Mani V E, Chauhan P S, Kalita J, Bhoi S K, Misra U K
Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow, 226014, India.
Eur J Clin Microbiol Infect Dis. 2016 Feb;35(2):305-10. doi: 10.1007/s10096-015-2546-z. Epub 2015 Dec 30.
Vascular endothelial growth factor (VEGF) and its receptors have been reported as severity markers of septicemia. Scrub typhus (ST) results in multi-organ dysfunction but the role of VEGF has not been evaluated. We report VEGF and its receptors in ST and its correlation with severity, outcome and laboratory findings. Thirty patients with ST diagnosed by solid phase immune chromatographic assay and Weil-Felix tests were included. Their clinical details, Glasgow Coma Scale (GCS), SOFA and modified Rankin Scale (mRS) scores and laboratory findings were noted. VEGF, VEGFR1 and VEGFR2 were done by ELISA at admission and repeated at 1 month. Outcome was defined at 1 month. Serum VEGF and VEGF-R1 levels were significantly higher and VEGFR2 was significantly lower in the ST patients compared to the controls. These levels significantly improved at 1 month. VEGF level correlated with SOFA score (p = 0.05) and SGPT (p = 0.04). VEGFR1 correlated with hemoglobin (p = 0.04), platelet count (p = 0.03), serum CK (p = 0.001), weakness (p = 0.04) and mRS score (p = 0.04). VEGFR2 did not correlate with any clinical or laboratory parameters. All the patients recovered with doxycycline. Serum VEGF and VEGFR1 levels increased in ST and suggest disease severity but do not predict outcome.
血管内皮生长因子（VEGF）及其受体已被报道为败血症的严重程度标志物。恙虫病（ST）可导致多器官功能障碍，但VEGF的作用尚未得到评估。我们报告了恙虫病中VEGF及其受体情况，以及它们与疾病严重程度、预后和实验室检查结果的相关性。纳入了30例经固相免疫色谱分析和外斐试验诊断为恙虫病的患者。记录了他们的临床详细信息、格拉斯哥昏迷量表（GCS）、序贯器官衰竭评估（SOFA）和改良Rankin量表（mRS）评分以及实验室检查结果。入院时通过酶联免疫吸附测定（ELISA）检测VEGF、VEGFR1和VEGFR2，并在1个月时重复检测。在1个月时确定预后情况。与对照组相比，恙虫病患者血清VEGF和VEGF-R1水平显著升高，而VEGFR2水平显著降低。这些水平在1个月时显著改善。VEGF水平与SOFA评分（p = 0.05）和谷丙转氨酶（p = 0.04）相关。VEGFR1与血红蛋白（p = 0.04）、血小板计数（p = 0.03）、血清肌酸激酶（p = 0.001）、虚弱（p = 0.04）和mRS评分（p = 0.04）相关。VEGFR2与任何临床或实验室参数均无相关性。所有患者使用强力霉素后康复。恙虫病患者血清VEGF和VEGFR1水平升高，提示疾病严重程度，但不能预测预后。
