title: IL-1beta, IL-6, and RANTES as biomarkers of Chikungunya severity.
abstract: BACKGROUND
  Little is known about the immunopathogenesis of Chikungunya virus. Circulating levels of immune mediators and growth factors were analyzed from patients infected during the first Singaporean Chikungunya fever outbreak in early 2008 to establish biomarkers associated with infection and/or disease severity.
  
  
  RESULTS
  Adult patients with laboratory-confirmed Chikungunya fever infection, who were referred to the Communicable Disease Centre/Tan Tock Seng Hospital during the period from January to February 2008, were included in this retrospective study. Plasma fractions were analyzed using a multiplex-microbead immunoassay. Among the patients, the most common clinical features were fever (100%), arthralgia (90%), rash (50%) and conjunctivitis (40%). Profiles of 30 cytokines, chemokines, and growth factors were able to discriminate the clinical forms of Chikungunya from healthy controls, with patients classified as non-severe and severe disease. Levels of 8 plasma cytokines and 4 growth factors were significantly elevated. Statistical analysis showed that an increase in IL-1beta, IL-6 and a decrease in RANTES were associated with disease severity.
  
  
  CONCLUSIONS
  This is the first comprehensive report on the production of cytokines, chemokines, and growth factors during acute Chikungunya virus infection. Using these biomarkers, we were able to distinguish between mild disease and more severe forms of Chikungunya fever, thus enabling the identification of patients with poor prognosis and monitoring of the disease.
authors.affiliation: Singapore Immunology Network, Agency for Science, Technology and Research, Singapore. lisa_ng@immunol.astar.edu.sg
authors.forename: Lisa F P
authors.initials: LF
authors.lastname: Ng
authors.forename: Angela
authors.initials: A
authors.lastname: Chow
authors.forename: Yong-Jiang
authors.initials: YJ
authors.lastname: Sun
authors.forename: Dyan J C
authors.initials: DJ
authors.lastname: Kwek
authors.forename: Poh-Lian
authors.initials: PL
authors.lastname: Lim
authors.forename: Frederico
authors.initials: F
authors.lastname: Dimatatac
authors.forename: Lee-Ching
authors.initials: LC
authors.lastname: Ng
authors.forename: Eng-Eong
authors.initials: EE
authors.lastname: Ooi
authors.forename: Khar-Heng
authors.initials: KH
authors.lastname: Choo
authors.forename: Zhisheng
authors.initials: Z
authors.lastname: Her
authors.forename: Philippe
authors.initials: P
authors.lastname: Kourilsky
authors.forename: Yee-Sin
authors.initials: YS
authors.lastname: Leo
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D015415:Biomarkers / Q000378:metabolism*; D016022:Case-Control Studies; D018946:Chemokine CCL5 / Q000502:physiology*; D002646:Chikungunya virus; D016000:Cluster Analysis; D005334:Fever; D015967:Gene Expression Regulation, Viral; D006801:Humans; D053583:Interleukin-1beta / Q000502:physiology*; D015850:Interleukin-6 / Q000502:physiology*; D008875:Middle Aged; D014036:Togaviridae Infections / Q000097:blood* / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D018946:Chemokine CCL5; D053583:Interleukin-1beta; D015850:Interleukin-6