{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:04:06Z","timestamp":1792083846041,"version":"4.4.0"},"reference-count":33,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,4]],"date-time":"2025-01-04T00:00:00Z","timestamp":1735948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Departamento Administrativo de Ciencia, Tecnolog\u00eda e Innovaci\u00f3n, Colciencias, and Universidad Industrial de Santander","award":["0037 de 2012"],"award-info":[{"award-number":["0037 de 2012"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Dengue infection has been associated with oxidative stress (OS) induction; however, whether such a response predicts the development of complications remains unknown. We conducted a case-control study (1:2 ratio) nested within a cohort of febrile patients with a presumptive or confirmed diagnosis of dengue. Incident cases were patients who developed hypotension or severe bleeding during the follow-up, whereas controls did not. Total antioxidant status (TAS), superoxide dismutase (SOD), and glutathione peroxidase activity (GPx) were quantified in serums obtained \u226496 h from disease onset. The association between each biomarker and complications was evaluated by estimating adjusted odds ratios (ORs) using logistic regression. We evaluated 132 patients (median age: 19.0 years; 58.2% males). TAS and SOD were higher among cases than controls (2.1 versus 1.7 mM and 6.7 versus 6.0 U\/mL, respectively), and the opposite was observed for GPx (128.1 versus 133.7 mmol\/min\/mL); however, none of these contrasts reached statistical significance. In the multivariate analysis, higher levels of TAS and SOD were associated with a higher likelihood of complications up to 3.5 mM (OR = 2.46; 95%CI: 1.10\u20135.53) and 8.0 U\/mL (OR = 1.69; 95%CI: 1.01\u20132.83), respectively. GPx did not show an association with hypotension or severe bleeding. Our results suggest that the induction of OS during the acute phase of dengue infection might be a prognostic factor of hypotensive and hemorrhagic complications.<\/jats:p>","DOI":"10.3390\/tropicalmed10010014","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T04:37:10Z","timestamp":1736138230000},"page":"14","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Antioxidant Response as a Candidate Prognostic Factor for Dengue Hypotensive and Hemorrhagic Complications: Results from a Nested Case-Control Study in Colombia"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6770-258X","authenticated-orcid":false,"given":"Anyela","family":"Lozano-Parra","sequence":"first","affiliation":[{"name":"Grupo de Epidemiolog\u00eda Cl\u00ednica, Escuela de Medicina, Universidad Industrial de Santander UIS, Calle 9 Carrera 27, Bucaramanga 680002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6295-1640","authenticated-orcid":false,"given":"V\u00edctor","family":"Herrera","sequence":"additional","affiliation":[{"name":"Grupo de Epidemiolog\u00eda Cl\u00ednica, Escuela de Medicina, Universidad Industrial de Santander UIS, Calle 9 Carrera 27, Bucaramanga 680002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3873-0901","authenticated-orcid":false,"given":"Luis \u00c1ngel","family":"Villar","sequence":"additional","affiliation":[{"name":"Centro de Atenci\u00f3n y Diagn\u00f3stico de Enfermedades Infecciosas (CDI), Fundaci\u00f3n INFOVIDA, Cra. 37 No. 51-126, Bucaramanga 680003, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,4]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024, November 01). Dengue and Dengue Severe. Available online: http:\/\/www.who.int\/mediacentre\/factsheets\/fs117\/en\/."},{"key":"ref_2","unstructured":"Pan American Health Organization (2024, November 11). Five-Fold Increase in Dengue Cases in the Americas over the Past Decade. Available online: https:\/\/www.paho.org\/en\/news\/29-5-2014-five-fold-increase-dengue-cases-americas-over-past-decade."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.12688\/f1000research.19197.1","article-title":"Recent Advances in Understanding Dengue","volume":"8","author":"Halstead","year":"2019","journal-title":"F1000Research"},{"key":"ref_4","unstructured":"Pan American Health Organization (2024, November 11). Dengue Fever Cases in the Americas. Available online: https:\/\/www3.paho.org\/data\/index.php\/en\/mnu-topics\/indicadores-dengue-en\/dengue-nacional-en\/252-dengue-pais-ano-en.html?start=1."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1111\/j.1365-3156.2011.02793.x","article-title":"Multicentre Prospective Study on Dengue Classification in Four South-East Asian and Three Latin American Countries","volume":"16","author":"Alexander","year":"2011","journal-title":"Trop. Med. Int. Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.coviro.2020.06.008","article-title":"Risk Factors and Biomarkers of Severe Dengue","volume":"43","author":"Rathore","year":"2020","journal-title":"Curr. Opin. Virol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/S1473-3099(20)30601-0","article-title":"Risk Predictors of Progression to Severe Disease during the Febrile Phase of Dengue: A Systematic Review and Meta-Analysis","volume":"21","author":"Sangkaew","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2448","DOI":"10.1073\/pnas.93.6.2448","article-title":"Pathogenesis of Influenza Virus-Induced Pneumonia: Involvement of Both Nitric Oxide and Oxygen Radicals","volume":"93","author":"Akaike","year":"1996","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_9","first-page":"362","article-title":"Sistema NADPH Oxidasa: Nuevos Retos y Perspectivas NADPH Oxidase System: New Challenges and Perspectives","volume":"23","year":"2010","journal-title":"Iatreia"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Meuren, L.M., Prestes, E.B., Papa, M.P., de Carvalho, L.R.P., Mustaf\u00e1, Y.M., da Costa, L.S., Da Poian, A.T., Bozza, M.T., and Arruda, L.B. (2022). Infection of Endothelial Cells by Dengue Virus Induces ROS Production by Different Sources Affecting Virus Replication, Cellular Activation, Death and Vascular Permeability. Front. Immunol., 13.","DOI":"10.3389\/fimmu.2022.810376"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2895","DOI":"10.1007\/s00705-019-04406-7","article-title":"Oxidative Stress Response in the Pathogenesis of Dengue Virus Virulence, Disease Prognosis and Therapeutics: An Update","volume":"164","author":"Pillai","year":"2019","journal-title":"Arch. Virol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"He, P., Talukder, M.A.H., and Gao, F. (2020). Oxidative Stress and Microvessel Barrier Dysfunction. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.00472"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"652","DOI":"10.4269\/ajtmh.2004.71.652","article-title":"Oxidative Stress in Adult Dengue Patients","volume":"71","author":"Gil","year":"2004","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.nut.2004.03.016","article-title":"Classic Dengue Fever Affects Levels of Circulating Antioxidants","volume":"20","author":"Klassen","year":"2004","journal-title":"Nutrition"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1093\/tropej\/45.1.4","article-title":"Status of Antioxidants and Other Biochemical Abnormalities in Children with Dengue Fever","volume":"45","author":"Ray","year":"1999","journal-title":"J. Trop. Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"743","DOI":"10.4067\/S0034-98872007000600008","article-title":"Correlaci\u00f3n Entre Los Niveles de Glutati\u00f3n Peroxidasa, Un Marcador de Estr\u00e9s Oxidativo, y La Presentaci\u00f3n Cl\u00ednica Del Dengue","volume":"135","author":"Rojas","year":"2007","journal-title":"Rev. M\u00e9d. Chile"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"237","DOI":"10.11594\/jtls.07.03.08","article-title":"A Different Approach to Assess Oxidative Stress in Dengue Hemorrhagic Fever Patients Through the Calculation of Oxidative Stress Index","volume":"7","author":"Hartoyo","year":"2017","journal-title":"J. Trop. Life Sci."},{"key":"ref_18","unstructured":"(2012). Dengue en Colombia. Epidemiologia de La Reemergencia a La Hiperendemia, LOS AUTORES."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"370","DOI":"10.4269\/ajtmh.2008.78.370","article-title":"Biochemical Alterations as Markers of Dengue Hemorrhagic Fever","volume":"78","year":"2008","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1157\/13085015","article-title":"Evaluaci\u00f3n de La Prueba de IgM En Suero Agudo Para El Diagn\u00f3stico Del Dengue En Un \u00c1rea End\u00e9mica","volume":"24","author":"Ocazionez","year":"2006","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1128\/jcm.30.3.545-551.1992","article-title":"Rapid Detection and Typing of Dengue Viruses from Clinical Samples by Using Reverse Transcriptase-Polymerase Chain Reaction","volume":"30","author":"Lanciotti","year":"1992","journal-title":"J. Clin. Microbiol."},{"key":"ref_22","unstructured":"World Health Organization (2009). Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Special Programme for Research and Training in Tropical Diseases, World Health Organization. Available online: https:\/\/iris.who.int\/bitstream\/handle\/10665\/44188\/9789241547871_eng.pdf?sequence=1."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/01.PCC.0000149131.72248.E6","article-title":"International Pediatric Sepsis Consensus Conference: Definitions for Sepsis and Organ Dysfunction in Pediatrics","volume":"6","author":"Goldstein","year":"2005","journal-title":"Pediatr. Crit. Care Med."},{"key":"ref_24","first-page":"158","article-title":"Studies on the Quantitative and Qualitative Characterization of Erythrocyte Glutathione Peroxidase","volume":"70","author":"Paglia","year":"1967","journal-title":"J. Lab. Clin. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1093\/clinchem\/34.3.497","article-title":"A Simple Method for Clinical Assay of Superoxide Dismutase","volume":"34","author":"Sun","year":"1988","journal-title":"Clin. Chem."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1042\/cs0840407","article-title":"A Novel Method for Measuring Antioxidant Capacity and Its Application to Monitoring the Antioxidant Status in Premature Neonates","volume":"84","author":"Miller","year":"1993","journal-title":"Clin. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1007\/s12291-017-0633-x","article-title":"A Study on Gene Expression Profile of Endogenous Antioxidant Enzymes: CAT, MnSOD and GPx in Dengue Patients","volume":"32","author":"Cherupanakkal","year":"2017","journal-title":"Indian J. Clin. Biochem."},{"key":"ref_28","first-page":"135","article-title":"A Systematic Review of Observational Studies on Oxidative\/Nitrosative Stress Involvement in Dengue Pathogenesis","volume":"46","author":"Castro","year":"2015","journal-title":"Colomb. M\u00e9d. CM"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1080\/09537100802155284","article-title":"Oxidative Stress in Severe Dengue Viral Infection: Association of Thrombocytopenia with Lipid Peroxidation","volume":"19","author":"Soundravally","year":"2008","journal-title":"Platelets"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ijid.2013.09.022","article-title":"Association between Proinflammatory Cytokines and Lipid Peroxidation in Patients with Severe Dengue Disease around Defervescence","volume":"18","author":"Soundravally","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1644","DOI":"10.1016\/S0140-6736(07)61687-0","article-title":"Dengue","volume":"370","author":"Halstead","year":"2007","journal-title":"Lancet"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Khanam, A., Guti\u00e9rrez-Barbosa, H., Lyke, K.E., and Chua, J.V. (2022). Immune-Mediated Pathogenesis in Dengue Virus Infection. Viruses, 14.","DOI":"10.3390\/v14112575"},{"key":"ref_33","first-page":"59","article-title":"NADPH-Oxidasa Fagoc\u00edtica: Componentes, Ensamblaje y Mecanismo de Acci\u00f3n","volume":"20","year":"2001","journal-title":"Rev. Cuba. De Investig. Biom\u00e9dicas"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/1\/14\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:23:00Z","timestamp":1759918980000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/1\/14"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,4]]},"references-count":33,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["tropicalmed10010014"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10010014","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,4]]}}}