Other Effects of HIV on the Blood System

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TGF[beta] mediated downregulation of thrombopoietin is associated with platelet decline in asymptomatic SIV infection

Metcalf Pate, Kelly A. DVM PhD; Lyons, Claire E.; Dorsey, Jamie L.; Queen, Suzanne E. MS; Adams, Robert J. DVM; Morrell, Craig N. DVM PhD; Mankowski, Joseph L. DVM PhD

Published Ahead-of-Print
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Abstract

Background: Thrombocytopenia is a known consequence of HIV infection, and decreased production of platelets has been previously implicated in the pathogenesis of platelet decline during asymptomatic infection. Thrombopoietin (THPO) drives platelet production by stimulating the maturation of bone marrow megakaryocytes, and can be transcriptionally down-regulated by cytokines that are increased during infection such as TGF[beta] and pf4.
Design: To determine whether transcriptional down-regulation of THPO contributed to decreased platelet production during asymptomatic infection in the SIV/ macaque model of HIV, we compared hepatic THPO mRNA levels to platelet number and megakaryocyte density. To identify potential inhibitory factors that decrease THPO transcription during asymptomatic infection, we measured TGF[beta] and pf4 plasma levels. To determine whether cART could correct platelet decline by altering cytokine levels, we measured TGF[beta] and pf4 in cART-treated SIV-infected macaques and compared these values to untreated SIV-infected macaques.
Results: Hepatic THPO transcription was down-regulated during asymptomatic SIV infection concurrent with platelet decline. Hepatic THPO mRNA levels correlated with bone marrow megakaryocyte density. In contrast, plasma TGF[beta] levels were inversely correlated with hepatic THPO transcription and bone marrow megakaryocyte density. With cART treatment, plasma TGF[beta] levels and platelet count returned to values similar to those in uninfected macaques.
Conclusions: TGF[beta] mediated downregulation of hepatic THPO may lead to decline in platelet number during asymptomatic SIV infection, and cART may prevent platelet decline by normalizing plasma TGF[beta] levels.
(C) 2013 by Lippincott Williams & Wilkins

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