title: Characterisation of lymphocyte response and cytokine patterns in patients with dengue fever.
abstract: It is believed that the pathogenesis of dengue is generated by a deregulation of the immunological response. Dengue virus-infected monocytes/macrophages are likely to secrete monokines, which play a role in clinical features observed in patients with dengue haemorrhagic fever or dengue shock syndrome. This is a report on a study on 45 individuals presenting clinical and laboratory characteristics of dengue virus infection. During the acute phase of infection, immunophenotyping of peripheral mononuclear leukocytes was carried out in 19 patients and demonstrated a reduced frequency of CD2+ lymphocytes and their CD4+ and CD8+ subsets. Normal ratios were recovered during convalescence. Also, during the acute phase, mononuclear cells proliferated poorly in response to mitogens and dengue antigens as detected by incorporation of radiolabeled thymidine. During convalescence the lymphoproliferative response was re-established. In addition, the presence of circulating cytokines was investigated in the plasma of the same 45 patients. Concentrations of tumour necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma), interleukin-10 (IL-10) and soluble tumor necrosis factor receptor (sTNF-Rp75) were found to be significantly elevated in patients when compared to normal controls. The increase in TNF-alpha was correlated with haemorrhagic manifestations and the increase in IL-10 with platelet decay. The data demonstrate that during the acute phase of dengue infection subsets of T lymphocytes are depressed in terms of both rate and function and provide evidence that circulating pro-inflammatory cytokines, such as TNF-alpha, are important in the pathogenesis and severity of dengue. IL-10 may be downregulating lymphocyte and platelet function.
authors.affiliation: Departamento de Virologia, IOC, Fundaçáo Oswaldo Cruz, Rio de Janeiro, Brazil.
authors.forename: E L
authors.initials: EL
authors.lastname: Azeredo
authors.forename: S M
authors.initials: SM
authors.lastname: Zagne
authors.forename: M A
authors.initials: MA
authors.lastname: Santiago
authors.forename: A S
authors.initials: AS
authors.lastname: Gouvea
authors.forename: A A
authors.initials: AA
authors.lastname: Santana
authors.forename: P C
authors.initials: PC
authors.lastname: Neves-Souza
authors.forename: R M
authors.initials: RM
authors.lastname: Nogueira
authors.forename: M P
authors.initials: MP
authors.lastname: Miagostovich
authors.forename: C F
authors.initials: CF
authors.lastname: Kubelka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002455:Cell Division; D003208:Concanavalin A; D016207:Cytokines / Q000097:blood / Q000276:immunology; D003715:Dengue / Q000097:blood / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007371:Interferon-gamma / Q000097:blood / Q000276:immunology*; D016753:Interleukin-10 / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology; D013601:T-Lymphocytes / Q000166:cytology / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology*
chemical_list: D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D003208:Concanavalin A; D016753:Interleukin-10; D007371:Interferon-gamma