CYTOKINE RESPONSES TO DENGUE INFECTION AMONG PUERTO-RICAN PATIENTS

Recently, a strong correlation between high concentration of tumor nec rosis factor (TNF alpha) in blood and severity of dengue hemorrhagic f ever/dengue shock syndrome has been reported from Asia and the Pacific . We wished to determine if a similar relationship could be found in d engue patients in the Americas where adult patients with severe syndro mes have been observed more frequently than in Asia where severe cases have been observed mostly among children. The concentrations of inter leukin-1 (IL-1 beta) in hospitalized adult groups were significantly l ower than that in outpatient adults. In contrast, the levels of interl eukin 6 (IL-6) were significantly higher in hospitalized adults and ch ildren than in the corresponding outpatients. Levels of TNF alpha were higher in hospitalized children than in outpatient children or hospit alized adults. There was no significant difference in the levels of th ese three cytokines among hospitalized patients with or without hemorr hagic manifestations. Thus, an elevated IL-6 level was positively asso ciated with severity of dengue infection in both children and adults, but IL-1 beta level was negatively associated with severity in adults.