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Clinical and Immunological Predictors of Hemorrhagic Fever with Renal Syndrome Outcome during the Early Phase

Authors
Lee, Geum-YoungKim, Won-KeunNo, Jin SunYi, YongjinPark, Hayne ChoJung, JaehunCho, SeungchanLee, JingyeongLee, Seung-HoPark, KyungminKim, JongwooSong, Jin-Won
Issue Date
Mar-2022
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Keywords
hemorrhagic fever with renal syndrome; biomarker; early phase; severity; prognosis
Citation
Viruses, v.14, no.3
Indexed
SCIE
SCOPUS
Journal Title
Viruses
Volume
14
Number
3
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/55555
DOI
10.3390/v14030595
Abstract
The ability to accurately predict the early progression of hemorrhagic fever with renal syndrome (HFRS) is crucial for reducing morbidity and mortality rates in severely affected patients. However, the utility of biomarkers for predicting clinical outcomes remains elusive in HFRS. The aims of the current study were to analyze the serum levels of immune function-related proteins and identify novel biomarkers that may help ascertain clinical outcomes of HFRS. Enzyme-linked immunosorbent assay, Luminex, and bioanalyzer assays were used to quantitatively detect 15 biomarkers in 49 serum samples of 26 patients with HFRS. High hemoglobin (HGB) and low urine output (UO) levels were identified as potential biomarkers associated with the acute HFRS. The serum soluble urokinase plasminogen activator receptor (suPAR) and C-X-C motif chemokine ligand 10 (CXCL10) values increased in the early phase of diseases. Elevated suPAR, interleukin-10 (IL-10), CXCL10, and decreased transforming growth factor-beta 3 (TGF-beta 3) were representative predictors of the disease severity. Upregulation of the HGB showed a significant correlation with high levels of suPAR and CXCL10. Reduced UO positively correlated with increased suPAR, CXCL10, and TGF-beta 2, and decreased vascular endothelial growth factor and TGF-beta 3. The changing HGB and UO criteria, high suPAR, IL-10, CXCL10, and low TGF-beta 3 of HFRS raise significant awareness for physicians regarding prospective biomarkers for monitoring early warning signs of HFRS. This study provides critical insights into the clinical and immunological biomarkers for disease severity and progression in patients with HFRS to identify early predictions of fatal outcomes.
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