title: Dynamics of interleukin-21 production during the clinical course of primary and secondary dengue virus infections.
abstract: Previous studies have revealed the clinical relevance of pro-inflammatory cytokine production during dengue virus (DENV) infections. In this study, we evaluated the production of interleukin-21 (IL-21), a key soluble mediator mainly produced by CD4+ T cells. The aim of this study was to investigate the role of IL-21 production during the clinical course of primary and secondary DENV infections and the potential association of IL-21 serum levels with the disease pathogenesis. Blood samples from DENV-infected patients were collected on different days after the onset of symptoms. Patients were classified according to their phase of disease (acute vs. convalescent phases), the type of infection (primary vs. secondary), and the clinical severity of their disease (dengue fever (DF) vs. dengue hemorrhagic fever (DHF)). IL-21 levels were measured using a quantitative capture ELISA assay. The levels of IL-21 were significantly elevated in the disease group compared with the control group. IL-21 was detected in primary and secondary DENV infections, with a significantly higher concentration in the convalescent phase of primary infections. IL-21 levels were significantly higher in patients with secondary acute DHF infections when compared with those with secondary acute DF infection. There was a relationship between the elevated serum levels of IL-21 and the production of DENV-specific IgM and IgG antibodies. Taking together, our results show for the first time the involvement of IL-21 during the clinical course of DENV infections. We speculate that IL-21 may play a protective role in the context of the convalescent phase of primary infections and the acute phase of secondary infections.
authors.affiliation: Instituto de Investigaciones Medico-Biológicas, Universidad Veracruzana, Veracruz, México; Universidad del Valle de México, campus Villa Rica, Facultad de Medicina "Dr. Porfirio Sosa Zárate", México. Electronic address: hvivanco@uv.mx.
authors.forename: H
authors.initials: H
authors.lastname: Vivanco-Cid
authors.affiliation: Instituto de Investigaciones Medico-Biológicas, Universidad Veracruzana, Veracruz, México.
authors.forename: M J
authors.initials: MJ
authors.lastname: Maldonado-Rentería
authors.affiliation: Instituto de Investigaciones Medico-Biológicas, Universidad Veracruzana, Veracruz, México.
authors.forename: L A
authors.initials: LA
authors.lastname: Sánchez-Vargas
authors.affiliation: Instituto de Investigaciones Medico-Biológicas, Universidad Veracruzana, Veracruz, México.
authors.forename: I Y
authors.initials: IY
authors.lastname: Izaguirre-Hernández
authors.affiliation: Instituto de Investigaciones Medico-Biológicas, Universidad Veracruzana, Veracruz, México.
authors.forename: K G
authors.initials: KG
authors.lastname: Hernández-Flores
authors.affiliation: Hospital Regional de Alta Especialidad de Veracruz, Servicios de Salud de Veracruz, México.
authors.forename: R
authors.initials: R
authors.lastname: Remes-Ruiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D000918:Antibody Specificity / Q000276:immunology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003715:Dengue / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism*; D003716:Dengue Virus / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D007378:Interleukins / Q000096:biosynthesis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D055815:Young Adult; D000098546:Interleukin-21
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007378:Interleukins; D000098546:Interleukin-21
keywords: Antibody response; Cellular immunity; Dengue; Interleukin 21