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Serum IL-10 as a marker of severe dengue infection.

Malavige GN, Gomes L, Alles L, Chang T, Salimi M, Fernando S, Nanayakkara KD, Jayaratne S, Ogg GS - BMC Infect. Dis. (2013)

Bottom Line: We found that serum IL-10 levels were significantly higher (p = 0.001) in patients with SD, when compared to those with non SD.However, IL-10 levels did not have a good predictive value in discriminating those who were likely to develop SD (AUC = 0.66).Serum IFNγ levels were also significantly higher (p = 0.04) in patients with SD when compared to non SD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Microbiology, University of Sri Jayawardanapura, Nugegoda, Sri Lanka. gathsaurie.malavige@ndm.ox.ac.uk

ABSTRACT

Background: Several studies have shown that serum IL-10, IFNγ and MIF are elevated in patients in severe dengue (SD) and could be used as potential biomarkers. We proceeded to determine if these cytokines could be used as biomarkers in a large cohort of adult dengue patients with varying severity of dengue infection.

Methods: Serum IL-10 levels were determined in 259 of whom 40 had severe dengue infection. Serum IFNγ and IFNα levels were done in 78 and MIF levels were done in 65 patients with acute dengue infection. Clinical features and laboratory investigations were undertaken during the febrile and critical phase.

Results: We found that serum IL-10 levels were significantly higher (p = 0.001) in patients with SD, when compared to those with non SD. Serum IL-10 levels significantly and inversely correlated with white cell counts (R = -0.23, p = 0.0002) and lymphocyte counts (R = -0.29, p < 0.0001) but significantly and positively correlated with aspartate tranaminase levels (R = 0.16, p = 0.01) and alanine transaminase levels (R = 0.22, p = 0.007). However, IL-10 levels did not have a good predictive value in discriminating those who were likely to develop SD (AUC = 0.66). Serum IFNγ levels were also significantly higher (p = 0.04) in patients with SD when compared to non SD. There was no difference (p = 0.34) in serum IFNα levels and serum MIF levels (p = 0.15) in patients with SD and non SD.

Conclusion: Although serum IL-10 was significantly elevated in patients with SD it had a poor discriminatory value in identifying those with SD and non SD and therefore, is unsuitable to be used as a robust biomarker in this cohort.

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Related in: MedlinePlus

Serum cytokine levels in primary and secondary dengue infection. A: Serum IL-10 levels in patients with primary (n = 9) and secondary dengue (n = 56) in the febrile phase and the critical phase. B: Serum IFNγ and serum IFNα levels in primary (n = 15) and secondary dengue (n = 63).
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Figure 3: Serum cytokine levels in primary and secondary dengue infection. A: Serum IL-10 levels in patients with primary (n = 9) and secondary dengue (n = 56) in the febrile phase and the critical phase. B: Serum IFNγ and serum IFNα levels in primary (n = 15) and secondary dengue (n = 63).

Mentions: 50 of our patients had a primary dengue infection whereas 209 had a secondary dengue infection. IL-10 levels were significantly higher (p = 0.01) in those with primary dengue (mean 363, SD ± 923.6 pg/ml) than those with secondary dengue (mean 161.1, SD ± 298.6 pg/ml). In primary dengue infection serum IL-10 was slightly lower in the febrile phase (mean 135.8, SD ± 129.7 pg/ml) when compared to the critical phase (mean 154. 2, SD ± 183.2 pg/ml) although not statistically significant. On the other hand, serum IL-10 levels slightly decreased in the critical phase in those with secondary dengue infection (168.3, SD ± 243.7 pg.ml) when compared to the febrile phase (mean 198.1, SD ± 293.7 pg/ml) (Figure 3A). There was no difference in the IL-10 levels in patients with primary dengue who had severe dengue (mean 162.1, SD ± 103.5 pg/ml) when compared to those with non severe dengue (mean 194.2, SD ± 151.1 pg/ml). However, serum IL-10 was higher in patients with severe secondary dengue infection (mean 329.1, SD ± 647.1 pg/ml) when compared to those with non severe dengue (mean 164, SD ± 155.1 pg/ml) (data not shown). Serum IFNγ levels were significantly higher (p = 0.007) in patients with primary dengue (mean 361.6, SD ± 399.6) when compared to those with secondary dengue infection (mean 161, SD ± 246.3) (Figure 3B). No such difference was seen in serum IFNα levels (p = 0.31). In contrast, serum MIF levels were significantly higher (p = 0.007) in patients with secondary dengue (mean 115,276, SD ± 538,567) when compared to those with primary dengue (mean 12669, SD ± 8.240).


Serum IL-10 as a marker of severe dengue infection.

Malavige GN, Gomes L, Alles L, Chang T, Salimi M, Fernando S, Nanayakkara KD, Jayaratne S, Ogg GS - BMC Infect. Dis. (2013)

Serum cytokine levels in primary and secondary dengue infection. A: Serum IL-10 levels in patients with primary (n = 9) and secondary dengue (n = 56) in the febrile phase and the critical phase. B: Serum IFNγ and serum IFNα levels in primary (n = 15) and secondary dengue (n = 63).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3733887&req=5

Figure 3: Serum cytokine levels in primary and secondary dengue infection. A: Serum IL-10 levels in patients with primary (n = 9) and secondary dengue (n = 56) in the febrile phase and the critical phase. B: Serum IFNγ and serum IFNα levels in primary (n = 15) and secondary dengue (n = 63).
Mentions: 50 of our patients had a primary dengue infection whereas 209 had a secondary dengue infection. IL-10 levels were significantly higher (p = 0.01) in those with primary dengue (mean 363, SD ± 923.6 pg/ml) than those with secondary dengue (mean 161.1, SD ± 298.6 pg/ml). In primary dengue infection serum IL-10 was slightly lower in the febrile phase (mean 135.8, SD ± 129.7 pg/ml) when compared to the critical phase (mean 154. 2, SD ± 183.2 pg/ml) although not statistically significant. On the other hand, serum IL-10 levels slightly decreased in the critical phase in those with secondary dengue infection (168.3, SD ± 243.7 pg.ml) when compared to the febrile phase (mean 198.1, SD ± 293.7 pg/ml) (Figure 3A). There was no difference in the IL-10 levels in patients with primary dengue who had severe dengue (mean 162.1, SD ± 103.5 pg/ml) when compared to those with non severe dengue (mean 194.2, SD ± 151.1 pg/ml). However, serum IL-10 was higher in patients with severe secondary dengue infection (mean 329.1, SD ± 647.1 pg/ml) when compared to those with non severe dengue (mean 164, SD ± 155.1 pg/ml) (data not shown). Serum IFNγ levels were significantly higher (p = 0.007) in patients with primary dengue (mean 361.6, SD ± 399.6) when compared to those with secondary dengue infection (mean 161, SD ± 246.3) (Figure 3B). No such difference was seen in serum IFNα levels (p = 0.31). In contrast, serum MIF levels were significantly higher (p = 0.007) in patients with secondary dengue (mean 115,276, SD ± 538,567) when compared to those with primary dengue (mean 12669, SD ± 8.240).

Bottom Line: We found that serum IL-10 levels were significantly higher (p = 0.001) in patients with SD, when compared to those with non SD.However, IL-10 levels did not have a good predictive value in discriminating those who were likely to develop SD (AUC = 0.66).Serum IFNγ levels were also significantly higher (p = 0.04) in patients with SD when compared to non SD.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Microbiology, University of Sri Jayawardanapura, Nugegoda, Sri Lanka. gathsaurie.malavige@ndm.ox.ac.uk

ABSTRACT

Background: Several studies have shown that serum IL-10, IFNγ and MIF are elevated in patients in severe dengue (SD) and could be used as potential biomarkers. We proceeded to determine if these cytokines could be used as biomarkers in a large cohort of adult dengue patients with varying severity of dengue infection.

Methods: Serum IL-10 levels were determined in 259 of whom 40 had severe dengue infection. Serum IFNγ and IFNα levels were done in 78 and MIF levels were done in 65 patients with acute dengue infection. Clinical features and laboratory investigations were undertaken during the febrile and critical phase.

Results: We found that serum IL-10 levels were significantly higher (p = 0.001) in patients with SD, when compared to those with non SD. Serum IL-10 levels significantly and inversely correlated with white cell counts (R = -0.23, p = 0.0002) and lymphocyte counts (R = -0.29, p < 0.0001) but significantly and positively correlated with aspartate tranaminase levels (R = 0.16, p = 0.01) and alanine transaminase levels (R = 0.22, p = 0.007). However, IL-10 levels did not have a good predictive value in discriminating those who were likely to develop SD (AUC = 0.66). Serum IFNγ levels were also significantly higher (p = 0.04) in patients with SD when compared to non SD. There was no difference (p = 0.34) in serum IFNα levels and serum MIF levels (p = 0.15) in patients with SD and non SD.

Conclusion: Although serum IL-10 was significantly elevated in patients with SD it had a poor discriminatory value in identifying those with SD and non SD and therefore, is unsuitable to be used as a robust biomarker in this cohort.

Show MeSH
Related in: MedlinePlus