在登革热发热期，炎症和血管标志物的联合与更严重的结局相关。

Combination of inflammatory and vascular markers in the febrile phase of dengue is associated with more severe outcomes.

机构信息

Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Viet Nam.

University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.

出版信息

Elife. 2021 Jun 22;10:e67460. doi: 10.7554/eLife.67460.

BACKGROUND

Early identification of severe dengue patients is important regarding patient management and resource allocation. We investigated the association of 10 biomarkers (VCAM-1, SDC-1, Ang-2, IL-8, IP-10, IL-1RA, sCD163, sTREM-1, ferritin, CRP) with the development of severe/moderate dengue (S/MD).

METHODS

We performed a nested case-control study from a multi-country study. A total of 281 S/MD and 556 uncomplicated dengue cases were included.

RESULTS

On days 1-3 from symptom onset, higher levels of any biomarker increased the risk of developing S/MD. When assessing together, SDC-1 and IL-1RA were stable, while IP-10 changed the association from positive to negative; others showed weaker associations. The best combinations associated with S/MD comprised IL-1RA, Ang-2, IL-8, ferritin, IP-10, and SDC-1 for children, and SDC-1, IL-8, ferritin, sTREM-1, IL-1RA, IP-10, and sCD163 for adults.

CONCLUSIONS

Our findings assist the development of biomarker panels for clinical use and could improve triage and risk prediction in dengue patients.

FUNDING

This study was supported by the EU's Seventh Framework Programme (FP7-281803 IDAMS), the WHO, and the Bill and Melinda Gates Foundation.

背景

早期识别重症登革热患者对于患者管理和资源分配至关重要。我们研究了 10 种生物标志物（VCAM-1、SDC-1、Ang-2、IL-8、IP-10、IL-1RA、sCD163、sTREM-1、铁蛋白、CRP）与重症/中度登革热（S/MD）发展的关系。

方法

我们进行了一项嵌套病例对照研究，该研究来自一项多国家研究。共纳入 281 例 S/MD 和 556 例无并发症登革热病例。

结果

在发病后第 1-3 天，任何生物标志物水平升高都会增加发生 S/MD 的风险。当一起评估时，SDC-1 和 IL-1RA 是稳定的，而 IP-10 则改变了从阳性到阴性的关联；其他标志物的关联较弱。与 S/MD 相关的最佳组合包括儿童的 IL-1RA、Ang-2、IL-8、铁蛋白、IP-10 和 SDC-1，以及成人的 SDC-1、IL-8、铁蛋白、sTREM-1、IL-1RA、IP-10 和 sCD163。