ORIGINAL ARTICLE

Elevated Serum Levels of Matrix Metalloproteinase 9 in Severe Dengue Virus Infection at Sanglah Hospital Denpasar, Bali - Indonesia

Dewi Dian Sukmawati , Eka Saputra, Tuti Parwati Merati

Dewi Dian Sukmawati
Tropical and Infectious Diseases Division – Internal Medicine Department Medical Faculty of Udayana University – Sanglah Hospital Bali Indonesia. Email: dewidian.sukmawati@yahoo.com

Eka Saputra
Tropical and Infectious Diseases Division – Internal Medicine Department Medical Faculty of Udayana University – Sanglah Hospital Bali Indonesia

Tuti Parwati Merati
Tropical and Infectious Diseases Division – Internal Medicine Department Medical Faculty of Udayana University – Sanglah Hospital Bali Indonesia
Online First: August 24, 2016 | Cite this Article
Sukmawati, D., Saputra, E., Merati, T. 2016. Elevated Serum Levels of Matrix Metalloproteinase 9 in Severe Dengue Virus Infection at Sanglah Hospital Denpasar, Bali - Indonesia. Bali Medical Journal 5(1): 119-124. DOI:10.15562/bmj.v5i1.278


Dengue virus - infected dendritic cells along with cytokines overproduction trigger endothelial barrier dysfunction and plasma leakage through matrix metalloproteinase (MMP)-9 over production. The event is responsible for more severe dengue virus infection’s manifestation. The study objective is to measure the association of MMP-9 serum level with disease severity of dengue virus infection.

Prospective study of 70 participants hospitalized in Internal Medicine ward of Sanglah Hospital Denpasar, during 1 July 2011 – 31 December 2011 and diagnosed as dengue virus infection were followed during their hospital stay. Baseline demographic were obtained on admission, serum level of MMP-9 was measured once at third – fifth day from fever onset. Independent-samples t test was used to compare the MMP 9 levels among diagnosis groups and exploration of variables were using logistic regression analysis.  

There was significant higher level of MMP-9 serum level on DHF (median [range]) compared to DF (367.78 ng/mL [81.16 – 797.79] vs. 128.67 ng/mL [41.79 – 327.32]; p < 0.0001). After adjusted with baseline hematocrit, for every 10 ng/mL elevation of MMP-9 serum contributes to 1.159 increased risk of DHF with optimal threshold MMP-9 level is 330 ng/mL (100 % sensitivity, 64% specificity).

MMP-9 level is associated with dengue severity. The measurement was able to predict the DHF among those infected with dengue virus infection. This may lead to a novel marker of dengue hemorrhagic fever predictor.
No Supplementary Material available for this article.
Article Views      : 0
PDF Downloads : 0