{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:40:48Z","timestamp":1760060448717,"version":"build-2065373602"},"reference-count":57,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico (CNPq)","award":["404128\/2013-0"],"award-info":[{"award-number":["404128\/2013-0"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Kala-azar is associated with case-fatality rates as high as 10% in certain regions. Early identification of mortality biomarkers can significantly reduce this risk. This study, strengthened by a relatively high number of kala-azar-related deaths, aimed to identify serum cytokines as predictive biomarkers of fatal kala-azar. We compared 48 deceased patients with kala-azar to 42 survivors. The concentrations of IL-1\u03b2, IL-6, IL-8, IL-10, IL-12, and tumor necrosis factor-\u03b1 (TNF-\u03b1) were measured by flow cytometry. Cytokine levels were compared between groups using the Wilcoxon rank-sum test. Receiver operating characteristic (ROC) analysis, coupled with Youden\u2019s index, defined the optimal diagnostic threshold. Upon admission, IL-8 concentrations were substantially higher in deceased kala-azar patients (median 76.5 pg\/mL [IQR 35.2\u2013242.4 pg\/mL]) than in survivors (median 26.4 pg\/mL [IQR 15.1\u201347.7 pg\/mL]; p &lt; 0.0001). ROC analysis identified 49.3 pg\/mL as the optimal cutoff. When rounded to the clinically convenient value of 50 pg\/mL, IL-8 predicted a fatal outcome with an area under the curve of 0.75, sensitivity of 70.8%, and specificity of 76.2%. In contrast, IL-1\u03b2, IL-6, IL-10, IL-12, and TNF-\u03b1 showed no significant prognostic utility. Our findings suggest that IL-8 levels equal to or greater than 50 pg\/mL are a reliable predictor of fatal kala-azar.<\/jats:p>","DOI":"10.3390\/tropicalmed10090250","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T14:02:46Z","timestamp":1756735366000},"page":"250","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Interleukin-8 Predicts Fatal Kala-Azar: A Case\u2013Control Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3013-8778","authenticated-orcid":false,"given":"Simone Soares","family":"Lima","sequence":"first","affiliation":[{"name":"Department of Maternal and Child Health, Federal University of Piau\u00ed, Teresina 64049-550, Piau\u00ed, Brazil"},{"name":"Postgraduate Program in Biotechnology, Northeast Network of Biotechnology (RENORBIO), Federal University of Piau\u00ed, Teresina 64049-550, Piau\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5978-1241","authenticated-orcid":false,"given":"D\u00e9bora Cavalcante","family":"Braz","sequence":"additional","affiliation":[{"name":"Pharmacy Course, Federal University of Piau\u00ed, Teresina 64049-550, Piau\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3109-7899","authenticated-orcid":false,"given":"Vladimir Costa","family":"Silva","sequence":"additional","affiliation":[{"name":"Laboratory of Genomic Surveillance and Molecular Biology (LVGBM), Oswaldo Cruz Foundation (FIOCRUZ-PIAUI), Teresina 64000-128, Piau\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-4027","authenticated-orcid":false,"given":"Teresinha","family":"de Jesus Cardoso Farias Pereira","sequence":"additional","affiliation":[{"name":"Secretary of Education of Piau\u00ed, Teresina 64081-110, Piau\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5545-6943","authenticated-orcid":false,"given":"L\u00edndia Kalliana","family":"da Costa Ara\u00fajo Alves Carvalho","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Biotechnology, Northeast Network of Biotechnology (RENORBIO), Federal University of Piau\u00ed, Teresina 64049-550, Piau\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7115-7978","authenticated-orcid":false,"given":"Dorcas Lamounier","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Maternal and Child Health, Federal University of Piau\u00ed, Teresina 64049-550, Piau\u00ed, Brazil"},{"name":"Intelligence Center for Emerging and Neglected Tropical Diseases (CIATEN), Teresina 64001-020, Piau\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7302-2006","authenticated-orcid":false,"given":"Carlos Henrique Nery","family":"Costa","sequence":"additional","affiliation":[{"name":"Intelligence Center for Emerging and Neglected Tropical Diseases (CIATEN), Teresina 64001-020, Piau\u00ed, Brazil"},{"name":"Laboratory of Leishmaniasis, Natan Portella Institute of Tropical Medicine, Teresina 64001-020, Piau\u00ed, Brazil"},{"name":"Department of Community Medicine, Federal University of Piau\u00ed, Teresina 64001-020, Piau\u00ed, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s13071-025-06796-x","article-title":"Global, regional, and national burden of visceral leishmaniasis, 1990\u20132021: Findings from the global burden of disease study 2021","volume":"18","author":"Zhang","year":"2025","journal-title":"Parasites Vectors"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Alvar, J., V\u00e9lez, I.D., Bern, C., Herrero, M., Desjeux, P., Cano, J., Jannin, J., and Boer, M.D. (2012). 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