Relationship between circulating vascular endothelial growth factor and its soluble receptors in adults with dengue virus infection: a case–control study

SummaryBackgroundWe performed a case–control study to assess the relationship between vascular endothelial growth factor (VEGF) and its soluble receptors (sVEGFR-1 and 2) in adult patients with dengue fever (DF) and dengue hemorrhagic fever (DHF).MethodsWe recruited 60 adult patients (34 DF and 26 DHF) with serologically-confirmed dengue infections, 10 patients with non-hemorrhagic infections, and 31 community-based healthy volunteers. The levels of VEGF, sVEGFR-1, and sVEGFR-2 were measured and the differences in these markers were compared using one-way analysis of variance (ANOVA), which was adjusted for multiple comparisons.ResultsWe observed lower VEGF levels in DF and DHF compared to study controls (p < 0.01). sVEGFR-1 was higher in DHF than DF, whilst sVEGFR-2 was lower in DF and DHF compared to study controls (all p < 0.01). In DHF, lower VEGF levels were observed in older patients. The use of a single marker, sVEGFR-1 >350 pg/ml, was predictive of DHF.ConclusionThe changes in VEGF and its soluble receptors highlight the importance of vascular permeability cytokines in the pathogenesis of DHF.