{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:29:54Z","timestamp":1789504194778,"version":"build-2803163510"},"reference-count":69,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T00:00:00Z","timestamp":1631059200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The incidence of dengue in Latin America has increased dramatically during the last decade. Understanding the pathogenic mechanisms in dengue is crucial for the identification of biomarkers for the triage of patients. We aimed to characterize the profile of cytokines (IFN-\u03b3, TNF-\u03b1, IL-1\u03b2, IL-6, IL-18 and IL-10), chemokines (CXCL8\/IL-8, CCL2\/MCP-1 and CXCL10\/IP-10) and coagulation mediators (Fibrinogen, D-dimer, Tissue factor-TF, Tissue factor pathway inhibitor-TFPI and Thrombomodulin) during the dengue-4 epidemic in Brazil. Laboratory-confirmed dengue cases had higher levels of TNF-\u03b1 (p &lt; 0.001), IL-6 (p = 0.005), IL-10 (p &lt; 0.001), IL-18 (p = 0.001), CXCL8\/IL-8 (p &lt; 0.001), CCL2\/MCP-1 (p &lt; 0.001), CXCL10\/IP-10 (p = 0.001), fibrinogen (p = 0.037), D-dimer (p = 0.01) and TFPI (p = 0.042) and lower levels of TF (p = 0.042) compared to healthy controls. A principal component analysis (PCA) distinguished between two profiles of mediators of inflammation and coagulation: protective (TNF-\u03b1, IL-1\u03b2 and CXCL8\/IL-8) and pathological (IL-6, TF and TFPI). Lastly, multivariate logistic regression analysis identified high aspartate aminotransferase-to-platelet ratio index (APRI) as independent risk factors associated with severity (adjusted OR: 1.33; 95% CI 1.03\u20131.71; p = 0.027), the area under the receiver operating characteristics curve (AUC) was 0.775 (95% CI 0.681\u20130.869) and an optimal cutoff value was 1.4 (sensitivity: 76%; specificity: 79%), so it could be a useful marker for the triage of patients attending primary care centers.<\/jats:p>","DOI":"10.3390\/v13091789","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T21:28:45Z","timestamp":1631136525000},"page":"1789","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Different Profiles of Cytokines, Chemokines and Coagulation Mediators Associated with Severity in Brazilian Patients Infected with Dengue Virus"],"prefix":"10.3390","volume":"13","author":[{"given":"Victor Edgar","family":"Fiestas Sol\u00f3rzano","sequence":"first","affiliation":[{"name":"Viral Immunology Laboratory, Instituto Oswaldo Cruz\u2014Fiocruz, Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieli Rodrigues","family":"da Costa Faria","sequence":"additional","affiliation":[{"name":"Viral Immunology Laboratory, Instituto Oswaldo Cruz\u2014Fiocruz, Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Fernandes","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Viral Immunology Laboratory, Instituto Oswaldo Cruz\u2014Fiocruz, Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladys","family":"Corr\u00eaa","sequence":"additional","affiliation":[{"name":"Viral Immunology Laboratory, Instituto Oswaldo Cruz\u2014Fiocruz, Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rcio da Costa","family":"Cipitelli","sequence":"additional","affiliation":[{"name":"Molecular Biology Laboratory, Instituto de Biologia do Ex\u00e9rcito, Rio de Janeiro 20911-270, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos","family":"Dornelas Ribeiro","sequence":"additional","affiliation":[{"name":"Molecular Biology Laboratory, Instituto de Biologia do Ex\u00e9rcito, Rio de Janeiro 20911-270, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Jos\u00e9","family":"de Souza","sequence":"additional","affiliation":[{"name":"Centro de Refer\u00eancia de Doen\u00e7as Imuno-Infecciosas, Campos dos Goytacazes 28025-496, Brazil"},{"name":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina de Campos, Campos dos Goytacazes 28035-581, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Vieira","family":"Damasco","sequence":"additional","affiliation":[{"name":"Rede Casa Hospital Rio Laranjeiras, Rio de Janeiro 22240-000, Brazil"},{"name":"Faculdade de Ci\u00eancias M\u00e9dicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-170, Brazil"},{"name":"Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-330, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rivaldo Ven\u00e2ncio","family":"da Cunha","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1309-5366","authenticated-orcid":false,"given":"Flavia Barreto","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Viral Immunology Laboratory, Instituto Oswaldo Cruz\u2014Fiocruz, Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luzia Maria","family":"de Oliveira Pinto","sequence":"additional","affiliation":[{"name":"Viral Immunology Laboratory, Instituto Oswaldo Cruz\u2014Fiocruz, Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elzinandes Leal","family":"de Azeredo","sequence":"additional","affiliation":[{"name":"Viral Immunology Laboratory, Instituto Oswaldo Cruz\u2014Fiocruz, Rio de Janeiro 21040-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,8]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2021, June 12). 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