Increased production of interleukin-4, interleukin-10, and granulocyte-macrophage colony-stimulating factor by type 2 diabetes' mononuclear cells infected with dengue virus, but not increased intracellular viral multiplication.
It has been reported that diabetes mellitus (DM) was an epidemiologically identified risk factor for development of dengue hemorrhagic fever (DHF)/severe dengue in dengue virus (DENV) affected patients, and T helper 2 (Th2) cytokines such as interleukin-4 (IL-4) and IL-10 each plays an important role in the immunopathogenesis of DHF in studies involving general population. To better understand the relationship between these epidemiological and immunological findings, we performed an in vitro study evaluating the sequential immunological reactions and viral load in the DENV infected mononuclear cells of adults with type 2 DM (T2DM group, n = 33) and normal adults (control group, n = 29). We found in the T2DM group significantly higher IL-4 level on the first (P = 0.049) and the third (P = 0.022) postinfection days, while higher IL-10 (P = 0.042) and granulocyte-macrophage colony-stimulating factor (GM-CSF) (P = 0.009) were detected on the third postinfection day. No significant difference in DENV viral load between the cultured mononuclear cells from both groups was found on the first and third post-infection days. These data immunologically suggest that patients with T2DM are at higher risk for development of DHF/severe dengue and strengthen the previously epidemiologically identified role of DM being a predictive risk factor for progressing into DHF/severe dengue in DENV-affected patients.
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan ; Chang Gung University Medical College, Tao-Yuan 333, Taiwan ; Infection Control Committee, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
Ing-Kit
IK
Lee
Ching-Jung
CJ
Hsieh
Rong-Fu
RF
Chen
Zih-Syuan
ZS
Yang
Lin
L
Wang
Chang-Mei
CM
Chen
Chiung-Fen
CF
Liu
Chung-Hao
CH
Huang
Chun-Yu
CY
Lin
Yen-Hsu
YH
Chen
Kuender D
KD
Yang
Jien-Wei
JW
Liu
D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000378:metabolism; D003710:Demography; D003715:Dengue / Q000150:complications / Q000821:virology; D003716:Dengue Virus / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000821:virology*; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000096:biosynthesis*; D006801:Humans; D016753:Interleukin-10 / Q000096:biosynthesis*; D015847:Interleukin-4 / Q000096:biosynthesis*; D042541:Intracellular Space / Q000821:virology; D007963:Leukocytes, Mononuclear / Q000821:virology*; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D019562:Viral Load; D014779:Virus Replication / Q000502:physiology*
C111835:CCL2 protein, human; D018932:Chemokine CCL2; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4; D016178:Granulocyte-Macrophage Colony-Stimulating Factor