Early circulating biomarkers to predict plasma leakage in dengue fever

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2025-02-01 DOI:10.1016/j.jinf.2024.106401

Samaneh Moallemi , Nicodemus Tedla , Chathurani Sigera , Praveen Weeratunga , Deepika Fernando , Senaka Rajapakse , Andrew R. Lloyd , Chaturaka Rodrigo

{"title":"Early circulating biomarkers to predict plasma leakage in dengue fever","authors":"Samaneh Moallemi , Nicodemus Tedla , Chathurani Sigera , Praveen Weeratunga , Deepika Fernando , Senaka Rajapakse , Andrew R. Lloyd , Chaturaka Rodrigo","doi":"10.1016/j.jinf.2024.106401","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Dengue, a mosquito-borne viral infection, poses a rapidly growing burden, particularly in low- and middle-income countries. Without early identification of patients at risk of severe outcomes (dengue haemorrhagic fever, severe dengue, and plasma leakage- the latter typically occurring on days 5–7 of illness), untriaged admissions lead to hospital overcrowding and suboptimal care.</div></div><div><h3>Methods</h3><div>This nested case-control study compared early-stage plasma samples (within the first 96 hours of fever) from dengue patients with and without plasma leakage. Thirty-four potential biomarkers, selected through systematic review, were tested on a multiplex bead-based immunoassay platform. Subgroup analysis stratified patients by primary or secondary dengue infection.</div></div><div><h3>Findings</h3><div>A total of 228 patient samples (114 had plasma leakage) were tested. Elevated Vascular cell adhesion molecule-1 (OR:3.289, 95% CI: 1.090–9.926, p<0.05), and Interleukin 33 receptor levels (OR: 2.677, 95% CI: 1.244–5.856, p<0.05) were associated with an increased risk of plasma leakage while eotaxin-1 was associated with a decreased risk (OR: 0.166, 95% CI: 0.057–0.483, p<0.05). When adjusted for prior dengue exposure, additional biomarkers (C-X-C motif chemokine 11, serum amyloid A) were also associated with plasma leakage.</div></div><div><h3>Interpretation</h3><div>Plasma leakage in dengue, being more objectively measurable than other severe outcomes, offers a reliable endpoint for biomarker studies. Identifying biomarkers that predict plasma leakage strengthens the evidence base in dengue research. These biomarkers could improve clinical assessment and patient care in dengue cases.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":"90 2","pages":"Article 106401"},"PeriodicalIF":14.3000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0163445324003360","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Dengue, a mosquito-borne viral infection, poses a rapidly growing burden, particularly in low- and middle-income countries. Without early identification of patients at risk of severe outcomes (dengue haemorrhagic fever, severe dengue, and plasma leakage- the latter typically occurring on days 5–7 of illness), untriaged admissions lead to hospital overcrowding and suboptimal care.

Methods

This nested case-control study compared early-stage plasma samples (within the first 96 hours of fever) from dengue patients with and without plasma leakage. Thirty-four potential biomarkers, selected through systematic review, were tested on a multiplex bead-based immunoassay platform. Subgroup analysis stratified patients by primary or secondary dengue infection.

Findings

A total of 228 patient samples (114 had plasma leakage) were tested. Elevated Vascular cell adhesion molecule-1 (OR:3.289, 95% CI: 1.090–9.926, p<0.05), and Interleukin 33 receptor levels (OR: 2.677, 95% CI: 1.244–5.856, p<0.05) were associated with an increased risk of plasma leakage while eotaxin-1 was associated with a decreased risk (OR: 0.166, 95% CI: 0.057–0.483, p<0.05). When adjusted for prior dengue exposure, additional biomarkers (C-X-C motif chemokine 11, serum amyloid A) were also associated with plasma leakage.

Interpretation

Plasma leakage in dengue, being more objectively measurable than other severe outcomes, offers a reliable endpoint for biomarker studies. Identifying biomarkers that predict plasma leakage strengthens the evidence base in dengue research. These biomarkers could improve clinical assessment and patient care in dengue cases.

查看原文本刊更多论文

预测登革热血浆渗漏的早期循环生物标志物。

背景：登革热是一种蚊媒病毒感染，造成的负担迅速增加，特别是在低收入和中等收入国家。如果不能及早发现有严重后果风险的患者（登革出血热、重症登革热和血浆泄漏——后者通常发生在发病后的第5-7天），未经分类的入院会导致医院过度拥挤和护理欠佳。方法：本巢式病例对照研究比较了伴有和不伴有血浆渗漏的登革热患者的早期血浆样本（发热最初96小时内）。通过系统评价选择34种潜在的生物标志物，在多重头部免疫分析平台上进行测试。亚组分析按原发性或继发性登革热感染对患者进行分层。结果：共检测了228例患者样本（114例有血浆泄漏）。血管细胞黏附分子-1升高（OR:3.289, 95% CI: 1.090-9.926）解释：登革热患者血浆渗漏比其他严重结局更客观可测量，为生物标志物研究提供了可靠的终点。识别预测血浆泄漏的生物标志物加强了登革热研究的证据基础。这些生物标志物可以改善登革热病例的临床评估和患者护理。资助：澳大利亚国家卫生和医学研究委员会（资助号：1173666），斯里兰卡科伦坡大学[资助号：AP /3/2/2017/ CG /25]。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.