Sustained High Level of Serum VEGF at Convalescent Stage Contributes to the Renal Recovery after HTNV Infection in Patients with Hemorrhagic Fever with Renal Syndrome

Ma, Ying; Liu, Bei; Yuan, Bin; Wang, Jiuping; Yu, Haitao; Zhang, Yun; Xu, Zhuwei; Yi, Jun; Zhang, Chunmei; Zhou, Xiaoting; Yang, An‐Gang; Zhuang, Ran; Jin, Boquan

doi:10.1155/2012/812386

Cited by 28 publications

(25 citation statements)

References 47 publications

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“…VEGF promotes angiogenesis but also induces capillary leakage (46,47). Previous studies have demonstrated the elevation of VEGF levels in HCPS and HFRS patients (48)(49)(50)(51). They observed early and rather localized elevation of VEGF levels and sustained systemic upregulation later in infection.…”

Section: Discussionmentioning

confidence: 96%

“…They observed early and rather localized elevation of VEGF levels and sustained systemic upregulation later in infection. Early in the infection VEGF seems to contribute to hantavirus pathogenesis, whereas VEGF at later time points may contribute to endothelial repair and convalescence (48,50). Local and systemic effects of cytokines may be involved in pathogenesis and repair (52,53).…”

Section: Discussionmentioning

confidence: 99%

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Mobilization of Circulating Endothelial Progenitor Cells Correlates with the Clinical Course of Hantavirus Disease

Krautkrämer

Grouls

Hettwer

et al. 2014

J Virol

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bInfections with hemorrhagic fever viruses are characterized by increased permeability leading to capillary leakage. Hantavirus infection is associated with endothelial dysfunction, and the clinical course is related to the degree of vascular injury. Circulating endothelial progenitor cells (cEPCs) play a pivotal role in the repair of the damaged endothelium. Therefore, we analyzed the number of cEPCs and their mobilizing growth factors in patients suffering from hantavirus disease induced by infection with Puumala virus. The numbers of EPCs of 36 hantavirus-infected patients and age-and gender-matched healthy controls were analyzed by flow cytometry. Concentrations of cEPC-mobilizing growth factors in plasma were determined by enzyme-linked immunosorbent assay. Laboratory parameters were correlated with the number of cEPCs. In patients infected with hantavirus, the number of cEPCs was significantly higher than that in healthy controls. Levels of mobilizing cytokines were upregulated in patients, and the mobilization of cEPCs is paralleled with the normalization of clinical parameters. Moreover, higher levels of cEPCs correlated with higher serum albumin levels and platelet concentrations. Our data indicate that cEPCs may play a role in the repair of hantavirus-induced endothelial damage, thereby influencing the clinical course and the severity of symptoms.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Mobilization of Circulating Endothelial Progenitor Cells Correlates with the Clinical Course of Hantavirus Disease

Krautkrämer

Grouls

Hettwer

et al. 2014

J Virol

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“…Xu et al demonstrated that thrombocytopenic disorders, characterized by increased platelet destruction, can exhibit increased levels of plasma VEGF [14]. Although serum VEGF has been shown to be upregulated in HFRS, the severe form of Hantavirus infection [15, 16], little is known about the association between VEGF and thrombocyte counts in NE cases.…”

Section: Introductionmentioning

confidence: 99%

High Triglycerides Are Associated with Low Thrombocyte Counts and High VEGF in Nephropathia Epidemica

Martynova

Valiullina

Gusev

et al. 2016

Journal of Immunology Research

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Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with renal syndrome. Several reports have demonstrated a severe alteration in lipoprotein metabolism. However, little is known about changes in circulating lipids in NE. The objectives of this study were to evaluate changes in serum total cholesterol, high density cholesterol (HDCL), and triglycerides. In addition to evaluation of serum cytokine activation associations, changes in lipid profile and cytokine activation were determined for gender, thrombocyte counts, and VEGF. Elevated levels of triglycerides and decreased HDCL were observed in NE, while total cholesterol did not differ from controls. High triglycerides were associated with both the lowest thrombocyte counts and high serum VEGF, as well as a high severity score. Additionally, there were higher levels of triglycerides in male than female NE patients. Low triglycerides were associated with upregulation of IFN-γ and IL-12, suggesting activation of Th1 helper cells. Furthermore, levels of IFN-γ and IL-12 were increased in patients with lower severity scores, suggesting that a Th1 type immune response is playing protective role in NE. These combined data advance the understanding of NE pathogenesis and indicate a role for high triglycerides in disease severity.

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“…17 Like dengue fever, the critical patients with HFRS typically appear to have a leukemoid reaction, severe plasma leakage, changes in capillary permeability and thrombocytopenia, which could influence the degree of clotting directly and indirectly and increase the probability of multiorgan bleeding and DIC. 6,18 It has been accepted that thrombocytopenia is most likely the result of decreased platelet production or increased platelet destruction and platelet dysfunction. 19,20 Heparin is an important anticoagulant in blood purification because of its low cost and easy monitoring, but it is associated with several negative characteristics and adverse effects, such as heparin-induced thrombocytopenia (HIT) and hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…5 Typical patients progress through the following five successive phases: febrile, hypotensive, oliguric, diuretic and convalescent. 6,7 In some severe and critical cases, the febrile, hypotensive and oliguric phases can overlap during the acute stage, resulting in acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), acute progressive noncardiogenic pulmonary edema, disseminated intravascular coagulation (DIC) and multiple organ dysfunction syndrome (MODS), with increasing hospital fatality remarkably without effective treatment.…”

mentioning

confidence: 99%

A Retrospective Study of Continuous Renal Therapy and Anticoagulation in Patients with Hemorrhagic Fever with Renal Syndrome

Du¹,

Li²,

Yu³

et al. 2014

Infection International

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Objective To observe the application of continuous renal replacement therapy (CRRT) and heparin anticoagulation in patients with HFRS, and to explore a more suitable anticoagulant strategy. Methods Eighty-five severe-type patients (severe group) and 71 critical-type patients (critical group) were enrolled in this study. The frequency of CRRT was compared between the two groups; the frequency of CRRT treated with and without heparin anticoagulation and the frequency of hemorrhage and channel blood clotting induced by the two anticoagulant strategies were observed. Results The frequency of CRRT in the critical group was higher than that in the severe group (P ＜ 0.001). The frequency of CRRT initiated during the overlapping phases in the critical group was significantly higher than that of the severe group (P = 0.032). The total times of CRRT was 103, and 70 of them were treated with heparin anticoagulation. The frequencies of hemorrhage induced by heparin anticoagulation and no heparinization were 16 and 0, respectively, and the frequencies of channel blood clotting were 2 and 4, respectively. Conclusions CRRT has been used extensively in the critical-type patients with HFRS. The heparin anticoagulation and no anticoagulant strategies should be used more rationally in patients treated with CRRT, according to the clinical characteristics of the disease.

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Sustained High Level of Serum VEGF at Convalescent Stage Contributes to the Renal Recovery after HTNV Infection in Patients with Hemorrhagic Fever with Renal Syndrome

Cited by 28 publications

References 47 publications

Mobilization of Circulating Endothelial Progenitor Cells Correlates with the Clinical Course of Hantavirus Disease

Mobilization of Circulating Endothelial Progenitor Cells Correlates with the Clinical Course of Hantavirus Disease

High Triglycerides Are Associated with Low Thrombocyte Counts and High VEGF in Nephropathia Epidemica

A Retrospective Study of Continuous Renal Therapy and Anticoagulation in Patients with Hemorrhagic Fever with Renal Syndrome

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