Decreased plasma levels of the endothelial protective XXXX are associated with dengue-induced plasma leakage.

@entity1 @entity281 @entity18791 @entity5596 @entity5595
BACKGROUND: A transient endothelial hyperpermeability is a hallmark of severe @entity281 . @entity5595 ( @entity5596 ) maintains vascular integrity and protects against plasma leakage. We related plasma @entity5596 levels to dengue-induced plasma leakage and studied mechanisms that may underlie the decrease in @entity5596 levels in dengue. METHODS: We determined circulating levels of @entity5596 in 44 Indonesian adults with acute dengue and related levels to plasma leakage, as determined by daily ultrasonography, and to levels of its chaperone apolipoprotein M, other lipoproteins and platelets. RESULTS: Plasma @entity5596 levels were decreased during dengue and @entity1 with plasma leakage had lower median levels compared to those without (638 vs. 745  nM; p  <  0.01). @entity18791 and other lipoprotein levels were also decreased during dengue, but did not correlate to @entity5596 levels. Platelet counts correlated positively with @entity5596 levels, but @entity5596 levels were not higher in frozen-thawed platelet rich plasma, arguing against platelets as an important cellular source of @entity5596 in dengue. CONCLUSIONS: Decreased plasma @entity5596 levels during dengue are associated with plasma leakage. We speculate that decreased levels of @entity18791 underlies the lower @entity5596 levels. Modulation of @entity5596 levels and its receptors may be a novel therapeutic intervention to prevent plasma leakage in dengue.
