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Shukla S, Jadhav SM, Gurav YK, Parashar D, Alagarasu K. Serum ferritin level as a prognostic biomarker for predicting dengue disease severity: A systematic review and meta-analysis. Rev Med Virol 2023; 33:e2468. [PMID: 37347209 DOI: 10.1002/rmv.2468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
Serum ferritin levels serves as biomarkers in many inflammatory and infectious diseases. This current systematic review and meta-analysis evaluated whether serum ferritin levels are associated with severe dengue and its utility as a biomarker of disease severity. Literature searches were conducted in PubMed, Scopus, ScienceDirect, the Cochrane library, and Google Scholar. A total of 18 studies examining the serum ferritin levels in dengue cases in the context of disease severity (nine studies having dengue classification as non-severe vs. severe dengue cases, and nine studies having dengue classification as dengue without warning signs (DwoWS), dengue with warning signs (DwWS), and severe dengue cases) were included and the quality of the studies was assessed using the Quality in Prognostic Factor Studies tool. The meta-analysis was performed using STATA software to calculate the effect size as a standardized mean difference (SMD) or Hedges 'g' for the continuous outcome. Higher serum ferritin levels were found in severe dengue cases compared to non-severe cases [SMD (Hedges 'g') 4.05 (95% C.I. 2.09-6.00), (I2 = 98.8%)]. In the second group, DwWS cases showed high serum ferritin levels compared to DwoWS [SMD 2.01 (95% C.I. 0.92-3.10), (I2 = 97.89%)], and severe dengue cases showed higher levels of serum ferritin compared to DwWS [SMD 2.66 (95% C.I. 1.72-4.48), (I2 = 98.78%)] and DwoWS cases [SMD 6.65 (95% C.I. 1.72-11.59), (I2 = 99.78%]. Subgroup analysis for the country of study (India vs. others), ferritin testing methods, and ferritin measurement day revealed testing method as a significant contributor to heterogeneity. To conclude, the present study suggests serum ferritin as a prognostic marker for dengue disease severity. Multi-centric studies involving a large number of dengue patients with a uniform case definition accounting for all the confounding variables might help in determining a universal cut-off value to discriminate between non-severe and severe dengue.
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Affiliation(s)
- Shridhar Shukla
- Diagnostic Reagent Facility, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Santosh M Jadhav
- Bioinformatics and Data Management Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Yogesh K Gurav
- Health Technology Assessment Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Deepti Parashar
- Diagnostic Reagent Facility, ICMR-National Institute of Virology, Pune, Maharashtra, India
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
| | - Kalichamy Alagarasu
- Dengue and Chikungunya Group, ICMR-National Institute of Virology, Pune, Maharashtra, India
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Van Herreweghe M, Breynaert A, De Bruyne T, Popescu CP, Florescu SA, Lustig Y, Schwartz E, Gobbi FG, Hermans N, Huits R. Can Biomarkers of Oxidative Stress in Serum Predict Disease Severity in West Nile Virus Infection? A Pilot Study. Trop Med Infect Dis 2022; 7:tropicalmed7090207. [PMID: 36136618 PMCID: PMC9505794 DOI: 10.3390/tropicalmed7090207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 12/31/2022] Open
Abstract
West Nile virus (WNV) can cause asymptomatic infection in humans, result in self-limiting febrile illness, or lead to severe West Nile Neuroinvasive disease (WNND). We conducted a pilot study to compare selected biomarkers of oxidative stress in sera of viremic West Nile virus patients and asymptomatic infected blood donors to investigate their potential as predictors of disease severity. We found that total oxidant status was elevated in WNND and in uncomplicated WNV infections (median 9.05 (IQR 8.37 to 9.74) and 7.14 (7.03 to 7.25) µmol H2O2 equiv./L, respectively) compared to asymptomatic infections (0.11 (0.07 to 0.19) µmol H2O2 equiv./L) (p = 0.048). MDA levels showed a similar trend to TOS, but differences were not significant at α = 0.05. Total antioxidant status did not differ significantly between different disease severity groups. Oxidative stress appears to be associated with more severe disease in WNV-infected patients. Our preliminary findings warrant prospective studies to investigate the correlation of oxidative stress with clinical outcomes and severity of WNV infection.
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Affiliation(s)
- Maxim Van Herreweghe
- NatuRA Research Group, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Wilrijk, Belgium
- Correspondence: (M.V.H.); (R.H.); Tel.: +31-6-1884-6086 (R.H.)
| | - Annelies Breynaert
- NatuRA Research Group, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Tess De Bruyne
- NatuRA Research Group, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Corneliu Petru Popescu
- Department of Adult Infectious and Tropical Diseases, Carola Davila University of Medicine and Pharmacy and Dr Victor Babeș Clinical Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania
| | - Simin-Aysel Florescu
- Department of Adult Infectious and Tropical Diseases, Carola Davila University of Medicine and Pharmacy and Dr Victor Babeș Clinical Hospital of Infectious and Tropical Diseases, 030303 Bucharest, Romania
| | - Yaniv Lustig
- The Central Virology Laboratory, Public Health Services, Ministry of Health, Sheba Medical Center, Tel Hashomer, Israel & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 52621, Israel
| | - Eli Schwartz
- Center for Geographic Medicine and Tropical Diseases, Sheba Medical Center, Tel Hashomer & Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 52621, Israel
| | - Federico Giovanni Gobbi
- IRCCS Ospedale Sacro Cuore Don Calabria, Department of Infectious Tropical Diseases and Microbiology, 37024 Verona, Italy
| | - Nina Hermans
- NatuRA Research Group, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Ralph Huits
- NatuRA Research Group, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Wilrijk, Belgium
- IRCCS Ospedale Sacro Cuore Don Calabria, Department of Infectious Tropical Diseases and Microbiology, 37024 Verona, Italy
- Institute of Tropical Medicine Antwerp, Department of Clinical Sciences, 2000 Antwerpen, Belgium
- Correspondence: (M.V.H.); (R.H.); Tel.: +31-6-1884-6086 (R.H.)
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Yong YK, Wong WF, Vignesh R, Chattopadhyay I, Velu V, Tan HY, Zhang Y, Larsson M, Shankar EM. Dengue Infection - Recent Advances in Disease Pathogenesis in the Era of COVID-19. Front Immunol 2022; 13:889196. [PMID: 35874775 PMCID: PMC9299105 DOI: 10.3389/fimmu.2022.889196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/30/2022] [Indexed: 12/12/2022] Open
Abstract
The dynamics of host-virus interactions, and impairment of the host’s immune surveillance by dengue virus (DENV) serotypes largely remain ambiguous. Several experimental and preclinical studies have demonstrated how the virus brings about severe disease by activating immune cells and other key elements of the inflammatory cascade. Plasmablasts are activated during primary and secondary infections, and play a determinative role in severe dengue. The cross-reactivity of DENV immune responses with other flaviviruses can have implications both for cross-protection and severity of disease. The consequences of a cross-reactivity between DENV and anti-SARS-CoV-2 responses are highly relevant in endemic areas. Here, we review the latest progress in the understanding of dengue immunopathogenesis and provide suggestions to the development of target strategies against dengue.
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Affiliation(s)
- Yean Kong Yong
- Laboratory Centre, Xiamen University Malaysia, Sepang, Malaysia
- *Correspondence: Esaki M. Shankar, ; Yean Kong Yong,
| | - Won Fen Wong
- Department of Medical Microbiology, Faculty Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ramachandran Vignesh
- Preclinical Department, Royal College of Medicine Perak (UniKL RCMP), Universiti Kuala Lumpur, Ipoh, Malaysia
| | - Indranil Chattopadhyay
- Cancer and Microbiome Biology, Department of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Vijayakumar Velu
- Division of Microbiology and Immunology, Emory Vaccine Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, United States
- Department of Pathology and Laboratory Medicine, Emory National Primate Research Center, Emory University, Atlanta GA, United States
| | - Hong Yien Tan
- School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Malaysia
| | - Ying Zhang
- Chemical Engineering, Xiamen University Malaysia, Sepang, Malaysia
| | - Marie Larsson
- Molecular Medicine and Virology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Esaki M. Shankar
- Infection Biology, Department of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
- *Correspondence: Esaki M. Shankar, ; Yean Kong Yong,
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Iversen PO, Abisay M, Seleki F, Majigo M, Luzzatto L, Makani J. Sickle cell disease, malaria and dengue fever: a case of triple jeopardy. J Travel Med 2019; 26:5568292. [PMID: 31518428 PMCID: PMC6796044 DOI: 10.1093/jtm/taz070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 09/05/2019] [Accepted: 09/05/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Per O Iversen
- Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mclean Abisay
- Department of Haematology, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Felister Seleki
- Department of Haematology, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lucio Luzzatto
- Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Julie Makani
- Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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