Increased endothelial and macrophage markers are associated with disease severity and mortality in scrub typhus.

[scrub typhus]

Scrub typhus is endemic in the Asia -Pacific region . Mortality is high even with treatment , and further knowledge of the immune response during this infection is needed . This study was aimed at comparing plasma levels of monocyte /macrophage and endothelial related inflammatory markers in patients and controls in South India and to explore a possible correlation to disease severity and clinical outcome .Plasma levels of ALCAM , VCAM-1 , sCD 163 , sCD 14 , YKL-40 and MIF were measured in scrub typhus patients (n Â =Â 129 ), healthy controls (n Â =Â 31 ) and in infectious disease controls (n Â =Â 31 ), both in the acute phase and after recovery , by enzyme immunoassays .Patients had markedly elevated levels of all mediators in the acute phase , differing from both healthy and infectious disease controls . During follow-up levels of ALCAM , VCAM-1 , sCD 14 and YKL-40 remained elevated compared to levels in healthy controls . High plasma ALCAM , VCAM-1 , sCD 163 , sCD 14 , and MIF , and in particular YKL-40 were all associated with disease severity and ALCAM , sCD 163 , MIF and especially YKL-40 , were associated with mortality .Our findings show that scrub typhus is characterized by elevated levels of monocyte /macrophage and endothelial related markers . These inflammatory markers , and in particular YKL-40 , may contribute to disease severity and clinical outcome .

Diseases
Validation

Diseases presenting "elevated levels" symptom

22q11.2 deletion syndrome

adrenal incidentaloma

adrenomyeloneuropathy

alexander disease

aniridia

cadasil

canavan disease

congenital adrenal hyperplasia

epidermolysis bullosa simplex

erythropoietic protoporphyria

esophageal carcinoma

fabry disease

familial hypocalciuric hypercalcemia

hereditary cerebral hemorrhage with amyloidosis

inclusion body myositis

kabuki syndrome

omenn syndrome

phenylketonuria

primary effusion lymphoma

pyruvate dehydrogenase deficiency

scrub typhus

sneddon syndrome

werner syndrome

wiskott-aldrich syndrome

wolf-hirschhorn syndrome

x-linked adrenoleukodystrophy

zellweger syndrome

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