Association between proinflammatory cytokines and lipid peroxidation in patients with severe dengue disease around defervescence.
OBJECTIVE
Proinflammatory cytokines and the oxidative stress response are reported to be involved in dengue viral disease. The present study investigated the correlation of proinflammatory cytokines and lipid peroxidation with dengue severity.


METHODS
Clinical samples from 27 dengue fever (DF) cases, 30 dengue haemorrhagic fever (DHF) cases, and 24 dengue shock syndrome (DSS) cases were studied around defervescence, along with samples from 30 healthy controls. Plasma samples were analysed for tumour necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ) by ELISA and for malondialdehyde (MDA) by thiobarbituric acid assay.


RESULTS
Dengue-infected individuals had significantly higher levels of TNF-α, IFN-γ, and MDA in comparison to controls. The ratio of TNF-α to IFN-γ was significantly higher in DHF and DSS than in DF. A TNF-α/IFN-γ ratio value of 5.69 around defervescence predicted DHF and DSS with moderate accuracy and thus may serve as an indicator to study dengue severity. The study observed a significant positive correlation of lipid peroxides with TNF-α levels and the TNF-α/IFN-γ ratio in severe dengue cases.


CONCLUSIONS
We propose that the oxidative stress response induced by the dengue virus may trigger the inflammatory cytokine responses in dengue severity and thereby contributes to the pathogenesis of the disease; however the interplay between the oxidative response and inflammatory activity in disease virulence needs further study.
Jawaharlal Institute of Postgraduate Medicine and Research, Pondicherry 605 006, India. Electronic address: soundy27@yahoo.co.in.
R
R
Soundravally
Vector Control Research Centre (VCRC), Pondicherry, India.
S L
SL
Hoti
National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Shripad A
SA
Patil
Jawaharlal Institute of Postgraduate Medicine and Research, Pondicherry 605 006, India.
C C
CC
Cleetus
Jawaharlal Institute of Postgraduate Medicine and Research, Pondicherry 605 006, India.
Bobby
B
Zachariah
Jawaharlal Institute of Postgraduate Medicine and Research, Pondicherry 605 006, India.
T
T
Kadhiravan
Jawaharlal Institute of Postgraduate Medicine and Research, Pondicherry 605 006, India.
P
P
Narayanan
SASTRA University, Thanjavur, Tamil Nadu 613401, India. Electronic address: agiesh@scbt.sastra.edu.
B Agiesh
BA
Kumar
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D003715:Dengue / Q000097:blood / Q000473:pathology; D003716:Dengue Virus; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D015227:Lipid Peroxidation; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress; D019595:Severe Dengue / Q000097:blood* / Q000473:pathology*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D008315:Malondialdehyde; D007371:Interferon-gamma
DHF; DSS; Lipid peroxides; Malondialdehyde; Proinflammatory cytokine; TNF-α/IFN-γ ratio