Patrón de citoquinas en niños con dengue hemorrágico en Neiva, Colombia
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Las citoquinas juegan un papel crítico en la patogénesis de la fiebre dengue hemorrágico (FDH) y han sido usadas como marcadores de severidad. En este estudio se midieron los niveles de cinco citoquinas en niños infectados con dengue y se correlacionaron con el choque y las formas complicadas tales como miocarditis, hepatitis o sangrado. Método: 30 pacientes que cumplían los criterios de la OMS para FDH fueron incluidos y clasificados en dos grupos: grupo 1, sin choque (grado I y II) y grupo 2, con choque (grado III y IV). Niveles séricos de TNFá, IL-6, IL-10. IL-4 e IFN ã fueron medidos por ELISA en el primer día de la defervescencia y comparados con los respectivos niveles de 28 niños sanos. Resultados: de los 30 pacientes, 9 fueron clasificados en el grupo número 1 (media de edad de 67 meses) y 21 en el grupo 2 (media de la edad 42 meses). Diferencias estadísticamente significativas fueron encontradas entre niños infectados con dengue y controles sanos: sanos IL-6 (5,2 pg/ml), grupo 1 (485 pg/ml) (p = 0,002) y grupo 2 (190 pg/ml) (p = 0,001); TNFá, grupo control (70 pg/ml), grupo 1 (586,7 pg/ml) (p = 0,021) y grupo 2 (320,7 pg/ml) (p < 0,001) y para IFNã, grupo control (12,3 pg/ml), grupo 2 (27,5 pg/ml) (p = 0,019). Sin embargo, no se encontró correlación entre las citoquinas y el choque o las otras formas evaluadas. IL-4 e IL-10 no fueron diferentes en ninguno de los grupos analizados. Conclusión: IL-6, TNFá e IFNã están elevadas en niños con FDH, pero no hubo correlación con las formas severas de choque.
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