Cytokine expression in dengue fever and dengue hemorrhagic fever patients with bleeding and severe hepatitis

Imad, HA; Phumratanaprapin, W; Phonrat, B; Chotivanich, K; Charunwatthana, P; Muangnoicharoen, S; Khusmith, S; Tantawichien, T; Phadungsombat, J; Nakayama, E; Konishi, E; Shioda, T

Journal article

Cytokine expression in dengue fever and dengue hemorrhagic fever patients with bleeding and severe hepatitis

Abstract:: Dengue is the most common mosquito-borne flaviviral infection in the world today. Several factors contribute and act synergistically to cause severe infection. One of these is dysregulated host immunological mediators that cause transient pathophysiology during infection. These mediators act on the endothelium to increase vascular permeability, which leads to plasma leakage compromising hemodynamics and coagulopathy. We conducted a prospective study to explore the expression of pro- and anti-inflammatory cytokines and how they relate to clinical dengue manifestations, by assessing their dynamics through acute dengue infection in adults admitted to the Hospital for Tropical Diseases, Bangkok, Thailand. We performed cytokine analysis at three phases of infection for 96 hospitalized adults together with serotyping of confirmed dengue infection during the outbreaks of 2015 and 2016. The serum concentrations of seven cytokines (interleukin [IL]-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor alpha, and interferon gamma) were measured in duplicate using a commercial kit (Bio-Plex Human Cytokine Assay). In this study, the cytokine profile was suggestive of a T-helper 2 response. Most patients had secondary infection, and the levels of viremia were higher in patients with plasma leakage than those without plasma leakage. In addition, we observed that bleeding and hepatitis were associated with significantly higher levels of IL-8 during the early phases of infection. Furthermore, IL-6 levels in the early phase of infection were also elevated in bleeding patients with plasma leakage. These results suggest that IL-6 and IL-8 may act in synergy to cause bleeding in patients with plasma leakage.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Imad, H. A., Phumratanaprapin, W., Phonrat, B., Chotivanich, K., Charunwatthana, P., Muangnoicharoen, S., Khusmith, S., Tantawichien, T., Phadungsombat, J., Nakayama, E., Konishi, E., & Shioda, T. (2020). Cytokine expression in dengue fever and dengue hemorrhagic fever patients with bleeding and severe hepatitis. American Journal of Tropical Medicine and Hygiene, 102(5), 943–950.

MLA Style

Imad, H. A., et al. “Cytokine Expression in Dengue Fever and Dengue Hemorrhagic Fever Patients with Bleeding and Severe Hepatitis.” American Journal of Tropical Medicine and Hygiene, vol. 102, no. 5, American Society of Tropical Medicine and Hygiene, 2020, pp. 943–50.

Chicago Style

Imad, HA, W Phumratanaprapin, B Phonrat, K Chotivanich, P Charunwatthana, S Muangnoicharoen, S Khusmith, et al. 2020. “Cytokine Expression in Dengue Fever and Dengue Hemorrhagic Fever Patients with Bleeding and Severe Hepatitis.” American Journal of Tropical Medicine and Hygiene 102 (5): 943–50.
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