Low levels of serum vitronectin associated with clinical phases in patients with hemorrhagic fever with renal syndrome.

beta(3) integrin has been identified as a cellular receptor for Hantaan virus which causes hemorrhagic fever with renal syndrome (HFRS). As one of the ligands of beta(3) integrin, vitronectin (VN) may be altered in HFRS. In this study, changes of serum VN levels were determined in 112 patients with HFRS and 30 age- and sex-matched healthy controls by quantitative sandwich enzyme immunoassay. The levels of serum VN were analyzed in patients at various phases of HFRS and with different severity of clinical types. Serum VN levels in patients with HFRS, at all clinical phases except the convalescent phase, were significantly decreased compared with those in the controls (P < 0.01). The serum levels of VN decreased at febrile phase, maintained at the lowest status during hypotensive and oliguric phases, started to increase from polyuric phase and reached almost normal condition till convalescent phase. The levels of serum VN between patients with milder and more severe clinical types showed no significant difference at each phase (P > 0.05). These results suggest that VN level was altered during the course of HFRS and chronological changes of serum levels of VN may correlate with the evolution of the disease.