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Mast cell mediators in relation to dengue severity: A systematic review and meta‐analysis
Author(s) -
Sherif Nourin Ali,
Zayan Ahmad Helmy,
Elkady Aya Hesham,
Ghozy Sherief,
Ahmed Ahmed Reda,
Omran Esraa Salah,
Taha Elsayed A.,
Eldesoky Esraa Ali,
Ebied Amr,
Tieu Thuan,
Maraie Noha,
Kamel Mohamed Gomaa,
Ngo Huyen Thi,
Mattar Omar Mohamed,
Hirayama Kenji,
Huy Nguyen Tien
Publication year - 2020
Publication title -
reviews in medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.06
H-Index - 90
eISSN - 1099-1654
pISSN - 1052-9276
DOI - 10.1002/rmv.2084
Subject(s) - dengue fever , medicine , chymase , immunology , meta analysis , vascular endothelial growth factor , dengue virus , pathogenesis , vascular permeability , histamine , tryptase , gastroenterology , degranulation , mast cell , vegf receptors , receptor
Summary Background Degranulation of mast cells (MCs) releases several mediators such as vascular endothelial growth factor (VEGF), chymase, tryptase, histamine, and cytokines, which all have important roles in the severity of dengue infection. We aimed to investigate the role of MCs in severity of dengue. Methods We searched for relevant studies in 10 databases on 15 August 2016. Meta‐analysis (MA) was conducted by R version 3.5.0. Results We included 24 studies. in vivo and in vitro studies showed higher MC products released from infected mice/cells with dengue virus. In addition, when administering MC stabilizers or antihistaminic drugs, there was a decrease in vascular/capillary permeability. In human and at early stages, studies revealed an insignificant difference in VEGF levels in dengue fever (DF) versus dengue hemorrhagic fever (DHF) (standardized mean difference [SMD] 0.145; 95% confidence interval [CI], −0.348‐0.638). Meanwhile, at acute stages and compared with healthy controls, high heterogeneity with an inconclusive difference in VEGF levels were noted in DF and DHF. However, pooled serum and plasma levels of VEGF were increased significantly in dengue shock syndrome (DSS) versus healthy controls (SMD 0.65; 95% CI, 0.3‐0.95). There were also significantly higher chymase levels in DHF patients compared with DF during the acute phase (MD −6.531; 95% CI, −12.2 to −0.9). Conclusion VEGF and chymase levels are mediators in dengue pathogenesis. However, limited data were available to support their role in severe dengue cases. Further studies are needed to evaluate the function of other mediators in dengue severity.