title: Study of interleukin-6 and interleukin-8 levels in patients with neurological manifestations of dengue.
abstract: Pro-inflammatory markers play a key role in the pathogenesis of various Flavivirus infection.
  
  
  
  In this study, we evaluated the role of these markers in neurological manifestations of dengue.
  
  
  
  Consecutive dengue cases with different neurological manifestations who presented between August 2012 and July 2014 were studied in hospital-based case-control study.
  
  
  
  Interleukin (IL-6) and IL-8 level were measured in serum and cerebrospinal fluid (CSF) of dengue cases with different neurological manifestations and also in age- and sex-matched controls. Level was analyzed with various parameters and outcomes.
  
  
  
  Statistical analysis was done using SPSS version 16.0 by applying appropriate statistical methods. P < 0.05 considered statistically significant.
  
  
  
  Out of the 40 enrolled cases of dengue with neurological manifestations, 29 had central nervous system and 11 had peripheral nervous system (CNS/PNS) manifestations. In CNS group, both IL-6 and IL-8 (CSF and serum) were significantly elevated (P < 0.001), whereas CSF IL-6 (P = 0.008), serum IL-6 (P = 0.001), and serum IL-8 (P = 0.005) were significantly elevated in PNS group. CSF IL-6, serum IL-6, and IL-8 were significantly elevated in poor outcome patients in CNS group (P < 0.05). CSF IL-6 and IL-8 were significantly elevated in CSF dengue positive cases as compared to CSF negative patients (P < 0.05). Cytokine level was not significantly correlated with neuroimaging abnormality in CNS group. Nine patients died and the remainder recovered.
  
  
  
  Elevated level of IL-6 and IL-8 is associated with different neurological manifestations and poor outcome, but whether they are contributing to neuropathogenesis or simply a correlate of severe disease remains to be determined.
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: V K
authors.initials: VK
authors.lastname: Mehta
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: R
authors.initials: R
authors.lastname: Verma
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Garg
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: H S
authors.initials: HS
authors.lastname: Malhotra
authors.affiliation: Department of Neurology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: P K
authors.initials: PK
authors.lastname: Sharma
authors.affiliation: Department of Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: A
authors.initials: A
authors.lastname: Jain
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002493:Central Nervous System Diseases / Q000821:virology*; D016207:Cytokines / Q000097:blood; D003715:Dengue / Q000097:blood / Q000134:cerebrospinal fluid / Q000150:complications* / Q000821:virology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007075:Immunoglobulin M; D015850:Interleukin-6 / Q000097:blood* / Q000134:cerebrospinal fluid*; D016209:Interleukin-8 / Q000097:blood* / Q000134:cerebrospinal fluid*; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000821:virology*
chemical_list: C508606:CXCL8 protein, human; D016207:Cytokines; C508600:IL6 protein, human; D007075:Immunoglobulin M; D015850:Interleukin-6; D016209:Interleukin-8