DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20181552

Cytokine IL-12, Dengue in children: analysis of a unique relationship

Rakesh Manoharan, Umapathy Pasupathy, Latha Ravichandran, Elayaraja Sivaprakasam, Srinivasan V., Krishna Sameera G.

Abstract


Background: Dengue is a mosquito borne viral infection caused by one of the four serotypes of dengue viruses (DENV1-DENV4). The consequences of DENV infection range from asymptomatic condition, dengue fever (DF), or severe forms, such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The host immune responses have been considered as the major factor responsible for dengue pathogenesis. In this study, the cytokine IL-12 is reviewed for its utility as potential biomarker of severe dengue disease.

Methods: 120 children of paediatric age group with either dengue NS1 antigen or dengue IgM positive were included. Cases were classified as uncomplicated dengue (dengue without warning signs) and complicated dengue (dengue with warning signs and severe dengue). Clinical features and IL-12 (ELISA KIT) levels were analyzed in the study population.

Results: Analysis of clinical features among the study groups revealed children with complicated dengue had persistent vomiting (95%), abdominal pain (80%), decreased urine output (50%), bleeding manifestations (83.3%), Hepatomegaly (70%) Haemoconcentration with concurrent thrombocytopenia (93.3%), altered coagulation profile (28.3%), ICU stay (54.7%), leukocytosis (15%), leucopoenia (66.6%) normal leucocytes, (18.4%). Analysis of IL-12 levels revealed children with complicated dengue showed significant elevation compared to controls and uncomplicated dengue.

Conclusions: In our study IL-12 levels were significantly higher in complicated dengue patients in comparison with uncomplicated dengue patients as well as normal control population.


Keywords


IL-12 and dengue, Predictors of dengue severity, Clinical features and dengue, Dengue and children

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References


WHO/SEARO. Concrete measure key in controlling dengue in South East Asia. Press Release SEA/PR/1479. New Delhi, World Health Organization Regional Office for South-East Asia, 2008. Available at http://www.searo.who.int/ EN/Section316/Section 503/Section2463_14619.htm.

WHO. Dengue haemorrhagic fever: diagnosis, treatment, prevention and control, 2nd ed. Geneva, World Health Organization, 1997.

World Health Organization. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva, Switzerland: WHO, 2009.

Halstead SB. Dengue. Lancet (London, England). 2007;370(9599):1644-52.

Chen LC, Lei HY, Liu CC. Correlation of serum levels of macrophage migration inhibitory factor with disease severity and clinical outcome in dengue patients. Am J Trop Med Hyg. 2006;74(1):142-7.

Chaturvedi UC, Agarwal R, Elbishbishi EA, Mustafa AS. Cytokine cascade in dengue hemorrhagic fever: implications for pathogenesis. FEMS Immunol Med Microbiol. 2000;28(3):183-8.

Kumar Y, Liang C, Bo Z, Rajapakse JC, Ooi EE, Tannenbaum SR. Serum proteome and cytokine analysis in a longitudinal cohort of adults with primary dengue infection reveals predictive markers of DHF. PLoS Negl Trop Dis. 2012;6(11):e1887.

Brasier AR, Garcia J, Wiktorowicz JE, Spratt HM, Comach G, Ju H, Recinos A et al. Discovery proteomics and nonparametric modeling pipeline in the development of a candidate biomarker panel for dengue hemorrhagic fever. Clin Transl Sci. 2012 February;5(1):8-20.

Sam SS, Teoh BT, Chinna K, AbuBakar S.. High producing tumor necrosis factor alpha gene alleles in protection against severe manifestations of dengue. Int J Med Sci. 2015;12(2):177-186.

Masaki H, Hasebe F, Ahmed K, Fukuda T, Furumoto A, Watanabe K, Oishi K, Igarashi A, Nagatake T. A clinical, serological, and immunological study in a Japanese traveler with dengue fever. J Infect Chemother. 2002 Dec; 8(4):365-7.

Guerrero CD, Arrieta AF, Ramirez ND, Rodríguez LS, Vega R, Bosch I et al. High plasma levels of soluble ST2 but not its ligand IL-33 is associated with severe forms of pediatric dengue "an official journal of the international cytokine and interferon society. 2013;61(3):766-71.