Changes in urinary LTE4 based on serostatus, viral loads and infecting virus serotype
It was previously shown that patients with secondary dengue infection had higher serum chymase levels and it was shown that this is likely to be due to increased infection of mast cell and degranulation by the DENV in the presence of DENV antibodies in mouse models(20, 25). There was no significant difference (p = 0.25) in urinary LTE4 levels in patients with primary dengue (median 1242, IQR 654.9- 1671 pg/mg creatinine) compared to those with secondary dengue (median=1560, IQR 775.0- 2650pg/mg creatinine) (Fig 2a) . However, patients with DHF during secondary dengue had significantly higher levels (p=0.02), than in those with DF.
There was no association between the viral loads and urinary LTE4 levels in either patients with DF (Spearmans r = -0.09, p = 0.46), or DHF (Spearmans r = 0.18, p = 0.27) (Fig 2b) . Of the 120 patients recruited in the study during early illness of which the infecting DENV serotype was known, 20 was infected with DENV 1, 61 with DENV 2 and 11 with DENV 3 (Fig 2c) . There was no significant difference in the urinary LTE4 levels in patients infected with different DENV serotypes (Fig 2c) . There was no association of urinary LTE4 levels with the white cell counts, although weak but significant inverse correlation was seen with the platelet counts (Spearman r = -0.19, p = 0.04)