Background: Considerable progress has been made in dengue management, however the lack of appropriate predictors of severity has led to huge number of unwanted admissions mostly decided on the grounds of warning signs. Apoptosis related mediators,among others, are known to correlate with severe dengue (SD) although no predictive validity is established. The objective of this study was to investigate the association of plasma cell-free DNA (cfDNA) with SD, and evaluate its prognostic value in SD prediction at acute phase. Methods: This was a hospital-based prospective cohort study conducted in Vietnam.All the recruited patients were required to be admitted to the hospital and were strictly monitored for various laboratory and clinical parameters(including progression to SD) until discharged. Plasma samples collected during acute phase (6-48 h before defervescence) were used to estimate the level of cfDNA. Results: Of the 61 dengue patients,SD patients (n = 8)developed shock syndrome in 4.8 days (95% CI 3.7-5.4) after the fever onset. Plasma cfDNA levels
before the defervescence of SD patients were significantly higher than the non-SD group (p = 0.0493). From the receiver operating characteristic (ROC) curve analysis, a cut-off of > 36.9 ng/mL was able to predict SD with a good sensitivity (87.5%), specificity (54.7%), and area under the curve (AUC) (0.72, 95% CI 0.55-0.88; p = 0.0493).Conclusions: Taken together, these findings suggest that cfDNA could serve as a potential prognostic biomarker of SD.
Studies with cfDNA kinetics and its combination with other biomarkers and clinical parameters would further improve
the diagnostic ability for SD.
雑誌名
Annals of Clinical Microbiology and Antimicrobials
巻
18
号
1
ページ
10
発行年
2019-03-13
出版者
BioMed Central Ltd.
EISSN
14760711
DOI
10.1186/s12941-019-0309-x
権利
c The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creat iveco mmons .org/licen ses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
著者版フラグ
publisher
引用
Annals of Clinical Microbiology and Antimicrobials, 18(1), art.no.10; 2019
Plasma cell-free DNA: a potential biomarker for early prediction of severe dengue
ACMA18_10.pdf
(826.4KB)
NAOSITEについて