title: Evaluation of the association of serum levels of hyaluronic acid, sICAM-1, sVCAM-1, and VEGF-A with mortality and prognosis in patients with Crimean-Congo hemorrhagic fever.
abstract: BACKGROUND
  Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral hemorrhagic disease. Pathogenesis of the disease has not been well described yet. A well-known pathogenic feature of CCHF virus is its capability to damage endothelium. Increased hyaluronic acid (HA) levels indicate liver sinusoidal endothelial damage. Soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and vascular endothelial growth factor-A (VEGF-A) play a role in the inflammatory process, vascular damage and plasma leakage.
  
  
  OBJECTIVE
  To investigate whether or not there is a relationship between HA, sICAM-1, sVCAM-1 and VEGF-A serum levels and fatality in CCHF.
  
  
  METHODS
  Sixty-one patients who were confirmed by RT-PCR and serological tests for CCHF, included in the current study. HA, sICAM-1, sVCAM-1, VEGF-A levels in serum samples were analyzed by ELISA.
  
  
  RESULTS
  There were statistically significant differences between fatal and non-fatal CCHF patients in terms of HA, sICAM-1, sVCAM-1, and VEGF-A levels. In addition, AST and ALT levels were positively correlated with HA, sICAM-1, sVCAM-1, and VEGF-A levels.
  
  
  CONCLUSIONS
  HA, sICAM-1, sVCAM-1, and VEGF-A levels of the patients that died during hospitalization were statistically significantly higher than the patients that survived, and this finding suggests that the level of these molecules could be used as a prognostic marker in CCHF.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey. dbarisozturk@yahoo.com
authors.forename: Baris
authors.initials: B
authors.lastname: Ozturk
authors.forename: Ferit
authors.initials: F
authors.lastname: Kuscu
authors.forename: Ediz
authors.initials: E
authors.lastname: Tutuncu
authors.forename: Irfan
authors.initials: I
authors.lastname: Sencan
authors.forename: Yunus
authors.initials: Y
authors.lastname: Gurbuz
authors.forename: Hakan
authors.initials: H
authors.lastname: Tuzun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006479:Hemorrhagic Fever, Crimean / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood; D020133:Reverse Transcriptase Polymerase Chain Reaction; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012367:RNA, Viral; C467484:VEGFA protein, human; D019010:Vascular Cell Adhesion Molecule-1; D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1; D006820:Hyaluronic Acid