biostudies-literatureYacoub SMedical Research CouncilNational Institute for Health Research (NIHR)Wellcome Trust1453-1461https://www.ebi.ac.uk/biostudies/studies/S-EPMC5850435biostudies-literatureUnknown65(9)<h4>Background</h4>Dengue can cause increased vascular permeability that may lead to hypovolemic shock. Endothelial dysfunction may underlie this; however, the association of endothelial nitric oxide (NO) pathways with disease severity is unknown.<h4>Methods</h4>We performed a prospective observational study in 2 Vietnamese hospitals, assessing patients presenting early (<72 hours of fever) and patients hospitalized with warning signs or severe dengue. The reactive hyperemic index (RHI), which measures endothelium-dependent vasodilation and is a surrogate marker of endothelial function and NO bioavailability, was evaluated using peripheral artery tonometry (EndoPAT), and plasma levels of l-arginine, arginase-1, and asymmetric dimethylarginine were measured at serial time-points. The main oClinical infectious diseases : an official publication of the Infectious Diseases Society of AmericaEndothelial Nitric Oxide Pathways in the Pathophysiology of Dengue: A Prospective Observational Study.PMC5850435G0801508100562/Z/12/ZG0600000NF-SI-0507-10303Yeo TWScreaton GSimmons CLe DHTNguyen Ho HHVan NTLien LTWills BYacoub SDong Thi HTHa QNTLam PKCulshaw AHuynh TTMongkolspaya JWertheim HfalseEndothelial Nitric Oxide Pathways in the Pathophysiology of Dengue: A Prospective Observational Study.<h4>Background</h4>Dengue can cause increased vascular permeability that may lead to hypovolemic shock. Endothelial dysfunction may underlie this; however, the association of endothelial nitric oxide (NO) pathways with disease severity is unknown.<h4>Methods</h4>We performed a prospective observational study in 2 Vietnamese hospitals, assessing patients presenting early (<72 hours of fever) and patients hospitalized with warning signs or severe dengue. The reactive hyperemic index (RHI), which measures endothelium-dependent vasodilation and is a surrogate marker of endothelial function and NO bioavailability, was evaluated using peripheral artery tonometry (EndoPAT), and plasma levels of l-arginine, arginase-1, and asymmetric dimethylarginine were measured at serial time-points. The main o2017-01-01T00:00:00Z2017 Oct2025-04-18T20:16:37.485Z2019-03-26T23:22:56ZS-EPMC58504352867303810.1093/cid/cix567