CD36 Gene Mutation In Patients With Platelet Transfusion Refractoriness

Objective:Platelet transfusion is the irreplaceable measure to prevent hemorrhage in clinical practice. At present, platelet transfusion refractoriness is the most troublesome problem in clinical blood transfusion.It can be caused by non-immune factors such as infection, fever, splenomegaly and immune factors such as HLA antibody, HPA antibody, CD36 antibody. Non-specific membrane glycoprotein CD36 not only plays a key role in physiological and pathological processes, such as inflammation, diabetes, atherosclerosis and thrombosis, CD36 deficiency in platelet also lead to platelet transfusion refractoriness. In this study to investigate the CD36 genetic mutations of platelet transfusion refractoriness, and explore the relationship between CD36 genetic mutations and nationality, gender, blood type. Provide clinical evidence for the platelet transfusion refractoriness caused by CD36 antibody.Methods:103 patients with platelet transfusion refractoriness and 230 healthy subjects were collected from October 2014 to August 2015 in the First Affiliated Hospital of Guangxi Medical University, and the clinical data such as blood type, nationality and gender of patients were collected. Platelet antibodies were detected by ELISA in 103 patients with platelet transfusion refractoriness.C268T,329-330delAC and A1237C three site mutations in the CD36 gene were detected by sequence-specific primers PCR (PCR-SSP), the difference between the case group and the control group was analyzed by SPSS 16.0 software. To search for the relationship between CD36 gene mutation and platelet transfusion refractoriness, and the further study of the relationship between CD36 gene mutation and gender, nationality, blood type, etc.Results:1. Among 103 patients with platelet transfusion refractoriness,15 patients existed platelet antibody. Among them,12 cases existed HLA antibody, 1 cases existed HPA antibody,1 case existed HLA and HPA antibody, and 1 case existed CD36 antibody.2. PTR is mainly caused by non-immune factors. The positive rate of platelet antibody has nothing to do with patient's gender, age and nationality, blood type, but associated with the number of platelet transfusion,amount of blood transfusion and the type of disease.3. In the detection of 230 cases of healthy subjects,9 cases happened to CD36 gene mutation, the mutation rate was 3.91%(9/230). Among them, there were 8 cases of 329-330delAC mutation and 1 case of C268T mutation. Among 103 cases of PTR, there were 10 cases happeded to 329-330delAC mutation, mutation rate was 9.71%(10/103).The frequency of CD36 gene mutation had differences in two group, the difference was statistically significant (P<0.05). Two groups had the same type of mutation.4. There is no evidence to suggest that CD36 gene mutation was associated with gender, nationality, blood type and the frequency of platelet infusion.Conclusion:1. The main antibody that caused PTR was HLA antibody, the incidence rate of platelet antibody has nothing to do with gender, age and blood group, but related to the number of platelet transfusion, amount of blood transfusion and the type of disease.2. CD36 gene mutations were related to PTR. We should alert platelet transfusion refractoriness caused by CD36 antibody.329del AC mutation was the main mutation of CD36 gene in China, and followed by the C268T mutation.