title: Association DENV1 and DENV2 infection with high serum levels of soluble thrombomodulin and VEGF in patients with dengue fever and dengue hemorrhagic fever.
abstract: INFECTION BY DENGUE VIRUS (DENV) CAN BE ASYMPTOMATIC OR MANIFEST IN TWO CLINICALLY DIFFERENTIATED FORMS: dengue fever (DF) and denguehemorrhagic fever (DHF). The principal pathophysiological characteristic of DHF is the increase in vascular permeability and the loss of plasma caused by the malfunction of the vascular endothelium that induces the release of chemical mediators. However, so far there is nothing that allows for the identification the patients that are at risk of developing the more severe form of the illness. The objective of this study was to investigate the relationship between the serum levels of soluble thrombomodulin (sTM) and VEGF with the severity of dengue and the viral serotype. 231 serum samples were analyzed, 70 DF, 80 DHF and 81 control group, all were residents of Guerrero state in Mexico. The infection by dengue virus as well and the levels of sTM and VEGF were determined using the ELISA sandwich, while the serotype was determined by real time RT-PCR. Our results show that the concentrations of sTM correlate with the degree of severity of the disease given that they are significantly higher (p<0.001) in the DHF group (median = 10.2 ng/mL) than in the DF group (median = 7.2 ng/mL), and these in turn higher than those of the control group (median = 3.3 ng/mL). The concentration of sTM was significantly higher (p=0.0002) in the patients infected with DENV2. For the VEGF, the highest levels were found in DF (median = 291.3 pg/mL) and did not correlate with the severity of the disease. In conclusion, our results indicate that sTM is a good marker for the severity of the infection by DENV, better than VEGF, and with higher sensibility and specificity.
authors.affiliation: Laboratorio de Biomedicina Molecular, Unidad Académica de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México Avenida Lázaro Cárdenas, Ciudad Universitaria Chilpancingo, Guerrero, México. C.P. 39090.
authors.forename: Oscar
authors.initials: O
authors.lastname: Del Moral-Hernández
authors.affiliation: Laboratorio Estatal de Salud Pública "Galo Soberon y Parra" Servicios Estatales de Salud Acapulco Guerrero México.
authors.forename: Norma E
authors.initials: NE
authors.lastname: Martínez-Hernández
authors.affiliation: Laboratorio de Biomedicina Molecular, Unidad Académica de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México Avenida Lázaro Cárdenas, Ciudad Universitaria Chilpancingo, Guerrero, México. C.P. 39090.
authors.forename: Manuel A
authors.initials: MA
authors.lastname: Mosso-Pani
authors.affiliation: Laboratorio de Biomedicina Molecular, Unidad Académica de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México Avenida Lázaro Cárdenas, Ciudad Universitaria Chilpancingo, Guerrero, México. C.P. 39090.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hernández-Sotelo
authors.affiliation: Laboratorio de Biomedicina Molecular, Unidad Académica de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México Avenida Lázaro Cárdenas, Ciudad Universitaria Chilpancingo, Guerrero, México. C.P. 39090.
authors.forename: Berenice
authors.initials: B
authors.lastname: Illades-Aguiar
authors.affiliation: Laboratorio de Epidemiologia Molecular, Unidad Académica de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México Avenida Lázaro Cárdenas, Ciudad Universitaria Chilpancingo, Guerrero, México. C.P. 39090.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Flores-Alfaro
authors.affiliation: Laboratorio de Biomedicina Molecular, Unidad Académica de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México Avenida Lázaro Cárdenas, Ciudad Universitaria Chilpancingo, Guerrero, México. C.P. 39090.
authors.forename: Verónica
authors.initials: V
authors.lastname: Antonio-Vejar
authors.affiliation: Laboratorio de Biomedicina Molecular, Unidad Académica de Ciencias Químico Biológicas, Universidad Autónoma de Guerrero, Chilpancingo, Guerrero, México Avenida Lázaro Cárdenas, Ciudad Universitaria Chilpancingo, Guerrero, México. C.P. 39090.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Leyva-Vázquez
keywords: DENV1; DENV2; Thrombomodulin; VEGF; dengue fever; dengue hemorrhagic fever