Role of cytokines produced by T helper immune-modulators in dengue pathogenesis: A systematic review and meta-analysis

Tran, Linh; Radwan, Ibrahim; Minh, Le Huu Nhat; Low, Soon Khai; Hashan, Mohammad Rashidul; Gomaa, Mohammad; Abdelmongy, Mohamed; Abdelaziz, Abdullah I.; Mohamed, Alaa S; Tawfik, Gehad Mohamed; Mizukami, Shusaku; Hirayama, Kenji; Huy, Nguyen Tien

doi:10.1016/j.actatropica.2021.105823

Cited by 7 publications

(6 citation statements)

References 108 publications

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“…Our analysis showed association of secondary dengue infection with severe dengue. As proven by other studies, patients presenting with a secondary dengue infection were associated with a higher risk of developing severe dengue [ 33 , 56 ], which suggests that the clinical presentation of severe dengue was affected by both host factors (secondary immune response and viral load) [ 57 ].…”

Section: Discussionmentioning

confidence: 87%

Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis

Htun

Xiong

Pang

2021

Emerging Microbes & Infections

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The World Health Organization (WHO) introduced the new dengue classification in 2009. We aimed to assess the association of clinical signs and symptoms with WHO severe dengue classification in clinical practice. A systematic literature search was performed using the databases of PubMed, Embase, and Scopus between 2009 and 2018 according to PRISMA guideline. Meta-analysis was performed with the RevMan software. A random or fixed-effect model was applied to pool odds ratios and 95% confidence intervals of important signs and symptoms across studies. Thirty nine articles from 1790 records were included in this review. In our meta-analysis, signs and symptoms associated with higher risk of severe dengue were comorbidity, vomiting, persistent vomiting, abdominal pain or tenderness, pleural effusion, ascites, epistaxis, gum bleeding, GI bleeding, skin bleeding, lethargy or restlessness, hepatomegaly (>2 cm), increased HCT with decreased platelets, shock, dyspnea, impaired consciousness, thrombocytopenia, elevated AST and ALT, gall bladder wall thickening and secondary infection. This review shows new factors comorbidity, epistaxis, GI and skin bleeding, dyspnea, gall bladder wall thickening and secondary infection may be useful to refine the 2009 classification to triage severe dengue patients.

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Section: Discussionmentioning

confidence: 87%

Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis

Htun

Xiong

Pang

2021

Emerging Microbes & Infections

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“…In addition, we next investigated any association between laboratory parameters and the circulating levels of cytokines/chemokines in the dengue patients. Our analysis revealed that there were positives correlation between plasma levels of IL- 18 thrombomodulin; Fibrinogen (normal range: 200-400 mg/dL); D-dimer (normal range: ≤500 ng/mL).…”

Section: Cytokines and Chemokinesmentioning

confidence: 68%

“…Thus, it has been hypothesized that TNF-α, which was found at significantly higher levels in DwoWS patients, belongs to the protective immunological profile, probably due to its ability to exert a protective effect on virus-induced, monocyte-derived dendritic cell apoptosis [ 51 ], while the findings on IL-1β and CXCL8/IL-8 could be associated with the predominant DENV-4 serotype and further studies are required. In addition, IL-6, which belongs to the pathological immunological profile and was found at significantly higher levels in DwWS/SD patients, has been associated with severe dengue in several studies [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…Secondary infection by a heterologous DENV serotype have been proposed as risk factor for the progression of severe cases, a phenomenon of antibody-dependent enhancement [ 17 ]. Extensive evidence suggests that excessive production of inflammatory mediators from immune cells is related to dengue severity [ 18 ]. In fact, the activation of innate and adaptive immune responses causes increased released of cytokines, a phenomenon described as a cytokine storm.…”

Section: Introductionmentioning

confidence: 99%

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Different Profiles of Cytokines, Chemokines and Coagulation Mediators Associated with Severity in Brazilian Patients Infected with Dengue Virus

Solórzano

Faria

Santos

et al. 2021

Viruses

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The incidence of dengue in Latin America has increased dramatically during the last decade. Understanding the pathogenic mechanisms in dengue is crucial for the identification of biomarkers for the triage of patients. We aimed to characterize the profile of cytokines (IFN-γ, TNF-α, IL-1β, IL-6, IL-18 and IL-10), chemokines (CXCL8/IL-8, CCL2/MCP-1 and CXCL10/IP-10) and coagulation mediators (Fibrinogen, D-dimer, Tissue factor-TF, Tissue factor pathway inhibitor-TFPI and Thrombomodulin) during the dengue-4 epidemic in Brazil. Laboratory-confirmed dengue cases had higher levels of TNF-α (p < 0.001), IL-6 (p = 0.005), IL-10 (p < 0.001), IL-18 (p = 0.001), CXCL8/IL-8 (p < 0.001), CCL2/MCP-1 (p < 0.001), CXCL10/IP-10 (p = 0.001), fibrinogen (p = 0.037), D-dimer (p = 0.01) and TFPI (p = 0.042) and lower levels of TF (p = 0.042) compared to healthy controls. A principal component analysis (PCA) distinguished between two profiles of mediators of inflammation and coagulation: protective (TNF-α, IL-1β and CXCL8/IL-8) and pathological (IL-6, TF and TFPI). Lastly, multivariate logistic regression analysis identified high aspartate aminotransferase-to-platelet ratio index (APRI) as independent risk factors associated with severity (adjusted OR: 1.33; 95% CI 1.03–1.71; p = 0.027), the area under the receiver operating characteristics curve (AUC) was 0.775 (95% CI 0.681–0.869) and an optimal cutoff value was 1.4 (sensitivity: 76%; specificity: 79%), so it could be a useful marker for the triage of patients attending primary care centers.

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“…5 Direct viral invasion of the muscle fibers and generation of myotoxic cytokines such as tumor necrosis factor have been described as the possible mechanism for dengue virus-associated myositis. 6 One study emphasizes the importance of serum CK in patients with fever and myalgias with or without overt muscle weakness and concludes that increased serum CK levels in the context of fever and myalgias should be considered as dengue fever even before serological confirmation, with a positive predictive value of 84% and negative predictive value of 98%. 7 ,8 Though the patients with dengue fever commonly present with myalgia, associated myositis may go undiagnosed due to the lack of clinical suspicion and necessary investigations.…”

Section: Discussionmentioning

confidence: 99%

Unusal Presentation of Dengue Fever as Pyomyositis

Runderawala¹,

Anvekar²

2021

J. Bahria Uni. Med. Dent. Coll.

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Dengue is the most common and widespread arthropod-borne arboviral infection. Symptoms include fever, headache, muscle, and joint pains, and a characteristic skin rash. Although viral myositis is common, myositis caused by the dengue virus is not commonly reported. The case of serologically confirmed dengue fever complicated by pyomyositis associated with a tenfold increase in serum creatine phosphokinase is presented.

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Role of cytokines produced by T helper immune-modulators in dengue pathogenesis: A systematic review and meta-analysis

Cited by 7 publications

References 108 publications

Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis

Clinical signs and symptoms associated with WHO severe dengue classification: a systematic review and meta-analysis

Different Profiles of Cytokines, Chemokines and Coagulation Mediators Associated with Severity in Brazilian Patients Infected with Dengue Virus

Unusal Presentation of Dengue Fever as Pyomyositis

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