title: Inflammatory mediators in dengue virus infection in children: interleukin-6 and its relation to C-reactive protein and secretory phospholipase A2.
abstract: To assess the potential role of interleukin-6 (IL-6) in the pathogenesis of dengue virus infection, levels of this cytokine were measured in children with dengue virus infection on admission to the hospital. As presumed surrogate markers of IL-6, C-reactive protein (CRP) and secretory phospholipase A2 (sPLA2) were measured. Three groups were studied: 33 apparently healthy children as negative controls, 11 children with bacterial infections as positive controls, and 186 children with serologically documented dengue virus infection. One-hundred and fifteen patients had dengue fever (DF) and 71 had dengue hemorrhagic fever (DHF). Compared with healthy controls, dengue shock syndrome (DSS) patients had significantly higher levels of IL-6 on admission (P < 0.05), comparable with those in positive controls. Dengue patients with shock had significantly higher levels of IL-6 than normotensive patients (P < 0.001) and higher levels of IL-6 were associated with a higher incidence of ascites. C-reactive protein concentrations in dengue patients and in healthy children were not different, but lower than in children with bacterial infections (P = 0.008). Secretory phospholipase A2 levels were higher in dengue patients than in apparently healthy children (P < or = 0.05) and similar to those in children with bacterial infection. Dengue shock syndrome patients had significantly higher sPLA2 concentrations than normotensive patients (P = 0.02). These data indicate that IL-6 and sPLA2 may have a pathogenetic role only in the most severe forms of dengue virus infection.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
authors.forename: M
authors.initials: M
authors.lastname: Juffrie
authors.forename: G M
authors.initials: GM
authors.lastname: Meer
authors.forename: C E
authors.initials: CE
authors.lastname: Hack
authors.forename: K
authors.initials: K
authors.lastname: Haasnoot
authors.lastname: Sutaryo
authors.forename: A J
authors.initials: AJ
authors.lastname: Veerman
authors.forename: L G
authors.initials: LG
authors.lastname: Thijs
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D002097:C-Reactive Protein / Q000276:immunology* / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D003716:Dengue Virus / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000097:blood / Q000276:immunology*; D008297:Male; D010741:Phospholipases A / Q000097:blood / Q000276:immunology* / Q000378:metabolism; D054467:Phospholipases A2; D019595:Severe Dengue / Q000097:blood / Q000276:immunology*; D018709:Statistics, Nonparametric
chemical_list: D000914:Antibodies, Viral; D015850:Interleukin-6; D002097:C-Reactive Protein; D010741:Phospholipases A; D054467:Phospholipases A2