Among the several hypothesis postulated to explain the pathogenesis of severe dengue disease, the model of immunopathogenesis is the most supported one with a likely important role played by the cascade of cytokines. This work describes single-nucleotide polymorphism of tumor necrosis factor (TNF)-alpha, interferon-gamma, interleukin (IL)-6, transforming growth factor-beta1, and IL-10 in patients with dengue virus infections and analyzes their relation with clinical manifestations of the disease. Because cytokine gene polymorphisms affect cytokine production, the significant increase of the TNF-308A allele we have observed among patients with dengue fever (DF) with hemorrhagic manifestations compared to patients with DF only indicates that the former patients are genetically predisposed to express higher levels of TNF-alpha. This finding supports studies reporting a possible association between elevated levels of circulating TNF, vascular permeability, and hemorrhage in patients with dengue hemorrhagic fever.

The results suggest that the presence of alleles HLA-G*0104, DRB1*07/06, HCMV sequences and the fetal inheritance of maternal G*0104, should be considered as conditioning factors for the development of preeclampsia.

Previous studies have reported reduced natural killer (NK) cell activity in cord blood (CB) compared with adult blood mononuclear cell populations. Using a non-radioactive killing assay, we have verified these findings suggesting that either the fetal NK cell function is suppressed or that these cells are functionally immature. We have shown that CB NK cells are functional, since activating them with cytokines known to activate adult NK cells [interleukin-2 (IL-2), IL-12 and IL-15] increased activation. However, resting the cells, which enhanced adult NK cell activity (P < 0.01), had no effect on fetal NK cells (P = 0.2). These results suggested that fetal NK cells have the capacity to kill, but this is suppressed in vitro. This hypothesis was strengthened by our observation that eight of nine CB mononuclear cell populations had their NK activity restored by freeze-thawing, whereas four of five adult peripheral blood mononuclear cells had a reduced killing ability on freeze-thawing. Freeze-thawing removes a population of cells that suppresses CB NK cell function. To determine which was the case we performed extensive phenotypic analysis of the CB populations pre- and post-freezing and found that the percentage of the CD3- CD56+ population within CB increased significantly (P < 0.0005 by paired t-test) with freezing, whereas freeze-thawing had no effect on this population within a normal adult peripheral blood mononuclear cell population. Our data suggest that within CB there is a population of cells, as yet undefined, which may be inhibiting NK cell function. This report therefore shows clear differences between NK cells within the adult periphery and in CB, and may lead to a better understanding of events occurring in vivo.

No abstract

No abstract