Plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the Hantaan virus

ObjectivesThis study aimed to investigate the Thrombomodulin (TM) levels in patients who suffered hemorrhagic fever with renal syndrome (HFRS) of varying severities, and to evaluate the predictive properties of TM for the seriousness of HFRS, thereby providing a clue for the monitoring and managemen...

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Main Authors: Han-Dong Zhao, Yan Zhang, Xiao-Hong Wang, Hong-Bo Qian, Tong-Bo Yu, Peng Li, Kang-Xiao Ma, Hong-Li Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2025.1563621/full
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author Han-Dong Zhao
Han-Dong Zhao
Yan Zhang
Xiao-Hong Wang
Hong-Bo Qian
Tong-Bo Yu
Peng Li
Kang-Xiao Ma
Hong-Li Liu
author_facet Han-Dong Zhao
Han-Dong Zhao
Yan Zhang
Xiao-Hong Wang
Hong-Bo Qian
Tong-Bo Yu
Peng Li
Kang-Xiao Ma
Hong-Li Liu
author_sort Han-Dong Zhao
collection DOAJ
description ObjectivesThis study aimed to investigate the Thrombomodulin (TM) levels in patients who suffered hemorrhagic fever with renal syndrome (HFRS) of varying severities, and to evaluate the predictive properties of TM for the seriousness of HFRS, thereby providing a clue for the monitoring and management of this patients in the future.MethodsChemiluminescence was used to determine the concentrations of TM in 196 patients with HFRS and 49 healthy controls. Conventional testing techniques were used to test the basic clinical reference values for leukocytes, platelets (PLT), C-reactive protein (CRP), creatine (Cr), uric acid (UA), and urea, and the values for activated partial thromboplastin time, prothrombin time, and fibrinogen. The colloidal gold method was used to measure HFRS antibody levels in the patients. The correlation of TM with conventional parameters was assessed using Spearman correlation analysis, and ordinal logistic regression analysis was used to analyze the severity risk factors. The predictive potency of TM for HFRS patients’ severity was evaluated by receiver operating characteristics (ROC) curve analysis.ResultsThe concentrations of TM increased with disease severity and peaked in the critical type patients. In addition, plasma levels of TM were proportionally correlated with the levels of leukocytes (r= 0.4218; p<0.01), creatine (r= 0.3797; p<0.01), urea (r= 0.3763; p<0.01), uric acid (r= 0.3624; p<0.01), and C-reactive protein (r= 0.2767; p<0.01). Conversely, there was an inverse correlation between TM, platelet counts (r= -0.4509; p<0.01), and fibrinogen levels (r= -0.2431; p<0.01). Furthermore, TM demonstrated significant predictive value for the severity of HFRS with an area under the ROC curve (AUC) of 0.872(95% CI: 0.822-0.921, P<0.001).ConclusionsTM levels are associated with HFRS severity, suggesting that TM detection might be beneficial for monitoring the status and effective management of HFRS patients.
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spelling doaj-art-071dc7e7285248ea9061eac71238cf3a2025-08-20T02:19:57ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-04-011510.3389/fcimb.2025.15636211563621Plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the Hantaan virusHan-Dong Zhao0Han-Dong Zhao1Yan Zhang2Xiao-Hong Wang3Hong-Bo Qian4Tong-Bo Yu5Peng Li6Kang-Xiao Ma7Hong-Li Liu8Central Laboratory of Virology, Shaanxi Provincial Hospital of Infectious Diseases, The Xi’an Eighth Hospital, Xi’an, ChinaClinical Laboratory Center, Shaanxi Provincial Hospital of Infectious Diseases, The Xi’an Eighth Hospital, Xi’an, ChinaExperimental Center of Xi’an Academy of Traditional Chinese Medicine, Xi’an Hospital of Traditional Chinese Medicine, Xi’an Affiliated Hospital of Shaanxi University of Chinese Medicine, Xi’an, ChinaShaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Shaanxi Provincial Hospital of Infectious Diseases, The Xi’an Eighth Hospital, Xi’an, ChinaClinical Laboratory Center, Shaanxi Provincial Hospital of Infectious Diseases, The Xi’an Eighth Hospital, Xi’an, ChinaClinical Laboratory Center, Shaanxi Provincial Hospital of Infectious Diseases, The Xi’an Eighth Hospital, Xi’an, ChinaClinical Laboratory Center, Shaanxi Provincial Hospital of Infectious Diseases, The Xi’an Eighth Hospital, Xi’an, ChinaShaanxi Provincial Clinical Medical Research Center of Infectious Diseases, Shaanxi Provincial Hospital of Infectious Diseases, The Xi’an Eighth Hospital, Xi’an, ChinaClinical Laboratory Center, Xi’an People’s Hospital (Xi’an Fourth Hospital), Affiliated People’s Hospital of Northwest University, Xi’an, ChinaObjectivesThis study aimed to investigate the Thrombomodulin (TM) levels in patients who suffered hemorrhagic fever with renal syndrome (HFRS) of varying severities, and to evaluate the predictive properties of TM for the seriousness of HFRS, thereby providing a clue for the monitoring and management of this patients in the future.MethodsChemiluminescence was used to determine the concentrations of TM in 196 patients with HFRS and 49 healthy controls. Conventional testing techniques were used to test the basic clinical reference values for leukocytes, platelets (PLT), C-reactive protein (CRP), creatine (Cr), uric acid (UA), and urea, and the values for activated partial thromboplastin time, prothrombin time, and fibrinogen. The colloidal gold method was used to measure HFRS antibody levels in the patients. The correlation of TM with conventional parameters was assessed using Spearman correlation analysis, and ordinal logistic regression analysis was used to analyze the severity risk factors. The predictive potency of TM for HFRS patients’ severity was evaluated by receiver operating characteristics (ROC) curve analysis.ResultsThe concentrations of TM increased with disease severity and peaked in the critical type patients. In addition, plasma levels of TM were proportionally correlated with the levels of leukocytes (r= 0.4218; p<0.01), creatine (r= 0.3797; p<0.01), urea (r= 0.3763; p<0.01), uric acid (r= 0.3624; p<0.01), and C-reactive protein (r= 0.2767; p<0.01). Conversely, there was an inverse correlation between TM, platelet counts (r= -0.4509; p<0.01), and fibrinogen levels (r= -0.2431; p<0.01). Furthermore, TM demonstrated significant predictive value for the severity of HFRS with an area under the ROC curve (AUC) of 0.872(95% CI: 0.822-0.921, P<0.001).ConclusionsTM levels are associated with HFRS severity, suggesting that TM detection might be beneficial for monitoring the status and effective management of HFRS patients.https://www.frontiersin.org/articles/10.3389/fcimb.2025.1563621/fullHFRSHantaan virusthrombomodulindisease monitoringevaluation
spellingShingle Han-Dong Zhao
Han-Dong Zhao
Yan Zhang
Xiao-Hong Wang
Hong-Bo Qian
Tong-Bo Yu
Peng Li
Kang-Xiao Ma
Hong-Li Liu
Plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the Hantaan virus
Frontiers in Cellular and Infection Microbiology
HFRS
Hantaan virus
thrombomodulin
disease monitoring
evaluation
title Plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the Hantaan virus
title_full Plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the Hantaan virus
title_fullStr Plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the Hantaan virus
title_full_unstemmed Plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the Hantaan virus
title_short Plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the Hantaan virus
title_sort plasma thrombomodulin is a valuable biomarker to predict the severity of hemorrhagic fever with renal syndrome caused by the hantaan virus
topic HFRS
Hantaan virus
thrombomodulin
disease monitoring
evaluation
url https://www.frontiersin.org/articles/10.3389/fcimb.2025.1563621/full
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