2019
DOI: 10.3390/v11090838
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Serum LPS Associated with Hantavirus and Dengue Disease Severity in Barbados

Abstract: Hantavirus and dengue virus (DENV) infections are caused by RNA viruses which infect immune systems’ cells including monocytes, macrophages and dendritic cells and occur year-round in Barbados. A retrospective serological study (2008–2015) was conducted on hantavirus and dengue patient sera confirmed by IgM and IgG ELISA, NS1 and RT-PCR using Limulus amoebocyte lysate (LAL) kinetic turbidimetric method to determine serum endotoxin levels. Hantavirus patients were categorized into two groups, namely (a) hospita… Show more

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Cited by 9 publications
(8 citation statements)
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“…Endotoxin (LPS) is a major component of Gram-negative bacteria in the gut [25], and the presence of LPS in circulation without bacterial infection implies microbial gut translocation [26]. Here, serum endotoxin was demonstrated in both severe and nonsevere dengue infection, but the level was higher in severe infection (Figure 3E), supporting several previous publications possibly due to leaky gut [6][7][8][9]. Interestingly, the intestinal permeability test using the fractional excretion of lactulose-mannitol in urine after oral administration (lactulose-to-mannitol excretion ratio, LMER), a gold standard test for the gut barrier [27] in several clinical studies (such as Crohn's disease) [27][28][29][30], was well correlated with serum LPS, supporting the use of LPS as a biomarker for the gut barrier in patients with dengue.…”
Section: Discussionsupporting
confidence: 87%
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“…Endotoxin (LPS) is a major component of Gram-negative bacteria in the gut [25], and the presence of LPS in circulation without bacterial infection implies microbial gut translocation [26]. Here, serum endotoxin was demonstrated in both severe and nonsevere dengue infection, but the level was higher in severe infection (Figure 3E), supporting several previous publications possibly due to leaky gut [6][7][8][9]. Interestingly, the intestinal permeability test using the fractional excretion of lactulose-mannitol in urine after oral administration (lactulose-to-mannitol excretion ratio, LMER), a gold standard test for the gut barrier [27] in several clinical studies (such as Crohn's disease) [27][28][29][30], was well correlated with serum LPS, supporting the use of LPS as a biomarker for the gut barrier in patients with dengue.…”
Section: Discussionsupporting
confidence: 87%
“…Although enterocyte injuries in severe dengue infection are mainly due to intestinal injury from plasma leakage-induced hemodynamic alteration (dengue shock syndrome), increased serum lipopolysaccharide (LPS or endotoxin) is correlated with dengue severity [6][7][8][9]. Because endotoxin is a major component of Gram-negative bacteria (the most predominant gut organisms), the detection of LPS in serum without Gram-negative bacterial infection is an indirect indicator of gut barrier defects [6][7][8][9].…”
Section: Introductionmentioning
confidence: 99%
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“…It has been reported a signi cant association of serum endotoxin levels with hantavirus disease severity (Douglas et al, 2019), and the HFRS patients with bacterial infection had a higher risk of death (Fan et al, 2018a;Fan et al, 2018b;Yu et al, 2017), indicating that secondary LPS-induced endotoxemia or polymicrobial sepsis might be a crucial lethal factor after HTNV infection. Since HTNV reprogrammed mice in ammatory macrophage to a pro-resolution phenotype at the late infection stage (Figure 2), we wondered whether this process could prevent the augmentation of immune responses during the subsequent bacterial sepsis.…”
Section: Late-phase Inactivation Of In Ammatory Macrophage By Htnv Confers Mice With Higher Resistance Against the Secondary Endotoxin Ormentioning
confidence: 99%