Prognostic value of mannose binding lectin and vitamin D in dengue: Study from a tertiary care centre from southern India

Background: Dengue disease severity is related to dysregulated immune response.Mannose binding lectin and vitamin D alter innate and adaptive immune responses.Hence, we wanted to assess the predictive value of these early serum biomarkers for reducing mortality and morbidity.Aim and Objectives: To determine serum mannose binding lectin and vitamin D levels in patients diagnosed with Dengue and to correlate with Dengue severity. Results:The study patients were divided into three groups, dengue without warning signs (group 1), dengue with warning signs (group 2), and severe dengue (group 3).Mannose binding lectin levels were found to have significant P values between group 1 and group 3 (p=0.002),and group 2 and group 3 (p=0.005).Vitamin-D levels showed a significant p-value between Group 1 and Group 2 (p=0.008), group 1 and Group 3 (p=0.000),and Group 2 and 3 (p=0.000).Hence lower levels of mannose binding lectin are associated with severe dengue and patients with low normal levels of vitamin D had severe dengue.Conclusions: This study highlights the immunomodulator role of Mannose binding lectin and vitamin D in shifting immune responses from Th-1 to Th-2 resulting in dengue severity.The role of vitamin D is always thought to be protective but it may act as a double-edged sword.This study also opens new doors of therapeutics for treating dengue infection.