Increased Serum Hyaluronic Acid and Heparan Sulfate in Dengue Fever: Association with Plasma Leakage and Disease Severity

Tang, Tommy Hing-Cheung, Alonso, Sylvie, Ng, Lisa Fong-Poh ORCID: 0000-0003-4071-5222, Thein, Tun-Linn, Pang, Vincent Jun-Xiong, Leo, Yee-Sin, Lye, David Chien-Boon and Yeo, Tsin-Wen (2017) Increased Serum Hyaluronic Acid and Heparan Sulfate in Dengue Fever: Association with Plasma Leakage and Disease Severity. SCIENTIFIC REPORTS, 7 (1). 46191-.

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Official URL: http://dx.doi.org/10.1038/srep46191

Abstract

Plasma leakage is a major pathogenic mechanism of severe dengue, but the etiology remains unclear. The association between endothelial glycocalyx integrity and vascular permeability in older adults with dengue has not been evaluated. A prospective cohort study of adults with undifferentiated fever screened for dengue by RT-PCR or NS1 antigen testing was performed. Patients were assessed daily while symptomatic and at convalescence. Serum hyaluronic acid (HA), heparan sulfate (HS) and selected cytokines (TNF-α, IL-6, IL-10) were measured on enrollment and convalescence. Patients were diagnosed as dengue fever (DF, n = 30), dengue hemorrhagic fever (DHF, n = 20) and non-dengue (ND) febrile illness (n = 11). Acute HA and HS levels were significantly higher in all dengue patients compared to ND (p = 0.0033 and p = 0.0441 respectively), but not different between DF and DHF (p = 0.3426 and p = 0.9180 respectively). Enrolment HA inversely correlated with serum albumin, protein and platelets in all dengue and DHF (p < 0.05). HA and HS in all dengue patients decreased significantly at convalescence. Serum IL-10 was significantly associated with HA in all dengue patients (p = 0.002). Serum HA and HS levels were increased in adult dengue and HA was associated with markers of disease severity. Endothelial glycocalyx damage may have a role in vascular leakage in dengue.

Item Type:	Article
Uncontrolled Keywords:	Humans, Dengue, Acute Disease, Heparitin Sulfate, Hyaluronic Acid, Inflammation Mediators, Cytokines, Severity of Illness Index, Adult, Middle Aged, Female, Male, Biomarkers
Depositing User:	Symplectic Admin
Date Deposited:	08 Feb 2019 10:27
Last Modified:	19 Jan 2023 01:04
DOI:	10.1038/srep46191
Open Access URL:	http://10.0.4.14/srep46191
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3032508