by Singapore: Scientists and clinicians at Nanyang Technological University, Singapore (NTU Singapore) and the National Center for Infectious Diseases (NCID) have made a groundbreaking discovery in the fight against dengue fever. They have identified two compounds, sST2 and suPAR, present in the blood of dengue patients that could determine if a patient is at risk of developing severe dengue in the early stages of the disease.
Dengue fever is a common mosquito-borne viral illness that is usually mild and self-limiting. However, in some cases, it can progress to severe dengue, also known as dengue hemorrhagic fever, which can be life-threatening. Identifying patients who are at risk of developing severe dengue is crucial for ensuring they receive appropriate and timely medical care.
Currently, the diagnosis of dengue infection is based on clinical assessment by a physician and confirmed through blood tests to detect the dengue virus or antibodies against the virus. However, there are no clinically available tests that can accurately predict or identify severe dengue infection in its early stages.
The symptoms of severe dengue, such as abdominal pain, vomiting, and mild bleeding, are non-specific and have an accuracy rate of less than 20% in screening for severe dengue infection. This lack of a reliable prognostic test has made it challenging for clinicians to identify patients at risk of developing severe dengue.
The researchers have found that the compounds sST2 and suPAR, which are proteins in the blood linked to heart health, hold promise in identifying patients at risk of severe dengue. High levels of sST2 indicate heart stress and fibrosis, while elevated suPAR levels indicate increased inflammation. Monitoring the levels of these proteins can provide insights into the severity of the disease and the progression of the illness.
The research team conducted a study between 2016 and 2019 involving 129 dengue patients treated at Tan Tock Seng Hospital in Singapore. They found that patients with severe dengue tended to have higher levels of sST2 and suPAR, while patients with non-severe dengue had lower levels. When the levels of these compounds exceeded specific values, there was a strong likelihood of developing severe dengue.
To make these findings more clinically accessible, the researchers are working on adapting commercially available lateral flow test kits for sST2 and suPAR, which are currently used to test for heart failure. By validating and adapting these tests, they hope to create a kit that can effectively diagnose severe dengue and aid clinicians in distinguishing between non-life-threatening cases and cases that require hospitalization.
The researchers estimate that this new method of monitoring the levels of sST2 and suPAR could bring a higher accuracy rate of 55% to 60% in predicting severe dengue compared to traditional assessment approaches. This would greatly improve patient outcomes and help prioritize healthcare resources for severe cases.
With approximately 4 billion people in more than 129 countries at risk of dengue, according to the World Health Organization, there is a critical need for an inexpensive and accurate test. The researchers plan to validate their findings by adapting lateral flow format test kits, similar to the Antigen Rapid Test kits used for COVID-19, to measure sST2 and suPAR levels.
If successful, these test kits could revolutionize dengue care and management worldwide. They would serve as an affordable and easy-to-use point-of-care tool, helping healthcare professionals avoid unnecessary hospitalization of patients with mild dengue and relieving the burden on healthcare systems during dengue outbreaks.
In addition to improving patient outcomes, these test kits could also contribute to the overall management of dengue by helping prioritize healthcare resources for severe cases. By accurately identifying patients at risk of developing severe dengue, healthcare professionals can ensure they receive the necessary care and interventions to prevent life-threatening complications.
The researchers are hopeful that their findings will lead to the development of an affordable and effective prognostic tool for early-phase dengue detection, ultimately contributing to the global efforts in combating this challenging disease.
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Source: Coherent Market Insights, Public sources, Desk research
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