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Good news for treatment of a fatal form of dengue, study finds



Team of researchers from Duke-NUS medical School in Singapore have discovered how an enzyme plays a key role in the potentially fatal dengue haemorrhagic fever. The finding presents a potential new therapy using nafamostat mesylate, a tryptase inhibitor, for severe dengue -- a fatal condition which currently has no treatment.


The dengue virus infects about 390 million people globally each year, causing substantial morbidity and mortality. While majority of patients experience a milder form of the disease, those who develop dengue haemorrhagic fever will suffer from dengue shock syndrome caused by ruptured blood vessels.


“We discovered that, in severe cases, a particular enzyme called tryptase cuts the proteins that act as seals between blood vessel cells, resulting in blood vessel leakage and shock during dengue infection,” said Assistant Professor Ashley St. John, from Duke-NUS’ Emerging Infectious Diseases Programme, corresponding author of the study.


Using pre-clinial models, the team manged to show the administration of nafamostat mesylate was able to reduce dengue vascular leakage. On top of that, they observed high tryptase levels in the blood of patients with severe dengue but low in patients with mild dengue, confirming the link between high levels of the enzyme and severe dengue disease.


The researchers are looking to conduct clinical trials to test whether tryptase inhibitors can reverse dengue vascular leakage and prevent shock in humans.