title: Elevated levels of interleukin-13 and IL-18 in patients with dengue hemorrhagic fever.
abstract: Interleukin (IL)-13 is produced by T helper 2 (Th2)-type cells and inhibits the production of proinflammatory cytokines by activated monocytes, while IL-18 is a pleiotropic cytokine that induces interferon-gamma and plays an important role in the development of Th1-type cells. Role of the shift from a Th1-type response to Th2-type has been suggested in the pathogenesis of dengue hemorrhagic fever (DHF). This study was undertaken to investigate the possible protective/pathogenic role of IL-13 and IL-18 in patients with DHF. Sera were collected from a total of 84 patients with various grades of dengue illness and 21 normal healthy controls and tested for IL-13 and IL-18 levels using commercial enzyme-linked immunosorbent assay kits. The results showed that very low levels of IL-13 (4+/-3 pg ml(-1)) and IL-18 (15+/-4 pg ml(-1)) were detected in the sera of healthy controls. In dengue patients, the levels of IL-13 and IL-18 were the highest in the patients with DHF grade IV (205+/-103 pg ml(-1) and 366+/-155 pg ml(-1), respectively) and the lowest in patients with dengue fever (22+/-12 pg ml(-1) and 76+/-50 pg ml(-1), respectively). Both the cytokines appeared (IL-13=20+/-11 pg ml(-1) and IL-18=70+/-45 pg ml(-1)) during the first 4 days of illness and reached peak levels (IL-13=204+/-96 pg ml(-1) and IL-18=360+/-148 pg ml(-1)) by day 9 onwards. The presence of high levels of IL-13 and IL-18 during severe illness and late phases of the disease suggests that both of these cytokines may contribute to the shift from a Th1- to Th2-type response and thus to the pathogenesis of DHF.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, P.O Box 24923, Safat 13110 Kuwait. abusalim@hsc.kuniv.edu.kw
authors.forename: A S
authors.initials: AS
authors.lastname: Mustafa
authors.forename: E A
authors.initials: EA
authors.lastname: Elbishbishi
authors.forename: R
authors.initials: R
authors.lastname: Agarwal
authors.forename: U C
authors.initials: UC
authors.lastname: Chaturvedi
mesh_terms: D006801:Humans; D018793:Interleukin-13 / Q000097:blood*; D020382:Interleukin-18 / Q000097:blood*; D011379:Prognosis; D019595:Severe Dengue / Q000097:blood / Q000276:immunology*
chemical_list: D018793:Interleukin-13; D020382:Interleukin-18