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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
"inflammatory markers"
symptom
acute rheumatic fever
dystrophic epidermolysis bullosa
erdheim-chester disease
inclusion body myositis
krabbe disease
legionellosis
malignant atrophic papulosis
pyomyositis
scrub typhus
sneddon syndrome
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