Association of Endothelial Glycocalyx and Tight and Adherens Junctions with Severity of Plasma Leakage in Dengue Infection

Abstract

Background.The role of vascular endothelial (VE) components in dengue infection with plasma leakage is unknown. Therefore, we conducted a study to determine the adjusted association of the endothelial glycocalyx layer (EGL) and tight and adherens junction markers with plasma leakage. Methods.A prospective observational study was conducted at Cipto Mangunkusumo Hospital and Persahabatan Hospital, Jakarta, Indonesia. Adult dengue patients admitted to the hospital on the third day of fever from November 2013 through August 2015 were included in the study. Multiple regression analysis was used to determine the adjusted association of the VE biomarkers with the severity of the plasma leakage. Results.A total of 103 dengue-infected patients participated in the study. In the critical phase, levels of syndecan-1 (odds ratio [OR] = 1.004; 95% confidence interval [CI] = 1.001–1.007) and chondroitin sulfate (OR = 1.157; 95% CI = 1.025–1.307) had an adjusted association with plasma leakage, whereas levels of syndecan-1 (OR = 1.004; 95% CI = 1.000–1.008) and claudin-5 (OR = 1.038; 95% CI = 1.004–1.074) had an adjusted association with severe plasma leakage.Conclusions.In dengue-infected patients, elevated levels of syndecan-1 and chondroitin sulfate are strongly associated with plasma leakage, and elevated levels of syndecan-1 and claudin-5 are strongly associated with severe plasma leakage.

Dengue viruses circulating in Indonesia: A systematic review and phylogenetic analysis of data from five decades

“…A full assessment of the 120 references resulted in the exclusion of 53 references due to the following: full texts were unavailable, and the available abstracts did not include adequate information to satisfy our outcome, the full text did not include adequate or complete serotype data, and nonstandard methods were used for serotyping. This resulted in 67 eligible studies, of which 13 references were from national journals . An additional 11 studies were included from reference list .…”

“…In total, 78 eligible studies were included for DENV serotype analysis . Of all the eligible studies, four studies were conducted based on mosquito isolates while the remaining studies assessed DENV isolates from human samples . Sixty two studies investigated dengue cases among local inhabitants of Indonesia,…”

Hubungan antara Konsentrasi D-Dimer dengan Parameter Laboratorium Kebocoran Plasma pada Infeksi Dengue

“…21 Pada DBD terjadi jejas pada endotel vaskular yang mengakibatkan lapisan glikokaliks permukaan endotel mengalami kerusakan. 22 Berkurangnya lapisan glikokaliks yang bermuatan negatif mengakibatkan serum albumin dalam pembuluh darah yang juga bermuatan negatif dapat melewati lapisan endotel pembuluh darah. 23 Mekanisme keluarnya albumin melalui lapisan endotel vaskular ke ruang ekstravaskular dikenal sebagai proses transitosis atau jalur transelular.…”

“…23 Mekanisme keluarnya albumin melalui lapisan endotel vaskular ke ruang ekstravaskular dikenal sebagai proses transitosis atau jalur transelular. 22 Pada keadaan kebocoran plasma pada infeksi dengue yang lebih berat, konsentrasi albumin dalam pembuluh darah dapat menurun hingga di bawah 3 g/dL. 24 Pada keadaan kebocoran plasma yang berat, selain terjadi kerusakan pada permukaan glikokaliks, terjadi pula kerusakan pada ikatan antar-endotel.…”

“…Kerusakan ikatan antar-endotel mengakibatkan albumin dapat keluar melalui celah antar-sel endotel yang dikenal sebagai jalur paraselular. 21,22 Penurunan konsentrasi serum albumin yang berat pada infeksi dengue terjadi akibat eksositosis albumin dari endotel pembuluh darah melalui jalur transelular dan paraselular. 22 Dari diskusi di atas, dapat disimpulkan bahwa semakin rendah konsentrasi serum albumin menunjukkan semakin berat jejas pada endotel pembuluh darah dan kebocoran plasma.…”