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Thrombosis with Thrombocytopenia Syndrome

Thrombosis with Thrombocytopenia Syndrome

21-06-2024

Thrombosis with thrombocytopenia syndrome rare but serious adverse event associated with Ad26.COV2.S vaccination

The Oxford-AstraZeneca vaccine, marketed as Covishield in India by the Serum Institute of India (SII), has been linked to a rare but serious adverse side effect called Thrombosis with Thrombocytopenia Syndrome (TTS).

What is Thrombosis with Thrombocytopenia Syndrome (TTS)?

TTS, also referred to as Vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) or vaccine-induced immune thrombotic thrombocytopenia (VITT), is a condition characterized by the unusual combination of blood clots (thrombosis) and low platelet count (thrombocytopenia).

  1. Occurrence: Primarily observed in individuals who have received COVID-19 vaccines using Adenoviral Vectors (like Covishield).
  2. Cause: Believed to be triggered by an immune reaction to the Adenovirus Vector.
  • Adenovirus Vectors, are commonly used in vaccine development due to their ability to induce strong immune responses.
  1. Symptoms: Difficulty breathing, chest or limb pain, small red spots or bruising beyond the injection site, headaches, numbness.
  2. Mechanism: TTS involves a complex interplay between the immune system and blood clotting mechanisms. The immune response to the Adenovirus Vector can lead to the activation of platelets, which are crucial for blood clotting. However, this activation also triggers the formation of abnormal blood clots, while simultaneously reducing the number of available platelets.

FLiRT- A New Variant of Covid-19

  1. A new wave of COVID-19 infections has emerged due to the circulation of the KP.2 and KP1.1 variants, collectively known as the "FLiRT" variants.
  2. These variants have been associated with increased cases and hospitalizations in the United States, United Kingdom, South Korea, and New Zealand.
  3. India has detected 238 cases of KP.2 and 30 cases of KP1.1 as of May 6, 2024, indicating the presence of these variants in the country.

What are FLiRT Variants?

  1. Origin: KP.2 and KP1.1 are descendants of the Omicron JN.1 variant, which spread globally in the winter of 2023.
  2. Dominance: These variants appear to be more dominant than their ancestor and other Omicron variants, with KP.2 being the most dominant.
  3. Immune Evasion: KP.2 is believed to be capable of evading immunity acquired through vaccination and prior infections.
  4. Mutations: FLiRT variants originated from the JN.1 variant and carry two new spike mutations.
  5. Transmission: FLiRT variants spread through respiratory droplets and contact with contaminated surfaces.
  6. Symptoms: Similar to other Omicron sub-variants: Sore throat, Cough, Nausea, Congestion etc.
  7. Prevention: Vaccination and adherence to preventive measures are crucial to curb the spread of these new variants.
  8. Additional Notes: The situation is evolving, and it is important to stay updated with the latest information from health authorities.

Ferroptosis: A Newly Discovered Form of Cell Death

Recent research suggests that ferroptosis plays a role in the development of lung damage in COVID-19 patients.

  • Definition: Ferroptosis is a distinct type of regulated cell death characterized by the buildup of toxic lipid peroxides on cell membranes.
  • Role of Iron: Iron plays a crucial role in ferroptosis as it catalyzes the formation of these harmful lipid peroxides.
  • Mechanisms: Ferroptosis is triggered by a decrease in intracellular glutathione and reduced activity of glutathione peroxidase, leading to lipid peroxidation and oxidative damage.
Implications of Ferroptosis in Diseases
  • Ferroptosis has been linked to various diseases, including, Ischemia-reperfusion injury, Kidney injuries , Nervous system diseases, Cancer, Blood diseases
Other Key Concepts
  • Apoptosis: Another form of programmed cell death, different from ferroptosis in terms of mechanisms and triggers.
  • Lipids: Fatty compounds essential for various bodily functions but can be harmful in excess.

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