title: Corticosteroids for dengue - why don't they work?
abstract: BACKGROUND
  Dysregulated immune responses may contribute to the clinical complications that occur in some patients with dengue.
  
  
  RESULTS
  In Vietnamese pediatric dengue cases randomized to early prednisolone therapy, 81 gene-transcripts (0.2% of the 47,231 evaluated) were differentially abundant in whole-blood between high-dose (2 mg/kg) prednisolone and placebo-treated patients two days after commencing therapy. Prominent among the 81 transcripts were those associated with T and NK cell cytolytic functions. Additionally, prednisolone therapy was not associated with changes in plasma cytokine levels.
  
  
  CONCLUSIONS
  The inability of prednisolone treatment to markedly attenuate the host immune response is instructive for planning future therapeutic strategies for dengue.
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam.
authors.forename: Thi Hanh Tien
authors.initials: TH
authors.lastname: Nguyen
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam.
authors.forename: Than Ha Quyen
authors.initials: TH
authors.lastname: Nguyen
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam.
authors.forename: Tuan Trung
authors.initials: TT
authors.lastname: Vu
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam ; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
authors.affiliation: Genome Institute of Singapore, Singapore.
authors.forename: Truong Long
authors.initials: TL
authors.lastname: Hoang
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam.
authors.forename: Thi Hoai Tam
authors.initials: TH
authors.lastname: Dong
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam.
authors.forename: Van
authors.initials: V
authors.lastname: Ngoc Tran
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam.
authors.forename: Khanh Lam
authors.initials: KL
authors.lastname: Phung
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam ; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Marcel
authors.initials: M
authors.lastname: Wolbers
authors.affiliation: Laboratory of Infectious Diseases (LID), National Institutes of Allergy and Infectious Diseases, Bethesda, Maryland, United States of America.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Whitehead
authors.affiliation: Genome Institute of Singapore, Singapore.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Hibberd
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam ; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.
authors.forename: Bridget
authors.initials: B
authors.lastname: Wills
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam ; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom ; Nossal Institute of Global Health, School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Cameron P
authors.initials: CP
authors.lastname: Simmons
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D003715:Dengue / Q000188:drug therapy*; D005260:Female; D020869:Gene Expression Profiling; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D056747:Immunomodulation; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D010919:Placebos / Q000008:administration & dosage; D011239:Prednisolone / Q000627:therapeutic use*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D017211:Treatment Failure; D014744:Vietnam; D055815:Young Adult
chemical_list: D016207:Cytokines; D007155:Immunologic Factors; D010919:Placebos; D011239:Prednisolone