Glycoprotein YKL-40 Is Elevated and Predicts Disease Severity in Puumala Hantavirus Infection

Outinen, Tuula; Mantula, Paula; Jaatinen, Pia; Hämäläinen, Mari; Moilanen, Eeva; Vaheri, Antti; Huhtala, Heini; Mäkelä, Satu; Mustonen, Jukka

doi:10.3390/v11090767

Cited by 8 publications

(12 citation statements)

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“…Interestingly, a study including both experimental and human data has revealed that YKL-40 may be able to discriminate been sepsis-induced acute kidney injury and sepsis without acute kidney injury [ 44 ]. In that context, patients with Puumala hantavirus infection—a virus infection typically inducing acute kidney injury—YKL-40 was more pronounced during the acute phase, and correlated with the degree of inflammation and severity of acute kidney injury [ 45 ]. These finding are in agreement with the present study demonstrating significantly higher levels plasma YKL-40 in those receiving RRT within 7 days from admission.…”

Section: Discussionmentioning

confidence: 99%

Associations between YKL-40 and markers of disease severity and death in patients with necrotizing soft-tissue infection

et al. 2021

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Background Necrotizing soft-tissue infection (NSTI) is a severe and fast-progressing bacterial infection. Prognostic biomarkers may provide valuable information in treatment guidance and decision-making, but none have provided sufficient robustness to have a clinical impact. YKL-40 may reflect the ongoing pathological inflammatory processes more accurately than traditional biomarkers as it is secreted by the activated immune cells, but its prognostic yields in NSTI remains unknown. For this purpose, we investigated the association between plasma YKL-40 and 30-day mortality in patients with NSTI, and assessed its value as a marker of disease severity. Methods We determined plasma YKL-40 levels in patients with NSTI (n = 161) and age-sex matched controls (n = 65) upon admission and at day 1, 2 and 3. Results Baseline plasma YKL-40 was 1191 ng/mL in patients with NSTI compared with 40 ng/mL in controls (p < 0.001). YKL-40 was found to be significantly higher in patients with septic shock (1942 vs. 720 ng/mL, p < 0.001), and in patients receiving renal-replacement therapy (2382 vs. 1041 ng/mL, p < 0.001). YKL-40 correlated with Simplified Acute Physiology Score II (Rho 0.33, p < 0.001). Baseline YKL-40 above 1840 ng/mL was associated with increased risk of 30-day mortality in age-sex-comorbidity adjusted analysis (OR 3.77, 95% CI; 1.59–9.24, p = 0.003), but after further adjustment for Simplified Acute Physiology Score II no association was found between YKL-40 and early mortality. Conclusion High plasma YKL-40 to be associated with disease severity, renal-replacement therapy and risk of death in patients with NSTI. However, YKL-40 is not an independent predictor of 30-day mortality.

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Section: Discussionmentioning

confidence: 99%

Associations between YKL-40 and markers of disease severity and death in patients with necrotizing soft-tissue infection

et al. 2021

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“…A marker reliably predicting the severity and prognosis of HFRS would be of clinical relevance, since it could help clinicians in individualized therapy allocation based on the disease severity. In recent years, some studies have identified several early predictors related to the severity and prognosis of HFRS, such as growth arrest-specific 6 protein, urinary neutrophil gelatinase-associated lipocalin and Glycoprotein YKL-40 [ 20 – 22 ]. In this study, we observed that high levels of pentraxin-3 (> 569.088 ng/mL) during the acute phase were significantly associated with the death in HFRS patients (Fig.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of pentraxin-3 on disease severity and mortality risk in patients with hemorrhagic fever with renal syndrome

Wang

et al. 2021

BMC Infect Dis

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Background Hemorrhagic fever with renal syndrome (HFRS) caused by Hantaan virus is characterized by systemic immunopathological injury. Pentraxin-3 is an acute-phase reactant involved in the processes of inflammation and infection. This study aimed to investigate the levels of plasma pentraxin-3 and evaluate its predictive value on disease severity and mortality risk in patients with HFRS. Methods This was a prospective real-world observational study. The concentrations of plasma pentraxin-3 were measured by enzyme linked immunosorbent assay (ELISA) in 105 HFRS patients and 27 healthy controls. We analyzed the clinical relevance between pentraxin-3 and clinical subtyping, hospital stay and conventional laboratory parameters of HFRS patients. Considering the prognosis (death) as the primary endpoint, the levels of pentraxin-3 between survivors and non-survivors were compared, and its association with mortality was assessed by Kaplan-Meier survival analysis. The predictive potency of pentraxin-3 for mortality risk in HFRS patients was evaluated by receiver operating characteristic (ROC) curve analysis. Results The levels of pentraxin-3 during the acute phase were increased with the aggravation of the disease, and showed the highest expression in critical-type patients (P < 0.05). Pentraxin-3 demonstrated significant correlations with conventional laboratory parameters (WBC, PLT, AST, ALB, APTT, Fib) and the length of hospital stay. Compared with the survivors, non-survivors showed higher levels of pentraxin-3 and worse expressions of conventional laboratory parameters during the acute phase. The Kaplan-Meier survival curves showed that high levels of pentraxin-3 during the acute phase were significantly associated with the death in HFRS patients. Pentraxin-3 demonstrated significant predictive value for the mortality risk of HFRS patients, with the area under ROC curve (AUC) of 0.753 (95%CI: 0.593 ~ 0.914, P = 0.003). Conclusions The detection of plasma pentraxin-3 might be beneficial to the evaluation of disease severity and to the prediction of mortality risk in HFRS patients.

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“…In PUUV infection, plasma YKL-40 levels are elevated during the acute phase [94]. Plasma YKL-40 level associates with the length of hospital stay, which reflects the overall severity of the infection.…”

Section: Ykl-40mentioning

confidence: 99%

“…Plasma YKL-40 level associates with the length of hospital stay, which reflects the overall severity of the infection. In addition, also in terms of inflammation and AKI, YKL-40 predicts the severity of the disease caused by PUUV [94]. Furthermore, plasma YKL-40 levels remain elevated during the acute phase of PUUV infection as a sign of undergoing inflammation [94].…”

Section: Ykl-40mentioning

confidence: 99%

“…In addition, also in terms of inflammation and AKI, YKL-40 predicts the severity of the disease caused by PUUV [94]. Furthermore, plasma YKL-40 levels remain elevated during the acute phase of PUUV infection as a sign of undergoing inflammation [94]. However, the YKL-40 level does not correlate with the signs of vascular leakage or with thrombocytopenia [94].…”

Section: Ykl-40mentioning

confidence: 99%

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Severity Biomarkers in Puumala Hantavirus Infection

Outinen

Mäkelä

Pörsti

et al. 2021

Viruses

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Annually, over 10,000 cases of hemorrhagic fever with renal syndrome (HFRS) are diagnosed in Europe. Puumala hantavirus (PUUV) causes most of the European HFRS cases. PUUV causes usually a relatively mild disease, which is rarely fatal. However, the severity of the infection varies greatly, and factors affecting the severity are mostly unrevealed. Host genes are known to have an effect. The typical clinical features in PUUV infection include acute kidney injury, thrombocytopenia, and increased vascular permeability. The primary target of hantavirus is the endothelium of the vessels of different organs. Although PUUV does not cause direct cytopathology of the endothelial cells, remarkable changes in both the barrier function of the endothelium and the function of the infected endothelial cells occur. Host immune or inflammatory mechanisms are probably important in the development of the capillary leakage. Several immunoinflammatory biomarkers have been studied in the context of assessing the severity of HFRS caused by PUUV. Most of them are not used in clinical practice, but the increasing knowledge about the biomarkers has elucidated the pathogenesis of PUUV infection.

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Glycoprotein YKL-40 Is Elevated and Predicts Disease Severity in Puumala Hantavirus Infection

Cited by 8 publications

References 58 publications

Associations between YKL-40 and markers of disease severity and death in patients with necrotizing soft-tissue infection

Associations between YKL-40 and markers of disease severity and death in patients with necrotizing soft-tissue infection

Predictive value of pentraxin-3 on disease severity and mortality risk in patients with hemorrhagic fever with renal syndrome

Severity Biomarkers in Puumala Hantavirus Infection

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