Chen Hongliu, Ning Zong, Qiu Ying, Liao Yuanli, Chang Haihua, Ai Yuanyuan, Wei Yinghua, Deng Yiming, Shen Ying
Department of Emergency, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530021, China.
Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Province, 530021, China.
Int J Infect Dis. 2017 Aug;61:114-120. doi: 10.1016/j.ijid.2017.06.015. Epub 2017 Jun 23.
This study aimed to investigate whether von Willebrand factor (vWF) and high mobility group box 1 (HMGB1) are associated with the severity and clinical outcome of scrub typhus and to seek novel biomarkers for surveillance and prediction of the prognosis of this infection.
Serum concentrations of vWF and HMGB1 were measured twice by ELISA for scrub typhus patients (n=103), once prior to doxycycline therapy and then on day 7 of doxycycline therapy; concentrations were measured once for healthy controls (n=32).
Among the total 103 patients enrolled, 38 had disease complicated by multiple organ dysfunction syndrome (MODS). Serum concentrations of vWF and HMGB1 were significantly higher in all the patients than in the healthy controls, both prior to doxycycline treatment and on day 7 of doxycycline treatment (p<0.01). Furthermore, serum levels of vWF, HMGB1, and creatinine (SCr) in the patients with MODS increased distinctly, while the platelet (PLT) count diminished markedly compared to the levels in patients without MODS (p<0.01). The concentration of vWF was positively correlated with that of HMGB1 (r=0.764, p<0.001) and SCr (r=0.528, p<0.001), but negatively correlated with the PLT count (r=-0.632, p<0.001). Both HMGB1 and vWF were significantly associated with mortality in scrub typhus (area under the curve (AUC)=0.864, p=0.001, and AUC=0.862, p=0.001, respectively).
Elevated levels of vWF and HMGB1 are associated with the severity and clinical outcome of scrub typhus. These represent possible new biomarkers for use in the assessment and prognostic prediction of this infection.
本研究旨在调查血管性血友病因子（vWF）和高迁移率族蛋白B1（HMGB1）是否与恙虫病的严重程度及临床结局相关，并寻找用于监测和预测该感染预后的新型生物标志物。
采用酶联免疫吸附测定法（ELISA）对103例恙虫病患者血清中的vWF和HMGB1浓度进行两次检测，一次在强力霉素治疗前，另一次在强力霉素治疗第7天；对32例健康对照者血清进行一次检测。
在纳入研究的103例患者中，38例患者并发多器官功能障碍综合征（MODS）。在强力霉素治疗前及治疗第7天，所有患者血清中的vWF和HMGB1浓度均显著高于健康对照者（p<0.01）。此外，与未并发MODS的患者相比，并发MODS患者的vWF、HMGB1及血清肌酐（SCr）水平明显升高，而血小板（PLT）计数显著降低（p<（0.01）。vWF浓度与HMGB1浓度呈正相关（r=0.764，p<0.001），与SCr呈正相关（r=0.528，p<0.001），但与PLT计数呈负相关（r=-0.632，p<0.001）。HMGB1和vWF均与恙虫病患者的死亡率显著相关（曲线下面积（AUC）分别为0.864，p=0.001和0.862，p=0.001）。
vWF和HMGB1水平升高与恙虫病的严重程度及临床结局相关。这些指标可能是用于评估和预测该感染的新型生物标志物。
