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

Background: We 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). Methods: We 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. Results: We 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. Conclusion: The changes in VEGF and its soluble receptors highlight the importance of vascular permeability cytokines in the pathogenesis of DHF. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.