{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:21:55Z","timestamp":1787772115644,"version":"build-2784847793"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Context:<\/jats:title>\n Dengue disease severity and progression are determined by the host immune response, with both pro- and anti-inflammatory cytokines are key mediators.<\/jats:p>\n <\/jats:sec>\n \n Aims:<\/jats:title>\n To study pro- and anti-inflammatory cytokines across dengue severity and as a biomarker for predicting severe dengue infection.<\/jats:p>\n <\/jats:sec>\n \n Settings and Design:<\/jats:title>\n Hospital-based cross-sectional study was conducted on 125 dengue-positive subjects across the 5-60 years age group of either gender in 2022.<\/jats:p>\n <\/jats:sec>\n \n Methods and Materials:<\/jats:title>\n \n 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\n \u2212<\/jats:bold>\n 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\n P<\/jats:italic>\n < 0.05 was considered significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n 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 (\n P<\/jats:italic>\n < 0.01) across the spectrum of dengue infection across age groups >20 years with a consistent and significant fall in platelet levels (\n P<\/jats:italic>\n < 0.01). The accuracy of IL-6 to predict severe dengue was 74.4% and platelet count was 16.2%.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_1576_23","type":"journal-article","created":{"date-parts":[[2024,5,5]],"date-time":"2024-05-05T20:00:07Z","timestamp":1714939207000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Pro- and anti-inflammatory cytokines signatures at different severity of dengue infection"],"prefix":"10.4103","author":[{"given":"Himani","family":"Prajapati","sequence":"first","affiliation":[{"name":"Department of Microbiology, Himalayan School of Bio-sciences, Swami Rama Himalayan University Jolly Grant, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Himalayan School of Bio-sciences, Swami Rama Himalayan University Jolly Grant, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garima","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Swami Rama Himalayan University Jolly Grant, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogesh","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Physiology, Swami Rama Himalayan University Jolly Grant, Dehradun, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"R2-20240828","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1126\/science.aan6836","article-title":"Antibody-dependent enhancement of severe dengue disease in humans","volume":"358","author":"Katzelnick","year":"2017","journal-title":"Science"},{"key":"R3-20240828","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.coviro.2020.07.010","article-title":"Understanding immunopathology of severe dengue:Lessons learnt from sepsis","volume":"43","author":"Aguilar-Briseno","year":"2020","journal-title":"Curr Opin Virol"},{"key":"R4-20240828","doi-asserted-by":"crossref","first-page":"5771","DOI":"10.4049\/jimmunol.180.9.5771","article-title":"IL-10:The master regulator of immunity to infection","volume":"180","author":"Couper","year":"2008","journal-title":"J Immunol"},{"key":"R5-20240828","doi-asserted-by":"crossref","first-page":"e2023","DOI":"10.1371\/journal.pntd.0002023","article-title":"Utilities and limitations of the World Health Organization 2009 warning signs for adult dengue severity","volume":"7","author":"Thein","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"key":"R6-20240828","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s00284-020-02284-w","article-title":"Current understanding of the pathogenesis of dengue virus infection","volume":"78","author":"Bhatt","year":"2021","journal-title":"Curr Microbiol"},{"key":"R7-20240828","doi-asserted-by":"crossref","first-page":"36","DOI":"10.4103\/tcmj.tcmj_161_18","article-title":"Dengue infection in North India:An experience of a tertiary care center from 2012 to 2017","volume":"32","author":"Dinkar","year":"2020","journal-title":"Tzu Chi Medical Journal"},{"key":"R9-20240828","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.virol.2008.03.028","article-title":"Phenotyping of peripheral blood mononuclear cells during acute dengue illness demonstrates infection and increased activation of monocytes in severe cases compared to classic dengue fever","volume":"376","author":"Durbin","year":"2008","journal-title":"Virology"},{"key":"R10-20240828","doi-asserted-by":"crossref","first-page":"657","DOI":"10.4049\/jimmunol.169.2.657","article-title":"Endothelial cell apoptosis induced by antibodies against dengue virus nonstructural protein 1 via production of nitric oxide","volume":"169","author":"Lin","year":"2002","journal-title":"J Immunol"},{"key":"R11-20240828","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1182\/blood.V74.4.1235.bloodjournal7441235","article-title":"Dengue virus, a flavivirus, propagates in human bone marrow progenitors and hematopoietic cell lines","volume":"74","author":"Nakao","year":"1989","journal-title":"Blood"},{"key":"R12-20240828","first-page":"350","article-title":"Observations related to pathogensis of dengue hemorrhagic fever. 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