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The association between endothelial glycocalyx integrity and vascular permeability in older adults with dengue has not been evaluated. A prospective cohort study of adults with undifferentiated fever screened for dengue by RT-PCR or NS1 antigen testing was performed. Patients were assessed daily while symptomatic and at convalescence. Serum hyaluronic acid (HA), heparan sulfate (HS) and selected cytokines (TNF-\u03b1, IL-6, IL-10) were measured on enrollment and convalescence. Patients were diagnosed as dengue fever (DF, n\u2009=\u200930), dengue hemorrhagic fever (DHF, n\u2009=\u200920) and non-dengue (ND) febrile illness (n\u2009=\u200911). Acute HA and HS levels were significantly higher in all dengue patients compared to ND (p\u2009=\u20090.0033 and p\u2009=\u20090.0441 respectively), but not different between DF and DHF (p\u2009=\u20090.3426 and p\u2009=\u20090.9180 respectively). Enrolment HA inversely correlated with serum albumin, protein and platelets in all dengue and DHF (p\u2009&lt;\u20090.05). HA and HS in all dengue patients decreased significantly at convalescence. Serum IL-10 was significantly associated with HA in all dengue patients (p\u2009=\u20090.002). Serum HA and HS levels were increased in adult dengue and HA was associated with markers of disease severity. Endothelial glycocalyx damage may have a role in vascular leakage in dengue.<\/jats:p>","DOI":"10.1038\/srep46191","type":"journal-article","created":{"date-parts":[[2017,4,10]],"date-time":"2017-04-10T10:12:46Z","timestamp":1491819166000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["Increased Serum Hyaluronic Acid and Heparan Sulfate in Dengue Fever: Association with Plasma Leakage and Disease Severity"],"prefix":"10.1038","volume":"7","author":[{"given":"Tommy Hing-Cheung","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Alonso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Fong-Poh","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tun-Linn","family":"Thein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Jun-Xiong","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yee-Sin","family":"Leo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Chien-Boon","family":"Lye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsin-Wen","family":"Yeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,4,10]]},"reference":[{"key":"BFsrep46191_CR1","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1016\/S0140-6736(14)60572-9","volume":"385","author":"MG Guzman","year":"2015","unstructured":"Guzman, M. 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