Sustained High Levels of Both Total and High Molecular Weight Adiponectin in Plasma during the Convalescent Phase of Haemorrhagic Fever with Renal Syndrome Are Associated with Disease Severity

Abstract

Haemorrhagic fever with renal syndrome (HFRS) is characterised by an uncontrolled immune response that causes vascular leakage. Adiponectin (APN) is an adipocytokine involved in prorevascularisation and immunomodulation. To investigate the possible effects of APN in the pathogenesis of HFRS, total and high molecular weight (HMW) APN levels in the plasma of patients with HFRS were quantified using enzyme-linked immunosorbent assay (ELISA). Compared with those in healthy controls, the plasma total and HMW APN levels in patients were elevated to different degrees from the fever onset and remained high at the convalescent phase. Consistent with these results, western blot analysis additionally showed that low molecular weight (LMW), middle molecular weight (MMW), and HMW APN levels were all elevated and contributed to the elevation of the total APN level. Importantly, sustained high levels of total and HMW APN at the convalescent phase were significantly higher in patients with critical disease than those in patients with mild or moderate disease. Moreover, total and HMW APN levels negatively correlated with white blood cell count and positively correlated with platelet count and serum albumin level. These results may provide insights into understanding the roles of total and HMW APN in the pathogenesis of HFRS.

Elevated plasma interleukin 34 levels correlate with disease severity-reflecting parameters of patients with haemorrhagic fever with renal syndrome

“…At the acute phase of HFRS patients, levels of TNF-α and IL-1β in serum were significantly elevated [5], which may increase the secretion of IL-34 from above immune cells and tissue cells and contribute to the elevation of plasma IL-34 levels. In our previous study, we found that level of plasma adiponectin, which is predominantly secreted by adipocytes, was significantly elevated in HFRS, suggesting that systemic inflammatory response influenced the function of adipocytes in patients with HFRS [33]. The systemic inflammatory response during HTNV infection may also promote the secretion of IL-34 by adipocytes.…”

Adenosine Deaminase is a Potential Molecular Marker for Diagnosis and Prognosis of Haemorrhagic Fever with Renal Syndrome

“…9 Many new biomarkers such as high molecular weight Adiponectin (HMW APN), soluble CD138, platelet distribution width (PDW) and high mobility group box protein-1 (HMGB-1) have been reported to be associated with the severity of orthohantavirus infection. [11][12][13][14] However, there is still a lack of effective markers for early diagnosis and monitoring of disease progression for HFRS.…”