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Serum Angiopoietin-2 as Marker of Plasma Leakage in Dengue Viral Infection

Received: 6 January 2015    Accepted: 18 January 2015    Published: 2 February 2015
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Abstract

Background. The immunopathology of DHF/DSS is yet completely understood. Angiopoietin-2 (Ang-2) produced by endothelial cell could promote vascular leakage by disrupting endothelial junction. Few studies reported the role of Ang-2 in dengue viral infection. Objective. To study the role of Ang-2 in promoting vascular leakage in dengue viral infection. Methods. Prospective cohort study conducted at Prof. Dr. R.D. Kandou, Pancaran Kasih and R.W. Mongonsidi General Hospitals in Manado, from March 2013 to October 2014. Children, aged 1-15 years old, with the diagnosis of dengue viral infection according to 1997 World Health Organization (WHO) criteria [Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), Dengue Shock Syndrome (DSS)],were recruited consecutively. Written informed consent was obtained from parents or legal guardian. Blood samples were obtained at the time of diagnosis and 48 hours after, evaluated for complete blood counts, albumin, NS-1, Ig M, Ig G anti-dengue, and Ang-2. Results. During the study period, there were 119 children with dengue viral infections (39 DF, 39 DHF, 41 DSS). Patient’s characteristics: female predominance, age between 1.5-8.5 years old, well nourished, and mean albumin level were less than ≤3.5 gr% in the DHF and DSS group. Ang-2 level at admission were 2,486.21 pg/dl, 3,194.95 pg/dl and 4,005.32 pg/dl in DF, DHF and DSS group, respectively. Anova test analyses shows significant differences in serum Ang-2 level at admission between DF, DHF and DSS group (p<0.0001). Between those groups, DSS group had the highest level of Ang-2, followed with DHF and DF. Discussion. Mean albumin level were 3.88 gr%, 3.39 gr% and 2.63gr% in DF, DHF and DSS group, respectively. This results shows increasing plasma leakage with increasing severity of dengue viral infection. Increasing level of Ang-2 can promote blood vessels instability therefore causing increased vascular permeability and subsequent plasma leakage. In this study, we found significant elevation of serum Ang-2 in patiens with DSS compared to DHF and DF but the difference was not significant between DF and DHF group. Conclusions. Angiopoietin-2 contributes in transient systemic vascular leak in dengue viral infection.

Published in American Journal of Clinical and Experimental Medicine (Volume 3, Issue 1)
DOI 10.11648/j.ajcem.20150301.15
Page(s) 39-43
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Dengue Viral Infection, DF, DHF, DSS, Angiopoietin-2

References
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[2] Dewi BE, Takasaki T, Kurane I. Peripheral blood mononuclear cells increase the permeability of dengue virus-infected endothelial cells in association with downregulation of vascular endothelial cadherin. J Gen Virol 2008; 89:642-52.
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[5] Srikiatkhachorn A, Ajariyakhajorn C, Endy TP, Kalayanarooj S, Libraty DH, Green S, et al. Virus-induced decline in soluble vascular endothelial growth receptor 2 is associated with plasma leakage in dengue hemorrhagic fever. J Virol 2007; 81:1592-600.
[6] Mitchel M, Djamiatun K, Faradz SMH, Koenders MMJF, de Mast Q, Van der Ven AJAM. High plasma mid regional pro-andrenomedulin levels in children with severe dengue virus infections. J Clin Vir 2011; 50:8-12.
[7] Siner JM, Bhandari V, Engle KM, Elias JA, Siegel MD. Elevated serum angiopoietin 2 levels are associated with increased mortality in sepsis. Shock 2009; 31:348-53.
[8] Mitchel M, van der Ven AJAM, Djamiatun K, Fijnheer R, de Groot P, Griffioen AW, et al. Imbalance of Angiopoietin 1 and Angiopoietin-2 in severe dengue and relationship with thrombocytopenia, endothelial activation and vascular stability. Am J Trop Hyg 2012; 87(5):943-6.
[9] Van de Weg CAM, Pannuti CS, Van den Ham HJ, de Araujo ESA, Boas LSV, Felix AC, et al. Serum Angiopoetin-2 and soluble VEGF receptor 2 are surrogate markers for plasma leakage in patients with acute dengue virus infection. J Clin Virol 2014; 60:328-35.
[10] Luplertlop N, Misse D. MMP Cellular responses to dengue infection-induced vascular leakage. J Infect Dis 2012;61:298-301.
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[15] Roviezzo F, Tsigkos S, Kotanidou A, Bucci M, Brancaleone V, Cirino G, et al. Angiopoietin-2 causes inflammation in vivo by promoting vascular leakage. JPET 2005; 314:738-44.
[16] Orfanos SE, Kotanidou A, Glynos C, Athanasiou C, Tsigkos S, et al. Angiopoietin-2 is increased in severe sepsis: correlation with inflammatory mediators. Crit Care Med 2007; 35(1):199-206.
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Cite This Article
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    Novie Homenta Rampengan, Dasril Daud, Sarah Warouw, Idham Jaya Ganda. (2015). Serum Angiopoietin-2 as Marker of Plasma Leakage in Dengue Viral Infection. American Journal of Clinical and Experimental Medicine, 3(1), 39-43. https://doi.org/10.11648/j.ajcem.20150301.15

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    ACS Style

    Novie Homenta Rampengan; Dasril Daud; Sarah Warouw; Idham Jaya Ganda. Serum Angiopoietin-2 as Marker of Plasma Leakage in Dengue Viral Infection. Am. J. Clin. Exp. Med. 2015, 3(1), 39-43. doi: 10.11648/j.ajcem.20150301.15

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    AMA Style

    Novie Homenta Rampengan, Dasril Daud, Sarah Warouw, Idham Jaya Ganda. Serum Angiopoietin-2 as Marker of Plasma Leakage in Dengue Viral Infection. Am J Clin Exp Med. 2015;3(1):39-43. doi: 10.11648/j.ajcem.20150301.15

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  • @article{10.11648/j.ajcem.20150301.15,
      author = {Novie Homenta Rampengan and Dasril Daud and Sarah Warouw and Idham Jaya Ganda},
      title = {Serum Angiopoietin-2 as Marker of Plasma Leakage in Dengue Viral Infection},
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {3},
      number = {1},
      pages = {39-43},
      doi = {10.11648/j.ajcem.20150301.15},
      url = {https://doi.org/10.11648/j.ajcem.20150301.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20150301.15},
      abstract = {Background. The immunopathology of DHF/DSS is yet completely understood. Angiopoietin-2 (Ang-2) produced by endothelial cell could promote vascular leakage by disrupting endothelial junction. Few studies reported the role of Ang-2 in dengue viral infection. Objective. To study the role of Ang-2 in promoting vascular leakage in dengue viral infection. Methods. Prospective cohort study conducted at Prof. Dr. R.D. Kandou, Pancaran Kasih and R.W. Mongonsidi General Hospitals in Manado, from March 2013 to October 2014. Children, aged 1-15 years old, with the diagnosis of dengue viral infection according to 1997 World Health Organization (WHO) criteria [Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), Dengue Shock Syndrome (DSS)],were recruited consecutively. Written informed consent was obtained from parents or legal guardian. Blood samples were obtained at the time of diagnosis and 48 hours after, evaluated for complete blood counts, albumin, NS-1, Ig M, Ig G anti-dengue, and Ang-2. Results. During the study period, there were 119 children with dengue viral infections (39 DF, 39 DHF, 41 DSS). Patient’s characteristics: female predominance, age between 1.5-8.5 years old, well nourished, and mean albumin level were less than ≤3.5 gr% in the DHF and DSS group. Ang-2 level at admission were 2,486.21 pg/dl, 3,194.95 pg/dl and 4,005.32 pg/dl in DF, DHF and DSS group, respectively. Anova test analyses shows significant differences in serum Ang-2 level at admission between DF, DHF and DSS group (p<0.0001). Between those groups, DSS group had the highest level of Ang-2, followed with DHF and DF. Discussion. Mean albumin level were 3.88 gr%, 3.39 gr% and 2.63gr% in DF, DHF and DSS group, respectively. This results shows increasing plasma leakage with increasing severity of dengue viral infection. Increasing level of Ang-2 can promote blood vessels instability therefore causing increased vascular permeability and subsequent plasma leakage. In this study, we found significant elevation of serum Ang-2 in patiens with DSS compared to DHF and DF but the difference was not significant between DF and DHF group. Conclusions. Angiopoietin-2 contributes in transient systemic vascular leak in dengue viral infection.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Serum Angiopoietin-2 as Marker of Plasma Leakage in Dengue Viral Infection
    AU  - Novie Homenta Rampengan
    AU  - Dasril Daud
    AU  - Sarah Warouw
    AU  - Idham Jaya Ganda
    Y1  - 2015/02/02
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ajcem.20150301.15
    DO  - 10.11648/j.ajcem.20150301.15
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
    SP  - 39
    EP  - 43
    PB  - Science Publishing Group
    SN  - 2330-8133
    UR  - https://doi.org/10.11648/j.ajcem.20150301.15
    AB  - Background. The immunopathology of DHF/DSS is yet completely understood. Angiopoietin-2 (Ang-2) produced by endothelial cell could promote vascular leakage by disrupting endothelial junction. Few studies reported the role of Ang-2 in dengue viral infection. Objective. To study the role of Ang-2 in promoting vascular leakage in dengue viral infection. Methods. Prospective cohort study conducted at Prof. Dr. R.D. Kandou, Pancaran Kasih and R.W. Mongonsidi General Hospitals in Manado, from March 2013 to October 2014. Children, aged 1-15 years old, with the diagnosis of dengue viral infection according to 1997 World Health Organization (WHO) criteria [Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), Dengue Shock Syndrome (DSS)],were recruited consecutively. Written informed consent was obtained from parents or legal guardian. Blood samples were obtained at the time of diagnosis and 48 hours after, evaluated for complete blood counts, albumin, NS-1, Ig M, Ig G anti-dengue, and Ang-2. Results. During the study period, there were 119 children with dengue viral infections (39 DF, 39 DHF, 41 DSS). Patient’s characteristics: female predominance, age between 1.5-8.5 years old, well nourished, and mean albumin level were less than ≤3.5 gr% in the DHF and DSS group. Ang-2 level at admission were 2,486.21 pg/dl, 3,194.95 pg/dl and 4,005.32 pg/dl in DF, DHF and DSS group, respectively. Anova test analyses shows significant differences in serum Ang-2 level at admission between DF, DHF and DSS group (p<0.0001). Between those groups, DSS group had the highest level of Ang-2, followed with DHF and DF. Discussion. Mean albumin level were 3.88 gr%, 3.39 gr% and 2.63gr% in DF, DHF and DSS group, respectively. This results shows increasing plasma leakage with increasing severity of dengue viral infection. Increasing level of Ang-2 can promote blood vessels instability therefore causing increased vascular permeability and subsequent plasma leakage. In this study, we found significant elevation of serum Ang-2 in patiens with DSS compared to DHF and DF but the difference was not significant between DF and DHF group. Conclusions. Angiopoietin-2 contributes in transient systemic vascular leak in dengue viral infection.
    VL  - 3
    IS  - 1
    ER  - 

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Author Information
  • Department of Child Health, Medical Faculty of Sam Ratulangi University, Manado, North Sulawesi, Indonesia

  • Department of Child Health, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

  • Department of Child Health, Medical Faculty of Sam Ratulangi University, Manado, North Sulawesi, Indonesia

  • Department of Child Health, Medical Faculty of Hasanuddin University, Makassar, South Sulawesi, Indonesia

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