Health, Singapore (Commonwealth Union) – Researchers from Nanyang Technological University, Singapore (NTU Singapore) and the National Centre for Infectious Diseases (NCID) have pinpointed two compounds, sST2 and suPAR, present in the blood of dengue patients. These compounds can serve as indicators during the early stages of the disease, helping determine the risk of severe dengue.
Researchers of the study pointed out that while dengue typically manifests as a mild illness, a subset of cases can escalate to severe dengue, posing a potential threat to patients lacking access to vigilant monitoring and specialized medical attention. Current diagnostic methods rely on clinical evaluations by physicians and blood tests to identify the dengue virus or antibodies against it. However, there is a lack of clinically available prognostic tests with the requisite sensitivity to predict or detect severe dengue in its initial phases.
Common symptoms such as abdominal pain, vomiting, and mild bleeding, while associated with dengue, exhibit less than 20 percent accuracy in screening for severe infection. These symptoms are often nonspecific, underscoring the need for more precise diagnostic tools.
Taking advantage of commercially available lateral flow test kits for sST2 and suPAR, originally designed for heart failure testing, the researchers are actively working on validating and customizing these kits for detecting severe dengue. Both sST2 and suPAR are proteins in the blood linked to heart health. Elevated levels of sST2 indicate heart stress and fibrosis, serving as indicators of heart failure severity. Similarly, heightened suPAR levels signify increased inflammation, correlating with a higher risk of heart issues. Monitoring these proteins offers valuable insights into both heart health and disease progression.
The application of this novel method to monitor the levels of the two compounds is anticipated to enhance predictive accuracy significantly, reaching 55 to 60 percent, surpassing traditional assessment approaches. The researchers assert that this advancement will be instrumental for clinicians in effectively distinguishing between cases of non-life-threatening dengue fever and severe dengue, which necessitates hospitalization.
The significance of sST2 and suPAR in gauging dengue severity was unveiled through a study conducted between 2016 and 2019. The research involved 129 dengue patients receiving treatment at Tan Tock Seng Hospital in Singapore, revealing the pivotal role of these compounds in assessing the gravity of the disease.
Lead author Dr Andrew Teo, a Dean’s Postdoctoral Fellow of the Lee Kong Chian School of Medicine (LKCMedicine) of NTU, says “Dengue is endemic in Singapore, and one of the primary challenges faced by clinicians is the identification of patients who are at risk of developing severe dengue. The current frequently used biomarkers do not consistently predict individuals at risk of severe dengue. We have found that both sST2 and suPAR, which are present in early dengue cases, show more promise in identifying those at risk of severe dengue. Furthermore, the availability of point-ofcare test kits using these biomarkers would improve the user experience, in contrast with laboratory testing that often has a longer turnaround time.”
Assistant Professor Chia Po Ying, a contributing author and Consultant at the National Centre for Infectious Diseases, as well as the Department of Infectious Diseases at Tan Tock Seng Hospital, led the clinical recruitment efforts for this study. She emphasized the critical need for a swift prognostic test or biomarker, particularly during the febrile phase, the initial stage marked by fever in an illness. This development has the potential to revolutionize the care and management of dengue patients, ultimately enhancing patient outcomes. Assistant Professor Chia also holds the position of National Healthcare Group (NHG)-NTU Clinician Scientist Fellow at NTU’s Lee Kong Chian School of Medicine.
The study, representing a notable advancement in diagnosing severe dengue fever infections, underscores NTU’s dedication to addressing the needs and challenges of healthy living and aging, a pivotal aspect of the university’s NTU 2025 strategic plan aimed at tackling significant global challenges.
