title: Early molecular markers predictive of dengue hemorrhagic fever.
abstract: The management of acute dengue patients during outbreaks is a challenging problem. Most of the dengue fever cases are benign, but some cases develop into a severe and possibly lethal vasculopathy, known as dengue hemorrhagic fever. Early symptoms of dengue and hemorrhagic fever are very similar. An early differential diagnosis is needed to predict which of these two clinical presentations is crucial to proper patient care and public health management. This study evaluates the predictive potential of specific mRNA expression markers of dengue hemorrhagic fever using quantitative real-time PCR assays. Six candidate 'dengue hemorrhagic fever specific signature genes' were evaluated and all showed good correlation among their transcription levels at early days of infection and the later development of severe vasculopathy. The markers selected were able to indicate, at early stages of infection, the evolution of a dengue-infected patient to the severe form of the illness. Despite the fact that these results grant further validation studies, the panel of candidate prognostic markers obtained demonstrated the potential to be useful for clinical use in the form of a fast assay based in blood samples.
authors.affiliation: Laboratório de Virologia e Terapia Experimental, Centro de Pesquisa Aggeu Magalhães, CPqAM/FIOCRUZ, Recife, PE, Brasil. calzavara@cpqam.fiocruz.br
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Calzavara-Silva
authors.forename: Ana L V
authors.initials: AL
authors.lastname: Gomes
authors.forename: Rita C C
authors.initials: RC
authors.lastname: Maia
authors.forename: Bartolomeu
authors.initials: B
authors.lastname: Acioli-Santos
authors.forename: Laura H V G
authors.initials: LH
authors.lastname: Gil
authors.forename: Ernesto T A
authors.initials: ET
authors.lastname: Marques
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D003716:Dengue Virus / Q000235:genetics*; D042241:Early Diagnosis; D005260:Female; D005819:Genetic Markers; D006801:Humans; D008297:Male; D046228:Microarray Analysis; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D011237:Predictive Value of Tests; D012333:RNA, Messenger / Q000032:analysis; D012367:RNA, Viral / Q000032:analysis; D019595:Severe Dengue / Q000175:diagnosis* / Q000821:virology
chemical_list: D004279:DNA, Viral; D005819:Genetic Markers; D012333:RNA, Messenger; D012367:RNA, Viral