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Association between dengue severity and plasma levels of dengue-specific IgE and chymase

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Abstract

There is no definitive predictor of dengue severity, and this has led to a very large number of unnecessary hospitalizations worldwide. Although mast cell mediators are believed to a play role in dengue severity, the lack of precise kinetic data demands further research on early predictors. We enrolled 111 patients with confirmed dengue and 85 with “other febrile illness” (OFI) in a hospital-based prospective study in Vietnam. Dengue patients were classified as level 1, 2, or 3 based on the clinical intervention received. Blood samples were collected from each patient every day (pre- and post-defervescence) and after discharge. Plasma chymase, total IgE, and dengue-specific IgE were measured. Dengue-specific IgE levels showed an increasing trend during the course of illness and remained high even at post-discharge, although no significant difference was observed among severity levels. Total IgE showed no such trend. The specific IgE/total IgE ratio (S/T ratio) remained constantly higher in level 3 patients compared to other levels, with a significant difference at some time points. The S/T ratio of acute phase samples (before defervescence) tended to increase with increasing severity (level 1 < 2 < 3), and was significantly higher in level 3 patients than in level 1 and OFI patients. As an early predictor of severity allowing level 3 patients to be distinguished from other dengue patients, the S/T ratio achieved a sensitivity of 75% and specificity of 68%. We describe the kinetic profiles of IgEs, their ratio, and chymase levels at different severity levels. The S/T ratio was found to be associated with dengue severity, suggesting that it could potentially be used as an early predictor of severity.

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Acknowledgments

The authors would like to thank all of the participants who generously enrolled in this study. This study was conducted (in part) at the Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine, Nagasaki University, Japan.

Funding

This work was supported by Japan Initiative for Global Research Network on Infectious Diseases (J-GRID) (Grant Number 16fm0108001h0002 to KH).

Author information

Author notes

  1. Miho Inokuchi and Shyam Prakash Dumre equally contributed the work.

Authors and Affiliations

  1. Department of Immunogenetics, Institute of Tropical Medicine, Nagasaki University, Nagasaki, 852-8523, Japan

    Miho Inokuchi, Shyam Prakash Dumre, Shusaku Mizukami, Dao Huy Manh & Kenji Hirayama

  2. Department of Virology, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan

    Mya Myat Ngwe Tun & Kouichi Morita

  3. Faculty of Medicine, Minia University, Minia, 61519, Egypt

    Mohamed Gomaa Kamel

  4. Nguyen Dinh Chieu Hospital, Ben Tre, Ben Tre Province, Vietnam

    Le Hong Phuc & Tran Van An

  5. Department of Immunology and Microbiology, Pasteur Institute, Ho Chi Minh City, Vietnam

    Nguyen Van Thuong, Lan Nguyen Weiss & Vu Thi Que Huong

  6. Faculty of Medicine, Damascus University, Damascus, Syria

    Tarek Turk

  7. Department of Environmental Health, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam

    Tran Ngoc Dang

  8. Department of Clinical Product Development, Institute of Tropical Medicine, Nagasaki University, Nagasaki, 852-8523, Japan

    Nguyen Tien Huy

Authors
  1. Miho Inokuchi
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  2. Shyam Prakash Dumre
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  16. Kenji Hirayama
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Contributions

MI, SPD, LNW, VTQH, KM, NTH, KH conceived and designed the study. MI, SPD, MMNT, LHP, NVT, TVA, LNW, VTQH performed the experiments and collected samples. MI, SPD, SM, DHM, NTH, KH analyzed and interpreted the data. SPD, MI, NTH, KH wrote the draft. All authors contributed to the writing and revisions and approved the final manuscript.

Corresponding authors

Correspondence to Nguyen Tien Huy or Kenji Hirayama.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

Ethical approval for this study was obtained from the Institutional Review Boards (IRBs) of the Pasteur Institute in Ho Chi Minh City, Vietnam (No. 602/ QD-Pas 27/12/10) and the Institute of Tropical Medicine, Nagasaki University, Japan (No. 11063072). All procedures performed in studies involving human participants were in accordance with the ethical standards of the IRBs and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All of the participants were duly informed about the study, and written informed consent was obtained from the study participants or their guardians/parents (in the case of minors) prior to their enrolment in the study.

Additional information

Handling Editor: Chan-Shing Lin.

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Supplementary material 1 (DOC 361 kb)

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Inokuchi, M., Dumre, S.P., Mizukami, S. et al. Association between dengue severity and plasma levels of dengue-specific IgE and chymase. Arch Virol 163, 2337–2347 (2018). https://doi.org/10.1007/s00705-018-3849-z

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  • DOI: https://doi.org/10.1007/s00705-018-3849-z

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