{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T16:11:56Z","timestamp":1782835916450,"version":"3.54.5"},"reference-count":59,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2017M3A9E4061992"],"award-info":[{"award-number":["NRF-2017M3A9E4061992"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005073","name":"Agency for Defense Development","doi-asserted-by":"publisher","award":["UE202026GD"],"award-info":[{"award-number":["UE202026GD"]}],"id":[{"id":"10.13039\/501100005073","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The ability to accurately predict the early progression of hemorrhagic fever with renal syndrome (HFRS) is crucial for reducing morbidity and mortality rates in severely affected patients. However, the utility of biomarkers for predicting clinical outcomes remains elusive in HFRS. The aims of the current study were to analyze the serum levels of immune function-related proteins and identify novel biomarkers that may help ascertain clinical outcomes of HFRS. Enzyme-linked immunosorbent assay, Luminex, and bioanalyzer assays were used to quantitatively detect 15 biomarkers in 49 serum samples of 26 patients with HFRS. High hemoglobin (HGB) and low urine output (UO) levels were identified as potential biomarkers associated with the acute HFRS. The serum soluble urokinase plasminogen activator receptor (suPAR) and C-X-C motif chemokine ligand 10 (CXCL10) values increased in the early phase of diseases. Elevated suPAR, interleukin-10 (IL-10), CXCL10, and decreased transforming growth factor-beta 3 (TGF-\u03b23) were representative predictors of the disease severity. Upregulation of the HGB showed a significant correlation with high levels of suPAR and CXCL10. Reduced UO positively correlated with increased suPAR, CXCL10, and TGF-\u03b22, and decreased vascular endothelial growth factor and TGF-\u03b23. The changing HGB and UO criteria, high suPAR, IL-10, CXCL10, and low TGF-\u03b23 of HFRS raise significant awareness for physicians regarding prospective biomarkers for monitoring early warning signs of HFRS. This study provides critical insights into the clinical and immunological biomarkers for disease severity and progression in patients with HFRS to identify early predictions of fatal outcomes.<\/jats:p>","DOI":"10.3390\/v14030595","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T02:56:20Z","timestamp":1647312980000},"page":"595","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical and Immunological Predictors of Hemorrhagic Fever with Renal Syndrome Outcome during the Early Phase"],"prefix":"10.3390","volume":"14","author":[{"given":"Geum-Young","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Microbiology, College of Medicine, Korea University, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3178-8569","authenticated-orcid":false,"given":"Won-Keun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Medicine, Hallym University, Chuncheon 24252, Korea"},{"name":"Institute of Medical Science, College of Medicine, Hallym University, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Sun","family":"No","sequence":"additional","affiliation":[{"name":"Division of High-Risk Pathogens, Bureau of Infectious Diseases Diagnosis Control, Korea Disease Control and Prevention Agency, Cheongju 28159, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8553-7189","authenticated-orcid":false,"given":"Yongjin","family":"Yi","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Internal Medicine, Dankook University Hospital, Cheonan 31116, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayne Cho","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaehun","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Gachon University College of Medicine, Incheon 21556, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungchan","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Medicine, Korea University, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyeong","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Medicine, Korea University, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7840-422X","authenticated-orcid":false,"given":"Seung-Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Chem-Bio Technology Center, Agency for Defense Development, Daejeon 34075, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2132-0674","authenticated-orcid":false,"given":"Kyungmin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Medicine, Korea University, Seoul 02841, Korea"},{"name":"BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jongwoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Medicine, Korea University, Seoul 02841, Korea"},{"name":"BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0796-8332","authenticated-orcid":false,"given":"Jin-Won","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Microbiology, College of Medicine, Korea University, Seoul 02841, Korea"},{"name":"BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1128\/CMR.00062-09","article-title":"A global perspective on hantavirus ecology, epidemiology, and disease","volume":"23","author":"Jonsson","year":"2010","journal-title":"Clin. 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