Pattern of serum cytokines in children with dengue hemorrhagic fever in Neiva, Colombia Patrón de citoquinas en niños con dengue hemorrágico en Neiva, Colombia

Abstract

Cytokines play a critical role in the pathogenesis of dengue hemorrhagic fever and have been used as markers of severity disease. In this study we measured serum levels of five cytokines in dengue infected children and correlate their levels with shock and complicated forms such as myocarditis, hepatitis or bleeding. Methods: 30 patients who met WHO criteria for dengue hemorrhagic fever (DHF) were enrolled and classified into two groups: group one without shock (grade I and II) and group two with shock (grade III and IV). Serum levels of TNFá, IL-6, IL-10, IL-4 and IFNã were measured by ELISA at first day of defervescence and were compared with serum levels of 28 healthy children. Results: from 30 patients, 9 were assigned to group number one (median age 67 months) and 21 to group two (median age 42 months). Statistical differences were found between dengue infected patients and controls: controls IL-6 (5.2 pg/ml), group 1 (485 pg/ml) (p=0.002) and group 2 (190 pg/ml) (p=0.001); TNFá, control group (70 pg/ml), group 1 (586.7 pg/ml) (p=0.021) and group 2 (320.7 pg/ml) (p<0.001) and for IFNã, control group (12.3 pg/ml), group 2 (27.5 pg/ml) (p=0.019). However, we could not find correlation between cytokines and shock or complicated forms of illness. IL-4 and IL-10 did not show differences between any tested groups. Conclusion: IL-6, TNFá and IFNã are elevated in children with dengue hemorrhagic fever, but there was not correlation with severe forms of shock.