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Sustained High Levels of Both Total and High Molecular Weight Adiponectin in Plasma during the Convalescent Phase of Haemorrhagic Fever with Renal Syndrome Are Associated with Disease Severity

View Article: PubMed Central - PubMed

ABSTRACT

Haemorrhagic fever with renal syndrome (HFRS) is characterised by an uncontrolled immune response that causes vascular leakage. Adiponectin (APN) is an adipocytokine involved in prorevascularisation and immunomodulation. To investigate the possible effects of APN in the pathogenesis of HFRS, total and high molecular weight (HMW) APN levels in the plasma of patients with HFRS were quantified using enzyme-linked immunosorbent assay (ELISA). Compared with those in healthy controls, the plasma total and HMW APN levels in patients were elevated to different degrees from the fever onset and remained high at the convalescent phase. Consistent with these results, western blot analysis additionally showed that low molecular weight (LMW), middle molecular weight (MMW), and HMW APN levels were all elevated and contributed to the elevation of the total APN level. Importantly, sustained high levels of total and HMW APN at the convalescent phase were significantly higher in patients with critical disease than those in patients with mild or moderate disease. Moreover, total and HMW APN levels negatively correlated with white blood cell count and positively correlated with platelet count and serum albumin level. These results may provide insights into understanding the roles of total and HMW APN in the pathogenesis of HFRS.

No MeSH data available.


Related in: MedlinePlus

Dynamic changes of the total adiponectin (APN) and high molecular weight (HMW) APN levels in the plasma of patients with HFRS. Comparison of (a) total APN and (b) HMW APN levels in the plasma of patients with HFRS over the different stages of the disease and 6 months after discharge from the hospital. Both total APN and HMW APN levels in the plasma of patients with HFRS were generally elevated starting from the onset of fever, gradually continued to elevate during the course of the disease, and recovered to normal levels when assessed 6 months after discharge. The data were obtained from 171 plasma samples of patients with HFRS and from 16 plasma samples of healthy subjects included as normal controls (NC). The Mann–Whitney U test was used to determine the significance of the difference between two groups, and the black lines represent the medians with the corresponding interquartile range. ∗p < 0.05; ∗∗p < 0.01; ∗∗∗p < 0.001; ∗∗∗∗p < 0.0001.
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fig1: Dynamic changes of the total adiponectin (APN) and high molecular weight (HMW) APN levels in the plasma of patients with HFRS. Comparison of (a) total APN and (b) HMW APN levels in the plasma of patients with HFRS over the different stages of the disease and 6 months after discharge from the hospital. Both total APN and HMW APN levels in the plasma of patients with HFRS were generally elevated starting from the onset of fever, gradually continued to elevate during the course of the disease, and recovered to normal levels when assessed 6 months after discharge. The data were obtained from 171 plasma samples of patients with HFRS and from 16 plasma samples of healthy subjects included as normal controls (NC). The Mann–Whitney U test was used to determine the significance of the difference between two groups, and the black lines represent the medians with the corresponding interquartile range. ∗p < 0.05; ∗∗p < 0.01; ∗∗∗p < 0.001; ∗∗∗∗p < 0.0001.

Mentions: In general, both the total APN and HMW APN levels in the patients with HFRS at different clinical stages of disease were elevated compared with those in the normal controls. The total APN level was elevated at the febrile/hypotensive stage (febrile/hypotensive versus NC, p < 0.001) and peaked in the diuretic/convalescent stage (diuretic/convalescent versus febrile/hypotensive, p < 0.001; diuretic/convalescent versus oliguric, p < 0.01). The median level of HMW APN was higher in the febrile/hypotensive stage of HFRS than that in the normal controls, but without statistical significance. In the oliguric stage, the HMW APN level was significantly higher than that in the normal controls (p < 0.05) and peaked in the diuretic/convalescent stage (diuretic/convalescent versus oliguric, p < 0.001). There was no significant difference in the total or HMW APN levels between the febrile/hypotensive and oliguric stages (Figure 1). Both the total APN and HMW APN levels in the plasma decreased to normal when detected 6 months after discharge from the hospital (Figure 1).


Sustained High Levels of Both Total and High Molecular Weight Adiponectin in Plasma during the Convalescent Phase of Haemorrhagic Fever with Renal Syndrome Are Associated with Disease Severity
Dynamic changes of the total adiponectin (APN) and high molecular weight (HMW) APN levels in the plasma of patients with HFRS. Comparison of (a) total APN and (b) HMW APN levels in the plasma of patients with HFRS over the different stages of the disease and 6 months after discharge from the hospital. Both total APN and HMW APN levels in the plasma of patients with HFRS were generally elevated starting from the onset of fever, gradually continued to elevate during the course of the disease, and recovered to normal levels when assessed 6 months after discharge. The data were obtained from 171 plasma samples of patients with HFRS and from 16 plasma samples of healthy subjects included as normal controls (NC). The Mann–Whitney U test was used to determine the significance of the difference between two groups, and the black lines represent the medians with the corresponding interquartile range. ∗p < 0.05; ∗∗p < 0.01; ∗∗∗p < 0.001; ∗∗∗∗p < 0.0001.
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Related In: Results  -  Collection

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Show All Figures
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fig1: Dynamic changes of the total adiponectin (APN) and high molecular weight (HMW) APN levels in the plasma of patients with HFRS. Comparison of (a) total APN and (b) HMW APN levels in the plasma of patients with HFRS over the different stages of the disease and 6 months after discharge from the hospital. Both total APN and HMW APN levels in the plasma of patients with HFRS were generally elevated starting from the onset of fever, gradually continued to elevate during the course of the disease, and recovered to normal levels when assessed 6 months after discharge. The data were obtained from 171 plasma samples of patients with HFRS and from 16 plasma samples of healthy subjects included as normal controls (NC). The Mann–Whitney U test was used to determine the significance of the difference between two groups, and the black lines represent the medians with the corresponding interquartile range. ∗p < 0.05; ∗∗p < 0.01; ∗∗∗p < 0.001; ∗∗∗∗p < 0.0001.
Mentions: In general, both the total APN and HMW APN levels in the patients with HFRS at different clinical stages of disease were elevated compared with those in the normal controls. The total APN level was elevated at the febrile/hypotensive stage (febrile/hypotensive versus NC, p < 0.001) and peaked in the diuretic/convalescent stage (diuretic/convalescent versus febrile/hypotensive, p < 0.001; diuretic/convalescent versus oliguric, p < 0.01). The median level of HMW APN was higher in the febrile/hypotensive stage of HFRS than that in the normal controls, but without statistical significance. In the oliguric stage, the HMW APN level was significantly higher than that in the normal controls (p < 0.05) and peaked in the diuretic/convalescent stage (diuretic/convalescent versus oliguric, p < 0.001). There was no significant difference in the total or HMW APN levels between the febrile/hypotensive and oliguric stages (Figure 1). Both the total APN and HMW APN levels in the plasma decreased to normal when detected 6 months after discharge from the hospital (Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

Haemorrhagic fever with renal syndrome (HFRS) is characterised by an uncontrolled immune response that causes vascular leakage. Adiponectin (APN) is an adipocytokine involved in prorevascularisation and immunomodulation. To investigate the possible effects of APN in the pathogenesis of HFRS, total and high molecular weight (HMW) APN levels in the plasma of patients with HFRS were quantified using enzyme-linked immunosorbent assay (ELISA). Compared with those in healthy controls, the plasma total and HMW APN levels in patients were elevated to different degrees from the fever onset and remained high at the convalescent phase. Consistent with these results, western blot analysis additionally showed that low molecular weight (LMW), middle molecular weight (MMW), and HMW APN levels were all elevated and contributed to the elevation of the total APN level. Importantly, sustained high levels of total and HMW APN at the convalescent phase were significantly higher in patients with critical disease than those in patients with mild or moderate disease. Moreover, total and HMW APN levels negatively correlated with white blood cell count and positively correlated with platelet count and serum albumin level. These results may provide insights into understanding the roles of total and HMW APN in the pathogenesis of HFRS.

No MeSH data available.


Related in: MedlinePlus