Imperial College London


Faculty of MedicineDepartment of Immunology and Inflammation

Visiting Professor



+44 (0)20 7594 1190g.screaton Website




Ms Claire Puddephatt +44 (0)20 7594 1190




2.15Faculty BuildingSouth Kensington Campus






BibTex format

author = {Yacoub, S and Lam, PK and Vu, LH and Le, TL and Ha, NT and Toan, TT and Van, NT and Quyen, NT and Duyen, HT and Kinh, NV and Fox, A and Mongkolspaya, J and Wolbers, M and Simmons, C and Screaton, G and Wertheim, H and Wills, B},
doi = {infdis/jiw220},
journal = {Journal of Infectious Diseases},
pages = {697--706},
title = {Association of microvascular function and endothelial biomarkers with clinical outcome in dengue: an observational study},
url = {},
volume = {214},
year = {2016}

RIS format (EndNote, RefMan)

AB - Background. The hallmark of severe dengue is increased microvascular permeability however alterations in the microcirculation and their evolution over the course of dengue are unknown.Methods. We conducted a prospective observational study to evaluate the sublingual microcirculation using sidestream dark field imaging in patients presenting early (<72 hours fever) and patients hospitalized with warning signs or severe dengue in Vietnam. Clinical, microvascular function, global haemodynamics assessed by echocardiograms and serological markers of endothelial activation were performed at 4 time points.Results. 165 patients were enrolled. No difference was found between the microcirculatory parameters comparing dengue with other febrile illnesses. Proportion of perfused vessels (PPV) and Mean Flow Index (MFI) were lower in dengue patients with plasma leakage (PPV: 88.1% vs. 90.6%, P=0.010 and MFI: 2.1 vs. 2.4, P=0.007) most marked during the critical phase. PPV and MFI correlated with the endothelial activation markers, VCAM-1 (P<0.001 for both) and Angiopoietin-2 (P<0.001 and P=0.001 respectively) with a negative association.Conclusion. Modest microcirculatory alterations occur in dengue, are associated with plasma leakage and correlate with molecules of endothelial activation, Angiopoietin-2 and VCAM-1.
AU - Yacoub,S
AU - Lam,PK
AU - Vu,LH
AU - Le,TL
AU - Ha,NT
AU - Toan,TT
AU - Van,NT
AU - Quyen,NT
AU - Duyen,HT
AU - Kinh,NV
AU - Fox,A
AU - Mongkolspaya,J
AU - Wolbers,M
AU - Simmons,C
AU - Screaton,G
AU - Wertheim,H
AU - Wills,B
DO - infdis/jiw220
EP - 706
PY - 2016///
SN - 1537-6613
SP - 697
TI - Association of microvascular function and endothelial biomarkers with clinical outcome in dengue: an observational study
T2 - Journal of Infectious Diseases
UR -
UR -
VL - 214
ER -