Maheshi Mapalagamage
University of Colombo, Sri Lanka
Title: High levels of serum Angiopoietin 2 and Angiopoietin 2/1 ratio at critical stage of dengue hemorrhagic fever patients and their associations with clinical and biochemical parameters
Biography
Biography: Maheshi Mapalagamage
Abstract
High vascular permeability is a main feature of severe dengue infection resulting in plasma leakage leading to many adverse effects on patients increasing disease morbidity and mortality. The role of serum Angiopoietin-1 (Ang-1), Angiopoietin-2 (Ang-2) which are known to be associated with endothelial stability in patients with different disease stages were studied. Serum samples were taken from confirmed dengue fever (DF) patients on admission (DFA, n=36) and discharge (DFD, n=18); from confirmed dengue hemorrhagic fever patients (DHF) three sets of samples were used; on admission (DHFA, n=36), at critical stage (DHFC, n=26) and on discharge (DHFD, n=18). Age-gender matched healthy individuals were also recruited as controls (HC, n=24). Results showed that Ang-1 and Ang-2 levels are associated with disease status in DHF but not in DF. The highest Ang-2 levels were observed in DHFC samples as compared to DHFA, DFA, DFD and HC (p<0.002 in all comparisons); the lowest Ang-1 levels were observed in DHFC samples compared to DHFA, DHFD and HC (p<0.050 for all). Specifically, the ratio of serum Ang-2/Ang-1 levels in DHFC were the highest compared to all other study categories tested (p<0.001 for all-Figure 1). A significant positive correlation was observed between serum Ang-1 and platelet count in DHFA samples (Pearson r=0.674, p<0.001) and Ang-1 with Pulse pressure in DHFC category (r=0.636, p=0.011). Using a cut-off value of 1.02 for the Ang-2/Ang-1 ratio of samples obtained at the critical stage a sensitivity of 82.6% and specificity of 80.4% discerning DF from DHF was obtained. This signifies the potential use of the serum Ang-2/Ang-1 ratio as a biomarker for DHF critical stage.