Dengue is the most common mosquito-borne viral disease affecting humans globally. In 2019, the World Health Organization identified dengue as one of the top 10 threats to global health, with transmission occurring in 129 countries and an estimated 3.9 billion people being at risk.
Biomarkers are naturally occurring molecules or genes in the vascular, inflammatory or other biological pathways that help to identify the state or risk of a disease in patients.
The findings reported in a study published recently in eLife about new developments in biomarker panels for dengue in clinical use improve the triage and risk prediction.
Vuong and colleagues selected 10 candidate biomarkers which are more likely to increase during the early stages of disease from vascular, immunological and inflammatory pathways associated with dengue disease pathogenesis.
These biomarkers were: VCAM-1, SDC-1, Ang-2, IL-8, IP-10, IL-1RA, sCD163, sTREM-1, ferritin, and CRP.
Later they selected 281 cases in four countries - Vietnam, Cambodia, Malaysia and El Salvador to compare with selected 556 patients with uncomplicated dengue who shared similar geographies and demographic characteristics.
Measuring the participants' blood biomarkers at two different time points - one during the first three days of illness, and the second following recovery (10-31 days after symptom onset).
They discovered that higher levels of any of the 10 biomarkers during the first three days of illness increase a patient's risk to develop moderate to severe dengue.
They also identified different clinical outcome based on biomarker in various age groups. Combination of six biomarkers was best associated with severe disease in children, and a combination of seven biomarkers was best associated with severe disease in adults.
All these findings can assist in the development of biomarker panels can improve individual patient management and healthcare allocation, especially in outbreak settings.