Decreased Thrombospondin-1 Titers Are Hallmarks of Patients with Severe Dengue Infection

Severe dengue is a life-threatening complication. Biological markers that can predict or serve as correlates for rapid identification of disease severity are urgently needed.Thrombospondin-1 (TSP-1) is a matricellular functional protein that plays an important role in the extracellular matrix. In the present investigation, the level of TSP-1 was investigated for its possible utility as a dengue severity marker. Accordingly, confirmed dengue cases were enrolled from July to November of 2020. Plasma from all the study subjects was subjected to the standard enzyme-linked immunosorbent assay test for TSP-1 analysis. This study showed that the TSP-1 titers significantly decreased in severe dengue (SD) patients in contrast to those with a milder form of dengue infection. This is the first study demonstrating that a combination of parameters like TSP-1titers and platelets exhibit sensitivity and specificity of 100% with an AUC of 1.000 in predicting severity. The investigation revealed that low TSP-1titers along with decreased platelet are novel indicators of dengue severity.