Endothelial Nitric Oxide Pathways in the Pathophysiology of Dengue: A Prospective Observational Study Simmons, Cameron 2018-09-14T11:15:10Z 2017-11-09T04:05:28Z 2017-06-20 en_US 2018-09-14T11:15:10Z 2017-11-01 en_US
dc.description.abstract Background: Dengue can cause increased vascular permeability that may lead to hypovolemic shock. Endothelial dysfunction may underlie this; however, the association of endothelial nitric oxide (NO) pathways with disease severity is unknown. Methods: We performed a prospective observational study in 2 Vietnamese hospitals, assessing patients presenting early (<72 hours of fever) and patients hospitalized with warning signs or severe dengue. The reactive hyperemic index (RHI), which measures endothelium-dependent vasodilation and is a surrogate marker of endothelial function and NO bioavailability, was evaluated using peripheral artery tonometry (EndoPAT), and plasma levels of l-arginine, arginase-1, and asymmetric dimethylarginine were measured at serial time-points. The main outcome of interest was plasma leakage severity. Results: Three hundred fourteen patients were enrolled; median age of the participants was 21(interquartile range, 13-30) years. No difference was found in the endothelial parameters between dengue and other febrile illness. Considering dengue patients, the RHI was significantly lower for patients with severe plasma leakage compared to those with no leakage (1.46 vs 2.00; P < .001), over acute time-points, apparent already in the early febrile phase (1.29 vs 1.75; P = .012). RHI correlated negatively with arginase-1 and positively with l-arginine (P = .001). Conclusions: Endothelial dysfunction/NO bioavailability is associated with worse plasma leakage, occurs early in dengue illness and correlates with hypoargininemia and high arginase-1 levels.
dc.identifier.uri http://localhost:8080/dspace7/handle/123456789/223
dc.language English en_US
dc.title Endothelial Nitric Oxide Pathways in the Pathophysiology of Dengue: A Prospective Observational Study en_US
dc.type Journal Article
relation.isAuthorOfPublication b1b2c768-bda1-448a-a073-fc541e8b24d9
relationship.type Publication