacariócitos, encarregadas apenas da reparação de feridas, as plaquetas têm tido um lugar secundário quanto a seu estudo e interesse em comparação com os outros componentes celulares do sangue. Entretanto, nos últimos 20 anos foi possível aprender muito a respeito destas fascinantes células que aos poucos foram recobrando um lugar de destaque dentro da hematologia. Ao longo deste trabalho foram revistas as contribuições mais destacadas e novas acerca do processo de biogênese plaquetária, sua regulação pelo microambiente medular e fatores humorais, percorrendo desde a geração de megacariócitos até a liberação de plaquetas livres.

Mediators and molecular pathways involved in the regulation of neutrophil extracellular trap formation mediated by activated platelets.

In addition to being key elements in hemostasis and thrombosis, platelets amplify neutrophil function. We aimed to gain further insight into the stimuli, mediators, molecular pathways, and regulation of neutrophil extracellular trap formation mediated by human platelets. Platelets stimulated by lipopolysaccharide, a wall component of gram-negative bacteria, Pam3-cysteine-serine-lysine 4, a mimetic of lipopeptide from gram-positive bacteria, Escherichia coli, Staphylococcus aureus, or physiologic platelet agonists promoting neutrophil extracellular trap formation and myeloperoxidase-associated DNA activity under static and flow conditions. Although P-selectin or glycoprotein IIb/IIIa were not involved, platelet glycoprotein Ib, neutrophil cluster of differentiation 18, and the release of von Willebrand factor and platelet factor 4 seemed to be critical for the formation of neutrophil extracellular traps. The secretion of these molecules depended on thromboxane A(2) production triggered by lipopolysaccharide or Pam3-cysteine-serine-lysine 4 but not on high concentrations of thrombin. Accordingly, aspirin selectively inhibited platelet-mediated neutrophil extracellular trap generation. Signaling through extracellular signal-regulated kinase, phosphatidylinositol 3-kinase, and Src kinases, but not p38 or reduced nicotinamide adenine dinucleotide phosphate oxidase, was involved in platelet-triggered neutrophil extracellular trap release. Platelet-mediated neutrophil extracellular trap formation was inhibited by prostacyclin. Our results support a role for stimulated platelets in promoting neutrophil extracellular trap formation, reveal that an endothelium-derived molecule contributes to limiting neutrophil extracellular trap formation, and highlight platelet inhibition as a potential target for controlling neutrophil extracellular trap cell death.

Poly (I:C) downregulates platelet production and function through type I interferon.

Thrombocytopenia is a frequent complication of viral infections; the underlying mechanisms appear to depend on the identity of the virus involved. Previous research, including reports from our group, indicates that as well as having antiviral activity type I interferons (IFN I) selectively downregulate platelet production. In this study we extended understanding of the role of endogenous IFN I in megakaryo/thrombopoiesis by evaluating platelet and megakaryocyte physiology in mice treated with polyinosinic:polycytidylic acid [poly (I:C)], a synthetic analogue of double-stranded RNA, Toll-like receptor-3 ligand and strong IFNß inducer. Mice-treated with poly (I:C) showed thrombocytopaenia, an increase in mean platelet volume and abnormal haemostatic and inflammatory platelet-mediated functionality, indicated by decreased fibrinogen binding and platelet adhesion, prolonged tail bleeding times and impaired P-Selectin externalisation, RANTES release and thrombin-induced platelet-neutrophil aggregate formation. These changes were associated with an increase in size and an abnormal distribution of bone marrow megakaryocytes within the vascular niche and were directly correlated with the plasmatic and bone marrow IFNß levels. All these effects were absent in genetically modified mice lacking the IFN I receptor. Our results suggest that IFN I is the central mediator of poly (I:C)-induced thrombocytopenia and platelet dysfunction and indicate that these abnormalities are due to changes in the last stages of megakaryocyte development. These data provide new evidence for the role of IFN I in megakaryocyte distribution in the bone marrow niches and its influence on thrombopoiesis and haemostasis.

Regulation of neutrophil extracellular trap formation by anti-inflammatory drugs.

The formation of neutrophil extracellular traps (NETs) is a newly described phenomenon that increases the bacteria-killing ability and the inflammatory response of neutrophils. Because NET generation occurs in an inflammatory microenvironment, we examined its regulation by anti-inflammatory drugs. Treatment of neutrophils with dexamethasone had no effect, but acetylsalicylic acid (ASA) treatment prevented NET formation. NETosis was also abrogated by the presence of BAY 11-7082 [(E)-3-[4-methylphenylsulfonyl]-2-propenenitrile] and Ro 106-9920 [6-(phenylsulfinyl)tetrazolo[1,5-b]pyridazine], two structurally unrelated nuclear factor-κB (NF-κB) inhibitors. The decrease in NET formation mediated by ASA, BAY-11-7082, and Ro 106-9920 was correlated with a significant reduction in the phosphorylation of NF-κB p65 subunit, indicating that the activation of this transcription factor is a relevant signaling pathway involved in the generation of DNA traps. The inhibitory effect of these drugs was also observed when NET generation was induced under acidic or hyperthermic conditions, two stress signals of the inflammatory microenvironment. In a mouse peritonitis model, while pretreatment of animals with ASA or BAY 11-7082 resulted in a marked suppression of NET formation along with increased bacteremia, dexamethasone had no effect. Our results show that NETs have an important role in the local control of infection and that ASA and NF-κB blockade could be useful therapies to avoid undesired effect of persistent neutrophil activation.

Acidosis downregulates platelet haemostatic functions and promotes neutrophil proinflammatory responses mediated by platelets.

Acidosis is one of the hallmarks of tissue injury such as trauma, infection, inflammation, and tumour growth. Although platelets participate in the pathophysiology of all these processes, the impact of acidosis on platelet biology has not been studied outside of the quality control of laboratory aggregation assays or platelet transfusion optimization. Herein, we evaluate the effect of physiologically relevant changes in extracellular acidosis on the biological function of platelets, placing particular emphasis on haemostatic and secretory functions. Platelet haemostatic responses such as adhesion, spreading, activation of αIIbß3 integrin, ATP release, aggregation, thromboxane B2 generation, clot retraction and procoagulant activity including phosphatidilserine exposure and microparticle formation, showed a statistically significant inhibition of thrombin-induced changes at pH of 7.0 and 6.5 compared to the physiological pH (7.4). The release of alpha granule content was differentially regulated by acidosis. At low pH, thrombin or collagen-induced secretion of vascular endothelial growth factor and endostatin were dramatically reduced. The release of von Willebrand factor and stromal derived factor-1α followed a similar, albeit less dramatic pattern. In contrast, the induction of CD40L was not changed by low pH, and P-selectin exposure was significantly increased. While the generation of mixed platelet-leukocyte aggregates and the increased chemotaxis of neutrophils mediated by platelets were further augmented under acidic conditions in a P-selectin dependent manner, the increased neutrophil survival was independent of P-selectin expression. In conclusion, our results indicate that extracellular acidosis downregulates most of the haemostatic platelet functions, and promotes those involved in amplifying the neutrophil-mediated inflammatory response.

Paracrine regulation of megakaryo/thrombopoiesis by macrophages.

OBJECTIVE: Megakaryo/thrombopoiesis is a complex process regulated by multiple signals provided by the bone marrow microenvironment. Because macrophages are relevant components of the bone marrow stroma and their activation induces an upregulation of molecules that can regulate hematopoiesis, we analyzed the impact of these cells on the control of megakaryocyte development and platelet biogenesis. MATERIALS AND METHODS: The different stages of megakaryo/thrombopoiesis were analyzed by flow cytometry using an in vitro model of human cord blood CD34(+) cells stimulated with thrombopoietin in either a transwell system or conditioned media from monocyte-derived macrophages isolated from peripheral blood. Cytokines secreted from macrophages were characterized by protein array and enzyme-linked immunosorbent assay. RESULTS: Resting macrophages released soluble factors that promoted megakaryocyte growth, cell ploidy, a size increase, proplatelet production, and platelet release. Lipopolysaccharide stimulation triggered the secretion of cytokines that exerted opposite effects together with a dramatic switch of CD34(+) commitment to the megakaryocytic lineage toward the myeloid lineage. Neutralization of interleukin-8 released by stimulated macrophages partially reversed the inhibition of megakaryocyte growth. Activation of nuclear factor κB had a major role in the synthesis of molecules involved in the megakaryocyte inhibition mediated by lipopolysaccharide-stimulated macrophages. CONCLUSIONS: Our study extends our understanding about the role of the bone marrow microenvironment in the regulation of megakaryo/thrombopoiesis by showing that soluble factors derived from macrophages positively or negatively control megakaryocyte growth, differentiation, maturation, and their ability to produce platelets.

Activation of cyclic AMP pathway prevents CD34(+) cell apoptosis.

OBJECTIVE: Although cAMP is involved in a number of physiologic functions, its role in hematopoietic cell fate decision remains poorly understood. We have recently demonstrated that in CD34(+)-derived megakaryocytes, cAMP-related agents prevent apoptosis. In this study we addressed the question of whether cAMP also regulates survival of their precursors, CD34(+) cells. METHODS: Apoptosis was evaluated by fluorescence microscopy, and detection of hypodiploid or annexin V(+) cells by flow cytometry. Mitochondrial membrane potential and bcl-xL or caspase-3 expression were assessed by flow cytometry. Colony-forming units were studied by clonogenic assays in methylcellulose. RESULTS: We found that two different cAMP analogs such as Dibutiril-cAMP and sp-5,6-DCl-BIMPS (BIMPS) promoted survival of human umbilical cord-derived CD34(+) cells by suppressing apoptosis induced by either nitric oxide (NO) or serum deprivation. Involvement of PKA and PI3K pathway was demonstrated by the ability of their specific inhibitors Rp-cAMP and Wortmannin or LY294002 respectively to reverse the antiapoptotic effect of BIMPS. Treatment of CD34(+) cell with BIMPS not only restrained the bcl-xL downregulation but also suppressed the loss of mitochondrial membrane potential and caspase-3 activation induced by serum starvation. While thrombopoietin (TPO), granulocyte colony-stimulating factor (G-CSF) or stem cell factor (SCF) were not able to increase cAMP levels, the antiapoptotic activity exerted by these growth factors was blocked by inhibition of the adenylate cyclase and synergized by BIMPS. Cyclic AMP analogs suppressed the decreased colony formation in cells exposed to NO or serum deprivation. CONCLUSION: Altogether, our results strongly suggest that cAMP appears to be not only a key pathway controlling CD34(+) survival, but also a mediator of the TPO-, G-CSF- and SCF-mediated cytoprotection.

Aspirin and salicylate suppress polymorphonuclear apoptosis delay mediated by proinflammatory stimuli.

During inflammation, polymorphonuclear leukocyte (PMN) apoptosis can be delayed by different proinflammatory mediators. Classically, it has been accepted that the widely used anti-inflammatory drug acetyl salicylic acid (ASA) exerts its action through inhibition of cyclooxygenases and subsequent prostaglandin synthesis. We hypothesized that another anti-inflammatory action of ASA could be the shortening of PMN survival. We found that at therapeutic concentrations (1-3 mM), ASA and its metabolite salicylate (NaSal), but not indomethacin or ibuprofen, counteracted the prolonged PMN survival mediated by lipopolysaccharide (LPS) through inhibition of nuclear factor-kappaB (NF-kappaB) activation. Both salicylates also inhibited interleukin (IL)-1alpha or acidic conditions antiapoptotic activity. Higher concentrations of both drugs had a direct apoptotic effect. Salicylates were not effective when PMN apoptosis delay was induced by granulocyte macrophage-colony-stimulating factor (GM-CSF), a NF-kappaB-independent cytokine. Promotion of PMN survival by the combination of IL-1alpha and LPS was also reversed by salicylates, but higher concentrations were required. ASA concentrations that did not trigger PMN death increase the zymosan- or tumor necrosis factor-alpha-mediated proapoptotic effect. The LPS- and IL-1alpha- but not GM-CSF-mediated antiapoptotic effect was markedly reduced in PMNs from donors who had ingested ASA. Using a thioglycolate-induced peritonitis model, we showed that in ASA- or NaSal-treated mice there was not only a decrease in the number of cells recruited but also an increase in the percentage of apoptotic PMNs as well as an enhancement of phagocytosis compared with controls. Our findings demonstrate that acceleration of PMN apoptosis by turning off the NF-kappaB-mediated survival signals elicited by proinflammatory stimuli is another anti-inflammatory action of ASA and NaSal.

The snake venom metalloproteases berythractivase and jararhagin activate endothelial cells.

PIII snake venom metalloproteases (SVMPs) are metalloproteases structurally related to ADAMs (a disintegrin and metalloprotease human family of proteins). Berythractivase and jararhagin are PIII SVMPs with 69% homology that have different hemostatic properties. In order to clarify these differences and further characterize the biological effects of these proteins, we have analyzed the effect of both proteases on human umbilical-vein endothelial cell functions. We found that both proteins enhanced nitric oxide generation, prostacyclin production and interleukin-8 release. Berythractivase but not jararhagin increased the expression of decay accelerating factor. Jararhagin decreased cell viability in a concentration-dependent manner and induced cellular apoptosis, while berythractivase did not modulate cell survival. Our results show for the first time that, besides the known anti-aggregating or procoagulant effects of PIII SVMPs, these proteins trigger endothelial cell effector responses. Although structurally related, berythractivase and jararhagin induce a dissimilar generation and release of endothelial molecules that may account for their different hemorrhagic activity.

Prostacyclin prevents nitric oxide-induced megakaryocyte apoptosis.

1 We have previously demonstrated that nitric oxide (NO) triggers CD34(+)-derived megakaryocyte apoptosis. We here show that prostacyclin (PGI(2)) inhibits PAPA/NO-induced megakaryocyte death detected by fluorescent microscopy and flow cytometry. 2 The cAMP-specific phosphodiesterase inhibitor, Ro 20-1724, and the permeable analog dibutyryl-cAMP also delayed apoptosis. PGI(2) effect was fully prevented when adenylyl cyclase activity was suppressed by SQ 22536, and partially reversed by the permeable protein kinase A inhibitor PKI 14-22 amide. ELISA showed that while both PGI(2) and NO alone or synergistically raised cAMP, only NO was able to increase intracellular cGMP levels. 3 Treatment of megakaryocytes with PGI(2) abolished both basal and NO-raised cGMP levels. Addition of 8-pCPT-cGMP or activation of soluble guanylyl cyclase by BAY 41-2272 induced cell death in a concentration-dependent manner, and ODQ, an inhibitor of guanylyl cyclase, prevented both PAPA/NO- or BAY 41-2272-induced apoptosis. Specific cGMP phosphodiesterase inhibition by Zaprinast or suppression of adenylyl cyclase by SQ 22536 enhanced the PAPA/NO proapoptotic effect. 4 PGI(2) completely inhibited NO-mediated generation and the increased activity of the cleaved form of caspase-3. 5 In conclusion, our results demonstrate that contrary to their well-known direct and synergistic inhibitory effects on platelets, PGI(2) and NO regulate opposite megakaryocyte survival responses through a delicate balance between intracellular cyclic nucleotide levels and caspase-3 activity control.

Endothelial cell function alteration after Junin virus infection.

Hematologic involvement is the main feature of Argentine hemorrhagic fever (AHF), an endemo-epidemic disease caused by Junin virus (JV). Since endothelial dysfunction could play a role in AHF-altered hemostasis, we studied human umbilical vein endothelial cell (HUVEC) infection with a virulent (JVv) and a non-virulent (JVa) JV strain. Cells were infected by the two JV variants with no detectable apoptosis or cytopathic effect. Both viral variants up-regulated ICAM-1 and VCAM-1 levels, while von Willebrand factor (VWF) production was decreased. Prostacyclin (PGI2) release and decay accelerating factor (DAF) expression were greater in JVv- than in JVa-infected or control cells. Furthermore, nitric oxide (NO) production and endothelial nitric oxide synthase (eNOS) expression was only raised in JVv-infected supernatants. Significant NO and PGI2 values were also detected in AHF patient sera. These data demonstrate that endothelial cell responses are triggered subsequently by JV infection, suggesting that such alterations play a major role in the pathogenesis of AHF and perhaps in other viral-induced hemorrhagic diseases.

Interrelación entre apoptosis del megacariocito y formación de plaquetas. Relevancia clínica / Interrelation between megakaryocyte apoptosis and platelet formation

En 1994 se caracterizó a la trombopoyetina como el principal regulador fisiológico del desarrollo megacariocítico y de la producción de plaquetas. A pesar de los importantes avances alcanzados en el conocimiento de los distintos pasos involucrados en la megacariocitopoyesis, el mecanismo molecular de la liberación de plaquetas a partir de megacariocitos maduros aún no está esclarecido. Una hipótesis es que la muerte celular o apoptosis del megacariocito sería el fenómeno que relaciona ambos eventos. El proceso de apoptosis está regulado por varias familias de proteínas: los receptores de muerte, las caspasas y la familia de proteínas Bcl-2. Recientemente se ha demostrado que en modelos de cultivo, entre los días 17 y 18, aproximadamente 50 por ciento de los megacariocitos presentan características de apoptosis y un aumento significativo del número de plaquetas. La proteína antiapoptótica Bcl-xl (miembro de la familia Bcl-2) sería necesaria para mantener la sobrevida de MCs en desarrollo y se liberaría con las plaquetas recién formadas permitiendo a los megacariocitos senescentes sufrir apoptosis y ser eliminados por los monocitos/macrófagos. La apoptosis de megacariocitos inmaduros que aún no son capaces de formar plaquetas sería la causa de la trombocitopenia observada en algunas patologías como síndrome mielodisplásico, trombocitopenia de radio y pacientes seropositivos para HIV.

Rol del óxido nítrico en la apoptosis del megacariocito / Nitric oxide role in megakaryocyte apoptosis

El óxido nítrico es uno de los metabolitos más pequeños biológicamente activo que regula distintos procesos fisiológicos y patofisiológicos en el sistema cardiovascular, inmune y nervioso. Hemos explorado recientemente su rol en la megacariocitopoyesis utilizando como modelo in-vitro el cultivo líquido de células mononucleares o de células indiferenciadas obtenidas a partir de médula ósea humana y estimuladas con trombopoyetina. Se observó que la generación de óxido nítrico de manera exógena es capaz de inhibir el crecimiento de los megacariocitos induciendo apoptosis tanto en células de estadios inmaduros como terminales por un mecanismo independiente de la guanilil ciclasa. La exposición de los cultivos a la L-arginina (sustrato fisiológico) o a una combinación de citoquinas proinflamatorias resultó en una supresión del crecimiento de los megacariocitos junto con un aumento significativo en los niveles de óxido nítrico. La presencia de inhibidores de la síntesis de óxido nítrico bloqueó su producción y revirtió parcialmente la inhibición del crecimiento de los megacariocitos. Nuestros resultados constituyen la primera evidencia de que el óxido nítrico inhibe el crecimiento de megacariocitos por inducción de apoptosis. Este hallazgo presenta nuevas perspectivas para comprender los fenómenos involucrados en la megacariocitopoyesis y en la formación de plaquetas.

Interrelación entre apoptosis del megacariocito y formación de plaquetas. Relevancia clínica / Interrelation between megakaryocyte apoptosis and platelet formation

En 1994 se caracterizó a la trombopoyetina como el principal regulador fisiológico del desarrollo megacariocítico y de la producción de plaquetas. A pesar de los importantes avances alcanzados en el conocimiento de los distintos pasos involucrados en la megacariocitopoyesis, el mecanismo molecular de la liberación de plaquetas a partir de megacariocitos maduros aún no está esclarecido. Una hipótesis es que la muerte celular o apoptosis del megacariocito sería el fenómeno que relaciona ambos eventos. El proceso de apoptosis está regulado por varias familias de proteínas: los receptores de muerte, las caspasas y la familia de proteínas Bcl-2. Recientemente se ha demostrado que en modelos de cultivo, entre los días 17 y 18, aproximadamente 50 por ciento de los megacariocitos presentan características de apoptosis y un aumento significativo del número de plaquetas. La proteína antiapoptótica Bcl-xl (miembro de la familia Bcl-2) sería necesaria para mantener la sobrevida de MCs en desarrollo y se liberaría con las plaquetas recién formadas permitiendo a los megacariocitos senescentes sufrir apoptosis y ser eliminados por los monocitos/macrófagos. La apoptosis de megacariocitos inmaduros que aún no son capaces de formar plaquetas sería la causa de la trombocitopenia observada en algunas patologías como síndrome mielodisplásico, trombocitopenia de radio y pacientes seropositivos para HIV. (AU)

Rol del óxido nítrico en la apoptosis del megacariocito / Nitric oxide role in megakaryocyte apoptosis

El óxido nítrico es uno de los metabolitos más pequeños biológicamente activo que regula distintos procesos fisiológicos y patofisiológicos en el sistema cardiovascular, inmune y nervioso. Hemos explorado recientemente su rol en la megacariocitopoyesis utilizando como modelo in-vitro el cultivo líquido de células mononucleares o de células indiferenciadas obtenidas a partir de médula ósea humana y estimuladas con trombopoyetina. Se observó que la generación de óxido nítrico de manera exógena es capaz de inhibir el crecimiento de los megacariocitos induciendo apoptosis tanto en células de estadios inmaduros como terminales por un mecanismo independiente de la guanilil ciclasa. La exposición de los cultivos a la L-arginina (sustrato fisiológico) o a una combinación de citoquinas proinflamatorias resultó en una supresión del crecimiento de los megacariocitos junto con un aumento significativo en los niveles de óxido nítrico. La presencia de inhibidores de la síntesis de óxido nítrico bloqueó su producción y revirtió parcialmente la inhibición del crecimiento de los megacariocitos. Nuestros resultados constituyen la primera evidencia de que el óxido nítrico inhibe el crecimiento de megacariocitos por inducción de apoptosis. Este hallazgo presenta nuevas perspectivas para comprender los fenómenos involucrados en la megacariocitopoyesis y en la formación de plaquetas. (AU)