Gut Leakage' in Dengue (GLiD)
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.
研究概览
研究类型
注册 (估计的)
联系人和位置
学习地点
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Chattogram Division
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Chittagong、Chattogram Division、孟加拉国、4203
- 招聘中
- Department of Medicine, Chittagong Medical College
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接触：
- Rabiul Alam Md Erfan Uddin, FCPS
- 电话号码：+8801711129798
- 邮箱：rubelerfan@gmail.com
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
取样方法
研究人群
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.
描述
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
学习计划
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
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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.
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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.
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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.
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研究衡量的是什么？
主要结果指标
结果测量 |
大体时间 |
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Level of gut leakage marker in blood and gastrointestinal findings in POCUS
大体时间：On enrollment, day of development of severity if non severe at enrolment, up to 28 days
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On enrollment, day of development of severity if non severe at enrolment, up to 28 days
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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Document clinical events occurred in dengue patients
大体时间：Through study completion, an average of 28 days
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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
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Document clinical events occurred in dengue patients
大体时间：Day of enrolment/ 4th or day 7 of illness
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For mSOFA: SpO2, FiO2 |
Day of enrolment/ 4th or day 7 of illness
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其他结果措施
结果测量 |
大体时间 |
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Level of I-FABP Level of LPS, Level of LBP, Level of sCD14, Positive Blood culture
大体时间：On enrollment in all cases, if clinical severity occur in initial non-severe group, 24 hours within developing severity
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On enrollment in all cases, if clinical severity occur in initial non-severe group, 24 hours within developing severity
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Alteration of gut microbiota
大体时间：Day seven of illness
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Day seven of illness
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Organ failure
大体时间：Through study completion, an average of 28 day
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Through study completion, an average of 28 day
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Development of shock
大体时间：Through study completion, an average of 28 day
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Through study completion, an average of 28 day
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Detectable fluid collection in abdomen, loss of haustration, loss of normal multi-layered appearance
大体时间：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.
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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.
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Measurement of gall bladder wall thickness, intestinal wall thickness
大体时间：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.
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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.
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他相关的 MeSH 术语
其他研究编号
- VIR26001
计划个人参与者数据 (IPD)
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IPD 计划说明
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