Affiliation:
1. Pharmacology Laboratory, Faculty of Human Medicine, Autonomous University of Chiapas, Tuxtla Gutiérrez, Chiapas,
México
2. Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico
Nacional, México City, México
Abstract
<p>Background: Severe dengue is characterized by thrombocytopenia, hemorrhaging,
and/or capillary extravasation and may be linked to a reduced plasma concentration of serotonin
(5-hydroxytriptamine, or 5-HT).
<p>
Objective: The aim of the current contribution was to conduct a systematic bibliographic review of
reports on the role of the peripheral serotonergic system in the pathophysiology of severe dengue.
<p>
Methods: A bibliographic review was carried out of in vivo/in vitro models, clinical trials, and
case series studies from 2010-2019. The selective criteria were the use of treatments with serotonin
reuptake inhibitors and/or agonists/antagonists of 5-HT receptors and their impact on inflammation,
coagulation, and endothelium. Moreover, cross-sectional and cohort studies on the relationship
between intraplatelet and plasma 5-HT levels in patients with dengue were also included.
The risk of bias in the selected reports was examined with domain-based assessment utilizing
Cochrane-type criteria. The main results are summarized in Tables and Figures.
<p>
Results: Based on descriptions of the effect of serotonergic drugs on 5-HT levels and the findings
of clinical trials of dengue treatment, most receptors of the peripheral serotonergic system, and
especially 5-HT2A, seem to participate in regulating serum 5-HT during severe dengue. Therefore,
the peripheral serotonergic system probably contributes to thrombocytopenia and capillary extravasation.
<p>
Conclusion: Regarding dengue, 5-HT may be a key parameter for predicting severity, and an understanding
of 5-HT-related mechanisms could possibly facilitate the development of new therapies.
These proposals require further research due to the limited number of publications on the role
of serotonergic receptors at the peripheral level.</p>
Publisher
Bentham Science Publishers Ltd.
Subject
Drug Discovery,Pharmacology,General Medicine
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