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Increase of plasminogen activator inhibitor-1 and decrease of transforming growth factor-b1 in children with dengue
Kis Djamiatun1, Sultana M H Faradz, Tatty E Setiati
1Faculty of Medicine, Department of Parasitology, Dr Kariadi Hospital and Faculty of Medicine, Diponegoro University, Semarang, Indonesia. ramus64@yahoo.com
Insights
Elevated plasminogen activator inhibitor-1 (PAI-1) in children with severe dengue haemorrhagic fever (DHF) is linked to lower platelet counts and increased plasma leakage. Understanding PAI-1 origins is crucial for managing DHF in Indonesia.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Severe dengue haemorrhagic fever (DHF) has high mortality in Indonesian children.
- The source of elevated plasminogen activator inhibitor-1 (PAI-1) in DHF patients remains unclear.
Purpose of the Study:
- To investigate the relationship between PAI-1 levels and clinical parameters in children with DHF.
- To explore the role of transforming growth factor-β1 (TGF-β1) in DHF pathogenesis.
Main Methods:
- Measured PAI-1, TGF-β1, platelet counts, plasma leakage, and liver function in 71 children with DHF and 30 healthy children.
- Assessed PAI-1 and TGF-β1 levels on admission and Day 2.
- Correlated PAI-1 levels with clinical and laboratory findings.
Main Results:
- PAI-1 concentrations were higher on admission in DHF patients compared to Day 2.
- TGF-β1 levels were lower on admission in DHF patients but increased by Day 2.
- PAI-1 correlated positively with platelet count and serum albumin, and with pleural effusion severity.
Conclusions:
- Elevated PAI-1 in DHF is associated with thrombocytopenia and plasma leakage.
- PAI-1 may play a role in DHF pathophysiology, particularly concerning vascular integrity.
Abstract:
Mortality in children with severe dengue haemorrhagic fever (DHF) in Indonesia is high. The origin of the elevated plasminogen activator inhibitor-1 (PAI-1) levels in these children is unclear. We measured PAI-1, transforming growth factor-β1 (TGF-β1), platelet counts, plasma leakage and liver function in 71 children with DHF (3-15 years old) and in 30 healthy children. We found that PAI-1 concentrations in children with DHF were significantly higher on admission than on Day 2. Circulating TGF-β1 concentrations on admission were significantly lower in DHF than in controls, but on Day 2 increased towards levels in controls. TGF-β1 and PAI-1 concentrations were not correlated on either day. PAI-1 was correlated with platelet count and serum albumin on admission, and with degree of pleural effusion. Liver function tests were mildly elevated but not correlated with PAI-1. In conclusion, elevated PAI-1 concentrations in DHF were associated with platelet counts and plasma leakage.
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