Pathophysiologic and Prognostic Role of Cytokines in Dengue Hemorrhagic Fever
Open accessAbstract
Dengue shock syndrome is a severe complication of dengue hemorrhagic fever (DHF), characterized by a massive increase in vascular permeability. Plasma cytokine concentrations were prospectively studied in 443 Vietnamese children with DHF, of whom 6 died. Shock was present in 188 children on admission to hospital, and in 71 children it developed later. Contrary to expectations, certain inflammatory markers (interleukin-6 and soluble intercellular adhesion molecule-1) were lower in the group with shock, and this may reflect the general loss of protein from the circulation due to capillary leakage. Only soluble tumor necrosis factor receptor (TNFR) levels showed a consistent positive relationship with disease severity. In patients with suspected DHF without shock, admission levels of sTNFR-75 in excess of 55 pg/mL predicted the subsequent development of shock, with a relative risk of 5.5 (95% confidence interval, 2.3-13.2). Large-scale release of soluble TNFR may be an early and specific marker of the endothelial changes that cause dengue shock syndrome.
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Elevated concentrations of TNF-RII predict severe dengue in children.
“Elevated concentrations of TNF-RII predict severe dengue in children (13).”
From Into the Eye of the Cytokine Storm (2012) · cites this paper as [13]
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- Authors
- Bethell, D. B., Flobbe, K., Phuong, C. X. T., Day, N. P. J., Phuong, P. T., Buurman, W. A., Cardosa, M. J., White, N. J., & Kwiatkowski, D.
- Affiliations
- John Radcliffe Hospital (GB)
- Corresponding author
- Bethell, Delia B.
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-03
- Volume
- 177
- Issue
- 3
- Pages
- 778-782
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2109947713
- Cited by
- 180
- References
- 13
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 7 · 2020: 8 · 2019: 4 · 2018: 6 · 2017: 7 · 2016: 5 · 2015: 9 · 2014: 11 · 2013: 7 · 2012: 6
- FWCI
- 7.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Unimas Institutional Repository (Universiti Malaysia Sarawak) (acceptedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Vectors
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Keywords
- dengue hemorrhagic fever, dengue shock syndrome, cytokines, soluble tumor necrosis factor receptor, interleukin-6, soluble intercellular adhesion molecule-1, vascular permeability, capillary leak syndrome, endothelial dysfunction, disease severity, prognostic factors, children
- MeSH terms
- Antibodies, Viral, Child, Child, Preschool, Female, Humans, Infant, Male, Prospective Studies, Shock, Syndrome, Tumor Necrosis Factor-alpha, Vietnam, Cytokines, Receptors, Tumor Necrosis Factor, Severe Dengue
About these checks
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