Study on expression of plasma sCD138 in patients with hemorrhagic fever with renal syndrome

Abstract

Background: Until now, there is non-specific treatment, and exploring early and novel biomarkers to determine the disease severity and prognosis of hemorrhagic fever with renal syndrome (HFRS) would be of importance for clinician to take systematic and timely intervention. This study observed the expression of plasma sCD138, a soluble component shedding from the glycocalyx (GCX) to the circulating blood, and evaluated its predictive value on disease severity and prognosis of HFRS.

Methods: One hundred and seventy-six patients with HFRS who were treated at our center between January 2011 and December 2013 were randomly enrolled in this study. The patients were divided into a mild-type group, a moderate-type group, a severe-type group and a critical-type group according to the HFRS criteria for clinical classification. Thirty-five blood samples from healthy subjects were obtained as the controls. The concentrations of sCD138 were detected using enzyme linked immunosorbent assay (ELISA). The levels of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), white blood cells (WBC), platelets (PLT), glucose (GLU), blood urea nitrogen (BUN) and serum creatinine (Scr) in the samples were routinely tested. The levels of sCD138 among the different types were compared; the correlation among sCD138 and the laboratory parameters mentioned above were analyzed. The predictive effectiveness for prognosis of sCD138 was evaluated using the receiver operating characteristic (ROC) curve analysis.

Results: Except for the mild-type, the levels of sCD138 in the moderate-, severe- and critical-type patients during the acute stage were significantly higher than that of the convalescent stage and the control (P<0.05). With the aggravation of the disease, the levels of sCD138 during the acute stage had an increasing tendency, while demonstrated no significant difference among the moderate-, severe- and critical-type patients (P>0.05). sCD138 was negatively correlated with Fib, PLT and ALB, and was positively correlated with WBC and AST (P<0.05). sCD138 demonstrated predictive effectiveness for prognosis with the area under the curve (AUC) of 0.778 (P<0.001).

Conclusion: Dynamic detection of plasma sCD138 might be benefit to evaluating the disease severity and prognosis of the patients with HFRS.

Keywords: Hantavirus; Hemorrhagic fever with renal syndrome; Prognosis; Soluble CD138.

Fig. 1

Levels of sCD138 during the clinical course in patients with HFRS. Except for the mild-type, the levels of sCD138 in the moderate-, severe- and critical-type patients during the acute stage were significantly higher than that of the convalescent stage (b.) and the control (a.), and with the aggravation of the disease, the levels of sCD138 had an increasing tendency, while demonstrated no significant difference among the moderate-, severe- and critical-type patients (a.). * P<0.05; ** P<0.001

Fig. 2

Correlation between sCD138 and WBC (a.), AST (b.), APTT (c.), Fib (d.), PLT (e.) and ALB (f.) in patients with HFRS by Spearman’s correlation analysis. sCD138 was obviously positively correlated with WBC and AST, and was negatively correlated with Fib, PLT and ALB (P<0.05). Abbreviations: sCD138, soluble CD138; WBC, white blood cells; PLT, platelets; ALB, albumin; AST, aspartate aminotransferase; APTT, activated partial thromboplastin time; Fib, fibrinogen

Fig. 3

Predictive values for prognosis with sCD138 by ROC curve analysis. sCD138 showed predictive value of prognosis, with the AUC of 0.778 (P<0.001)