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登革热感染不同严重程度下的促炎和抗炎细胞因子特征。

Pro- and anti-inflammatory cytokines signatures at different severity of dengue infection.

作者信息

Prajapati Himani, Kumar Vivek, Mittal Garima, Saxena Yogesh

机构信息

Department of Microbiology, Himalayan School of Bio-sciences, Swami Rama Himalayan University Jolly Grant, Dehradun, Uttarakhand, India.

Department of Microbiology, Swami Rama Himalayan University Jolly Grant, Dehradun, Uttarakhand, India.

出版信息

J Family Med Prim Care. 2024 May;13(5):1975-1982. doi: 10.4103/jfmpc.jfmpc_1576_23. Epub 2024 May 6.

Abstract

CONTEXT

Dengue disease severity and progression are determined by the host immune response, with both pro- and anti-inflammatory cytokines are key mediators.

AIMS

To study pro- and anti-inflammatory cytokines across dengue severity and as a biomarker for predicting severe dengue infection.

SETTINGS AND DESIGN

Hospital-based cross-sectional study was conducted on 125 dengue-positive subjects across the 5-60 years age group of either gender in 2022.

METHODS AND MATERIALS

Haematological parameters and blood samples were drawn to measure cytokines IL6, IL-10 and TNF alpha using the ELISA technique.

STATISTICAL ANALYSIS

One-way ANOVA and the Kruskal - Wallis test were used to compare the dependent variables across categories of the dengue spectrum. Receiver operating characteristic curve was drawn to calculate the predictability of the cytokines as a predictor of severe dengue. A < 0.05 was considered significant.

RESULTS

34.4% of cases had severe dengue infection with 53.2% of severe cases reported in >40 years of age. Only IL-6 levels significantly increased ( < 0.01) across the spectrum of dengue infection across age groups >20 years with a consistent and significant fall in platelet levels ( < 0.01). The accuracy of IL-6 to predict severe dengue was 74.4% and platelet count was 16.2%.

CONCLUSIONS

Only IL-6 cytokine levels were significantly increased across the spectrum of dengue infection observed in age >20 years and can significantly predict the probability of severe dengue by 74% (sensitivity 81.4%). A significant decrease in platelet values is consistent with the severity but is not a good predictor for severe dengue infection.

摘要

背景

登革热疾病的严重程度和病程由宿主免疫反应决定,促炎和抗炎细胞因子都是关键介质。

目的

研究不同登革热严重程度下的促炎和抗炎细胞因子,并将其作为预测重症登革热感染的生物标志物。

设置与设计

2022年对125名年龄在5至60岁的登革热阳性受试者进行了一项基于医院的横断面研究,受试者不限性别。

方法与材料

采集血液学参数和血样,采用酶联免疫吸附测定(ELISA)技术检测细胞因子白细胞介素6(IL6)、白细胞介素10(IL - 10)和肿瘤坏死因子α(TNFα)。

统计分析

采用单因素方差分析和克鲁斯卡尔 - 沃利斯检验比较登革热谱各分类中的因变量。绘制受试者工作特征曲线以计算细胞因子作为重症登革热预测指标的预测能力。P < 0.05被认为具有统计学意义。

结果

34.4%的病例发生重症登革热感染,53.2%的重症病例出现在40岁以上人群中。仅白细胞介素6水平在20岁以上各年龄组的登革热感染谱中显著升高(P < 0.01),同时血小板水平持续且显著下降(P < 0.01)。白细胞介素6预测重症登革热的准确率为74.4%,血小板计数的准确率为16.2%。

结论

在20岁以上人群观察到的登革热感染谱中,只有白细胞介素6细胞因子水平显著升高,且能够以74%的准确率(敏感性81.4%)显著预测重症登革热的发生概率。血小板值的显著下降与疾病严重程度相符,但并非重症登革热感染的良好预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d8f/11213393/aa8b5e01707b/JFMPC-13-1975-g001.jpg

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