Plasma levels of tumour necrosis factor alpha and transforming growth factor beta-1 in children with dengue 2 virus infection in French Polynesia

The pathogenesis of dengue haemorrhagic fever (DHF) is not well understood. In the absence of predictive clinical or biological criteria, the manageme nt of DHF patients remains difficult. The role played by cytokines in the o ccurrence of DHF has been suggested by several authors. In this study, we d etermined the plasma levels of tumour necrosis factor alpha (TNF alpha) and transforming growth factor beta-1 (TGF beta-1) in 52 children with laborat ory-confirmed dengue virus infection admitted to hospital during the recent dengue 2 outbreak in French Polynesia. Thirty-three children were classifi ed as having dengue fever (DF) and 19 as DHF. The plasma of both DF and DHF patients contained similar levels of TNF alpha. By contrast, plasma obtain ed from children with DHF had significantly higher levels of TGF beta-1 tha n plasma fi om children with DF, especially from days I to 3 after the onse t of fever.