IL-1beta, IL-6, and RANTES as biomarkers of Chikungunya severity.
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.
Ng
Lisa F P
LF
Singapore Immunology Network, Agency for Science, Technology and Research, Singapore. lisa_ng@immunol.astar.edu.sg
Chow
Angela
A
Sun
Yong-Jiang
YJ
Kwek
Dyan J C
DJ
Lim
Poh-Lian
PL
Dimatatac
Frederico
F
Ng
Lee-Ching
LC
Ooi
Eng-Eong
EE
Choo
Khar-Heng
KH
Her
Zhisheng
Z
Kourilsky
Philippe
P
Leo
Yee-Sin
YS
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*
D015415:Biomarkers; D018946:Chemokine CCL5; D053583:Interleukin-1beta; D015850:Interleukin-6