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Gut Leakage' in Dengue (GLiD)

maanantai 3. elokuuta 2026 päivittänyt: University of Oxford

Gut Leakage and Sonographic Abdominal Changes in Hospitalized Dengue Patients: an Observational Study

Dengue infections are imposing an increasing global burden of disease, particularly in tropical countries such as Bangladesh. The World Health Organization (WHO) has identified Dengue virus as a priority pathogen for the development of medical counter measures because of the high risk of it causing a Public Health Emergency of Intenational Concern (PHEIC). Warning signs for severe dengue, associated with mortality, include gastrointestinal features including abdominal pain, vomiting, and diarrhoea. Multiple alterations may occur in in the gastrointestinal tract that could lead to damaging of the gastrointestinal wall and gut leakage, the translocation of gut metabolites into the bloodstream. Study team hypothesize that gut leakage initiates inflammatory processes underlying the further development of severe dengue, including features associated with plasma leakage.

This study aims to investigate intestinal barrier dysfunction (gut leakage) in dengue infection by detecting the translocation of gut-derived bacteria and their products (Lipopolysaccharides, LPS binding protein, sCD14, I-Fatty Acid Binding Protein) into the bloodstream. Study team will recruit hospitalized adult dengue patients (18 years and older) presenting with warning signs or severe disease in a tertiary care public hospital at Chattogram, Bangladesh. Circulating biomarkers indicative of gut permeability and microbial translocation will be measured to assess their presence and association with disease severity.

Abdominal ultrasonography will be performed to characterize gastrointestinal alterations and determine their correlation with biochemical markers of gut leakage and clinical severity. In addition, study team will analyze the gut bacteriome from stool/ rectal swab of these patients to explore whether dengue infection induces compositional changes in intestinal microbiota and whether such alterations are linked to gut leakage or disease progression.

Tutkimuksen yleiskatsaus

Opintotyyppi

Havainnollistava

Ilmoittautuminen (Arvioitu)

190

Yhteystiedot ja paikat

Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.

Opiskelupaikat

    • Chattogram Division
      • Chittagong, Chattogram Division, Bangladesh, 4203
        • Rekrytointi
        • Department of Medicine, Chittagong Medical College
        • Ottaa yhteyttä:

Osallistumiskriteerit

Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.

Kelpoisuusvaatimukset

Opintokelpoiset iät

  • Aikuinen
  • Vanhempi Aikuinen

Hyväksyy terveitä vapaaehtoisia

Joo

Näytteenottomenetelmä

Ei-todennäköisyysnäyte

Tutkimusväestö

Adult (≥18 years) male and non-pregnant female patients with confirmed dengue (positive NS1 antigen and/or IgM) admitted to the Department of Medicine, Chittagong Medical College Hospital will be recruited. Blood biomarkers will be collected at enrollment for all patients. Those initially classified as non-severe dengue will have no repeat sampling unless they progress to severe disease, in which case a second sample will be obtained within 24 hours. Serum ALT and blood culture will be performed on day 7 of illness. Stool samples will be collected on day 7 from 100 patients for gut microbiota analysis.

Additionally, 10 healthy adult participants (5 male, 5 female) will be recruited from patient attendants. They will undergo a single visit for baseline biomarker sampling and POCUS, serving as healthy controls for comparison.

Kuvaus

Inclusion Criteria:

Dengue participants

  • Participant/ legally authorised representative willing and able to give informed consent for participation in the study.
  • Male or Female, adults ≥18 years
  • Diagnosed as a case of Dengue on the basis of clinical features and positive NS1 antigen and/or IgM dengue antibody
  • Hospitalized in medicine or dengue ward in Chittagong Medical College Hospital.
  • Enrolled within 24 hours of hospitalization.

Healthy participants

  • Participant/ legally authorised representative willing and able to give informed consent for participation in the study.
  • Male or Female, adults ≥18 years
  • Clinically healthy with no acute or chronic illness
  • Attendant of a dengue patient (not a patient)

Exclusion Criteria:

Dengue participants

  • Unable to provide consent or participate in follow-up procedures
  • Known chronic gastrointestinal (GI) disease affecting intestinal permeability (IBD, celiac disease), chronic liver disease, active chronic diarrhoea, short bowel loop syndrome, recent (<3 months) major GI surgery.
  • Immunosuppression (for example chemotherapy, high-dose steroids), advanced chronic kidney disease, decompensated heart failure.
  • Drugs that can alter the level of biomarkers in blood like metformin, statin, probiotics, steroid within last 48 hours of hospitalization.
  • Pregnancy

Healthy participants

  • Unable to provide consent
  • Known chronic gastrointestinal (GI) disease affecting intestinal permeability (IBD, celiac disease), chronic liver disease, active chronic diarrhoea, short bowel loop syndrome, recent (<3 months) major GI surgery.
  • Immunosuppression (for example chemotherapy, high-dose steroids), advanced chronic kidney disease, decompensated heart failure.
  • Drugs that can alter the level of biomarkers in blood like metformin, statin, probiotics, steroid within last 48 hours of hospitalization.
  • Pregnancy
  • History of current or recent dengue or other arbo viral infection

Opintosuunnitelma

Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.

Miten tutkimus on suunniteltu?

Suunnittelun yksityiskohdat

Kohortit ja interventiot

Ryhmä/Kohortti
Severe dengue
All enrolled dengue patients will have blood biomarkers at enrolment whether they present with non-severe or severe dengue. If participant enrolled as non-severe and do not progress to severe dengue, they will be no second test for biomarkers but if they developed clinical feature of severity, a second biomarker sample will be collected within 24 hours of developing clinical severity. S ALT and Blood culture will be performed on day 7 of illness for all dengue patients. Stool will be collected on day 7 of illness from 100 patients for testing gut microbiota.
Non-severe dengue
All enrolled dengue patients will have blood biomarkers at enrolment whether they present with non-severe or severe dengue. If participant enrolled as non-severe and do not progress to severe dengue, they will be no second test for biomarkers but if they developed clinical feature of severity, a second biomarker sample will be collected within 24 hours of developing clinical severity. S ALT and Blood culture will be performed on day 7 of illness for all dengue patients. Stool will be collected on day 7 of illness from 100 patients for testing gut microbiota.
Healthy individual
These participants will undergo only one study visit for baseline biomarker sampling, baseline POCUS and will not undergo follow-up. Their results will serve as healthy control reference values for comparison with biomarker findings in dengue patients.

Mitä tutkimuksessa mitataan?

Ensisijaiset tulostoimenpiteet

Tulosmittaus
Aikaikkuna
Level of gut leakage marker in blood and gastrointestinal findings in POCUS
Aikaikkuna: On enrollment, day of development of severity if non severe at enrolment, up to 28 days
On enrollment, day of development of severity if non severe at enrolment, up to 28 days

Toissijaiset tulostoimenpiteet

Tulosmittaus
Toimenpiteen kuvaus
Aikaikkuna
Document clinical events occurred in dengue patients
Aikaikkuna: Through study completion, an average of 28 days

Demographic: Age, gender, BMI

Clinical: respiratory rate, blood pressure, heart rate, ascites, pleural effusion, any major bleeding, GCS

Through study completion, an average of 28 days
Document clinical events occurred in dengue patients
Aikaikkuna: Day of enrolment/ 4th or day 7 of illness

For mSOFA:

SpO2, FiO2

Day of enrolment/ 4th or day 7 of illness

Muut tulostoimenpiteet

Tulosmittaus
Aikaikkuna
Level of I-FABP Level of LPS, Level of LBP, Level of sCD14, Positive Blood culture
Aikaikkuna: On enrollment in all cases, if clinical severity occur in initial non-severe group, 24 hours within developing severity
On enrollment in all cases, if clinical severity occur in initial non-severe group, 24 hours within developing severity
Alteration of gut microbiota
Aikaikkuna: Day seven of illness
Day seven of illness
Organ failure
Aikaikkuna: Through study completion, an average of 28 day
Through study completion, an average of 28 day
Development of shock
Aikaikkuna: Through study completion, an average of 28 day
Through study completion, an average of 28 day
Detectable fluid collection in abdomen, loss of haustration, loss of normal multi-layered appearance
Aikaikkuna: Baseline (within 24 hours of enrollment) and at the time of first development of clinical severity, assessed from enrollment until clinical severity occurs, hospital discharge, death, or up to 7 days of hospitalization, whichever occurs first.
Baseline (within 24 hours of enrollment) and at the time of first development of clinical severity, assessed from enrollment until clinical severity occurs, hospital discharge, death, or up to 7 days of hospitalization, whichever occurs first.
Measurement of gall bladder wall thickness, intestinal wall thickness
Aikaikkuna: Baseline (within 24 hours of enrollment) and at the time of first development of clinical severity, assessed from enrollment until clinical severity occurs, hospital discharge, death, or up to 7 days of hospitalization, whichever occurs first.
Baseline (within 24 hours of enrollment) and at the time of first development of clinical severity, assessed from enrollment until clinical severity occurs, hospital discharge, death, or up to 7 days of hospitalization, whichever occurs first.

Yhteistyökumppanit ja tutkijat

Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.

Opintojen ennätyspäivät

Nämä päivämäärät seuraavat ClinicalTrials.gov-sivustolle lähetettyjen tutkimustietueiden ja yhteenvetojen edistymistä. National Library of Medicine (NLM) tarkistaa tutkimustiedot ja raportoidut tulokset varmistaakseen, että ne täyttävät tietyt laadunvalvontastandardit, ennen kuin ne julkaistaan ​​julkisella verkkosivustolla.

Opi tärkeimmät päivämäärät

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Ensisijainen valmistuminen (Arvioitu)

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Opintojen valmistuminen (Arvioitu)

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Opintoihin ilmoittautumispäivät

Ensimmäinen lähetetty

Tiistai 28. huhtikuuta 2026

Ensimmäinen toimitettu, joka täytti QC-kriteerit

Perjantai 15. toukokuuta 2026

Ensimmäinen Lähetetty (Todellinen)

Perjantai 22. toukokuuta 2026

Tutkimustietojen päivitykset

Viimeisin päivitys julkaistu (Todellinen)

Torstai 6. elokuuta 2026

Viimeisin lähetetty päivitys, joka täytti QC-kriteerit

Maanantai 3. elokuuta 2026

Viimeksi vahvistettu

Keskiviikko 1. huhtikuuta 2026

Lisää tietoa

Tähän tutkimukseen liittyvät termit

Yksittäisten osallistujien tietojen suunnitelma (IPD)

Aiotko jakaa yksittäisten osallistujien tietoja (IPD)?

JOO

IPD-suunnitelman kuvaus

Participant data and results from blood analyses stored in the database may be shared according to the terms defined in the MORU data sharing policy with other researchers to use in the future. Datasets will be de-identified to ensure patient privacy and confidentiality

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