Hyperferritinaemia in dengue virus infected patients is associated with immune activation and coagulation disturbances

Contains fulltext : 138893.pdf (publisher's version ) (Open Access)BACKGROUND: During a dengue outbreak on the Caribbean island Aruba, highly elevated levels of ferritin were detected in dengue virus infected patients. Ferritin is an acute-phase reactant and hyperferritinaemia is a hallmark of diseases caused by extensive immune activation, such as haemophagocytic lymphohistiocytosis. The aim of this study was to investigate whether hyperferritinaemia in dengue patients was associated with clinical markers of extensive immune activation and coagulation disturbances. METHODOLOGY/PRINCIPAL FINDINGS: Levels of ferritin, standard laboratory markers, sIL-2R, IL-18 and coagulation and fibrinolytic markers were determined in samples from patients with uncomplicated dengue in Aruba. Levels of ferritin were significantly increased in dengue patients compared to patients with other febrile illnesses. Moreover, levels of ferritin associated significantly with the occurrence of viraemia. Hyperferritinaemia was also significantly associated with thrombocytopenia, elevated liver enzymes and coagulation disturbances. The results were validated in a cohort of dengue virus infected patients in Brazil. In this cohort levels of ferritin and cytokine profiles were determined. Increased levels of ferritin in dengue virus infected patients in Brazil were associated with disease severity and a pro-inflammatory cytokine profile. CONCLUSIONS/SIGNIFICANCE: Altogether, we provide evidence that ferritin can be used as a clinical marker to discriminate between dengue and other febrile illnesses. The occurrence of hyperferritinaemia in dengue virus infected patients is indicative for highly active disease resulting in immune activation and coagulation disturbances. Therefore, we recommend that patients with hyperferritinaemia are monitored carefully

Process Designs for Converting Propylene Glycol to Acrylic Acid via Lactic Acid and Allyl Alcohol

The chemical industry is currently facing the challenge of developing biobased production processes suitable for a more sustainable chemical industry. Acrylic acid produced from monopropylene glycol is a good candidate to become a cost-competitive and sustainable platform chemical. The propylene glycol price is expected to drop due to the expected abundance of propylene glycol as a sugar hydrogenolysis byproduct, which is required to make the conversion to acrylic acid cost-competitive. Two different processes for the conversion of propylene glycol to acrylic acid are evaluated in this work, either by (1) low temperature oxidation of propylene glycol to lactic acid and high temperature dehydration to acrylic acid or by (2) high temperature dehydration of propylene glycol to allyl alcohol and further high temperature oxidation to acrylic acid. Liquid-liquid extraction was found to be a key operation in both production processes. At similar overall yields, the allyl alcohol route appears inherently favored, as a result of the opportunity to integrate the reaction heat available at high temperature. To conclude, the price of propylene glycol has to drop by 45-55% to make the biobased production of acrylic acid from propylene glycol economically feasible

Archeologische Kroniek 2005: Holland, Historisch Tijdschrift

In de Archeologische Kroniek wordt een overzicht gegeven van archeologische vondsten in Noord- en Zuid-Holland, per plaats. Dit wordt weergegeven in alfabetische volgorde per provincie