Cytokine responses to Dengue Infection among Puerto Rican Patients

Abstract

Recently, a strong correlation between high concentration of tumor necrosis factor (TNF alpha) in blood and severity of dengue hemorrhagic fever/dengue shock syndrome has been reported from Asia and the Pacific. We wished to determine if a similar relationship could be found in dengue patients in the Americas where adult patients with severe syndromes have been observed more frequently than in Asia where severe cases have been observed mostly among children. The concentrations of interleukin-1 (IL-1 beta) in hospitalized adult groups were significantly lower than that in outpatient adults. In contrast, the levels of interleukin 6 (IL-6) were significantly higher in hospitalized adults and children than in the corresponding outpatients. Levels of TNF alpha were higher in hospitalized children than in outpatient children or hospitalized adults. There was no significant difference in the levels of these three cytokines among hospitalized patients with or without hemorrhagic manifestations. Thus, an elevated IL-6 level was positively associated with severity of dengue infection in both children and adults, but IL-1 beta level was negatively associated with severity in adults.

Inflammatory mediators in dengue virus infection in children: interleukin-6 and its relation to C-reactive protein and secretory phospholipase A2.

“…[15][16][17][18] There are only limited data on the importance of IL-6 in dengue-infected patients. [19][20][21][22][23] These data are somewhat conflicting. Some studies show a correlation between severity of illness and IL-6 levels, i.e., highest levels in DHF/DSS.…”

“…Some studies show a correlation between severity of illness and IL-6 levels, i.e., highest levels in DHF/DSS. [19][20][21] In one large prospective study, 22 IL-6 levels tended to be lower in patients in shock than those not in shock. Also there are discrepancies with respect to the proportion of patients showing elevated IL-6 levels.…”

Detection of circulant tumor necrosis factor-alpha , soluble tumor necrosis factor p75 and interferon-gamma in Brazilian patients with dengue fever and dengue hemorrhagic fever

“…Pro-inflammatory cytokines have been detected in patients from Asia and Central America (Hober et al 1993, Kuno & Bailey 1994 and also in Brazilian patients (Kubelka et al 1995, Pinto et al 1999. The association of cytokine production and severity has been suggested.…”

“…Moreover, the follow up of a child infected by Dengue-4 demonstrated that an increase in severity was followed by elevation of serum levels of TNF-α, IL-6 and IL-1β (Iyngkaran et al 1995). The only study previously performed in Central America correlated higher cytokine levels with child hospitalization (Kuno & Bailey 1994) but no other severity parameter was described. We observed in an earlier work, one fatal case in Rio de Janeiro with a serum level of 900 pg/ml TNF-α (Kubelka et al 1995).…”

Biomarcadores pronósticos de severidad del dengue

“…En este estudio se observó un incremento significativo de los niveles de FNTα para la forma grave de la enfermedad, hallazgos ya descritos en la literatura científica (38,39). Los niveles de ST2 fueron más elevados en dengue grave comparados con dengue no grave; estos resultados sugieren que los niveles de ST2 podrían estar correlacionados con la gravedad del cuadro clínico.…”