Hyperglycemia exacerbates dengue virus infection by facilitating poly(A)-binding protein–mediated viral translation

Shen, Ting-Jing; Chen, Chia-Ling; Tsai, Tsung-Ting; Jhan, Ming-Kai; Bai, Chyi‐Huey; Yen, Yu-Chun; Tsai, Ching-Wen; Lee, Cheng-Yi; Tseng, Po-Chun; Yu, Chia-Yi; Lin, Chiou–Feng

doi:10.1172/jci.insight.142805

“…One study demonstrated that hyperglycemic stress facilitates dengue virus translation and increases protein expression [ 29 ]. Our study also showed patients with dengue virus infection had higher glucose levels than the dengue-negative group.…”

Section: Discussionmentioning

confidence: 99%

Association of Hematological and Biochemical Parameters with Serological Markers of Acute Dengue Infection during the 2022 Dengue Outbreak in Nepal

Bhattarai

¹

,

Mishra

²

,

Aryal

³

et al. 2023

Journal of Tropical Medicine

3

0

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Background. Nepal faced a major dengue outbreak in 2022. The majority of hospitals and laboratories had limited resources for dengue confirmation and had to rely on rapid dengue diagnostic tests. The purpose of the study is to find the predictive hematological and biochemical parameters in each serological phase of dengue infection (NS1 and IgM) that may assist in dengue diagnosis, severity assessment, and patient management via the use of rapid serological tests. Method. A laboratory-based cross-sectional study was conducted among dengue patients. Rapid antigen (NS1) and serological test (IgM/IgG) was performed to diagnose positive dengue cases. Furthermore, hematological and biochemical investigations were carried out and compared between NS1 and/or IgM-positive participants. A logistic regression analysis was used to identify the validity of the hematological and biochemical characteristics for dengue diagnosis as well as patient management. Receiver-operating characteristic (ROC) curve analysis was used to define the best cut-off, sensitivity, and specificity. Result. Multiple logistic regression showed thrombocytopenia (ORA = 1.000; p = 0.006), leukopenia (ORA = 0.999; p < 0.001 ), glucose level (ORA = 1.028; p = 0.029 ), aspartate aminotransferase (ORA = 1.131; p = 0.001 ), and monocytosis (ORA = 2.332; p = 0.020 ) as significant parameters in the NS1-only positive group. Similarly, thrombocytopenia (ORA = 1.000; p = 0.001 ), glucose level (ORA = 1.037; p = 0.004 ), and aspartate aminotransferase (ORA = 1.141; p < 0.001 ) were significant in IgM-only positive patients. Moreover, thrombocytopenia (ORA = 1.000; p < 0.001 ), leukopenia (ORA = 0.999; p < 0.001 ), glucose (ORA = 1.031; p = 0.017 ), aspartate aminotransferase (ORA = 1.136; p < 0.001 ), and lymphopenia (ORA = 0.520; p = 0.067 ) were independent predictors in both NS1 + IgM positive groups. Platelets consistently demonstrated a higher area under the curve with increased sensitivity and specificity throughout all models, while aspartate aminotransferase (AUC = 0.811) and glucose (AUC = 0.712) demonstrated better results when single IgM positivity was observed. The total leukocyte count performed better when both NS1 + IgM were positive (AUC = 0.814). Conclusion. Hence, thrombocytopenia, elevated AST, high glucose level, leukopenia with monocytosis, and leukopenia with lymphopenia may predict dengue diagnosis and its severity during an active infection. Therefore, these laboratory parameters can be used to complement less sensitive rapid tests, improve dengue diagnosis, and help with proper patient management.

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“…Among the mechanisms raised to promote the aggravation of dengue in the DP, apoptosis of leucocytes and endothelial microvascular cells has been proposed from post-mortem findings [33], while more recently, a mouse model unravelled the role of hyperglycaemic stress to facilitate DENV replication through the poly(A)-binding protein PI3K/AKT signalling [34]. Together with the microvascular and macrovascular damages of diabetes complications, this would increase the susceptibility of the DPs to the severe plasma leakage key to SD pathogenesis [35].…”

Section: Discussionmentioning

confidence: 99%

Dengue clinical features and predictors of severity in the diabetic patient: a retrospective cohort study on Reunion island, 2019

Issop

¹

,

Bertolotti

²

,

Diarra

³

et al. 2023

Preprint

0

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AimDiabetes mellitus is associated with both the risks of severe dengue and dengue-related deaths, however the factors characterizing dengue in the diabetic patient are ill-recognized. The objective of this hospital-based cohort study was to identify the factors characterizing dengue and those able to predict dengue severity in the diabetic patient.MethodsWe retrospectively analysed demographic, clinical and biological parameters at admission in the cohort of patients who consulted at the university hospital between January and June 2019 with confirmed dengue. Bivariate and multivariate analyses were conducted.ResultsOf 936 patients, 184 patients (20%) were diabetic. One hundred and eighty-eight patients (20%) developed severe dengue according to the WHO 2009 definition. Diabetic patients were older and had more comorbidities than non-diabetics. In an age-adjusted logistic regression model, loss of appetite, altered mental status, high neutrophil to platelet ratios (>14.7), low haematocrit (≤ 38%), upper-range serum creatinine (>100 μmol/l) and high urea to creatinine ratio (>50) were indicative of dengue in the diabetic patients. In a modified Poisson regression model, four key independent variables were predictive of severe dengue in the diabetic patient: presence of diabetes complications, non-severe bleeding, altered mental status and cough. Among diabetes complications, diabetic retinopathy, and neuropathy but not diabetic nephropathy nor diabetic foot were predictive of severe dengue.ConclusionAt hospital first presentation, dengue in the diabetic patient is characterized by deteriorations in appetite, mental and renal functioning, while severe dengue can be predicted by presence of diabetes complication, dengue-related non-severe haemorrhages, cough, and dengue-related encephalopathy.

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Dengue fever in hyperglycemic patients: an emerging public health concern demanding eyes on the effective management strategies

Shawon,

Hamid,

Ahmed

et al. 2024

Health Science Reports

0

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Background and aimsHyperglycemia, also known as diabetes, is a metabolic disorder characterized by elevated levels of glucose in the bloodstream. It can lead to the prolonged dysfunction, injury, and deterioration of several organs. In addition, dengue is a viral illness transmitted by mosquitoes that has reached epidemic proportions worldwide. In this article, we focused on the severity of comorbidities, difficulties in managing them, and preventive measures meant to lessen the risks associated with comorbidities in diabetic patients with dengue infection.MethodsWe explored a number of databases, including PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library, for this review article using various related keywords.ResultsThe findings of this review article indicate that elderly dengue patients with diabetes should be admitted to the hospital for close observation and early management using fluid therapy. An observed association exists between dengue hemorrhagic fever (DHF) and diabetes, indicating a possible consequence in this specific group. Additionally, patients with diabetes who contract dengue show elevated levels of inflammatory markers. Diabetes mellitus deteriorates the immune system, which exacerbates the progression of dengue fever. Cutting‐edge technology and scientific research may assist in addressing the challenges that diabetes and dengue viruses pose in low‐ and middle‐income countries. Implementing innovative diabetic care management is essential to ensuring consistency of care, improving a healthy lifestyle, and lowering patient risk factors and comorbidities.ConclusionDengue fever has spread to epidemic levels throughout the world. Inflammatory markers increase and the prevalence of DHF is greater in diabetes individuals with dengue infection. Given the continued growth of dengue in Asian nations, it is imperative that we concentrate our efforts and resources on providing more precise and effective treatment for this emerging issue.

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Hyperglycemia exacerbates dengue virus infection by facilitating poly(A)-binding protein–mediated viral translation

Cited by 7 publications

References 61 publications

Association of Hematological and Biochemical Parameters with Serological Markers of Acute Dengue Infection during the 2022 Dengue Outbreak in Nepal

Association of Hematological and Biochemical Parameters with Serological Markers of Acute Dengue Infection during the 2022 Dengue Outbreak in Nepal

Dengue clinical features and predictors of severity in the diabetic patient: a retrospective cohort study on Reunion island, 2019

Dengue fever in hyperglycemic patients: an emerging public health concern demanding eyes on the effective management strategies

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