| Autor: |
Fiestas Solórzano VE; Viral Immunology Laboratory, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro 21040-360, Brazil., da Costa Faria NR; Viral Immunology Laboratory, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro 21040-360, Brazil., Dos Santos CF; Viral Immunology Laboratory, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro 21040-360, Brazil., Corrêa G; Viral Immunology Laboratory, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro 21040-360, Brazil., Cipitelli MDC; Molecular Biology Laboratory, Instituto de Biologia do Exército, Rio de Janeiro 20911-270, Brazil., Dornelas Ribeiro M; Molecular Biology Laboratory, Instituto de Biologia do Exército, Rio de Janeiro 20911-270, Brazil., de Souza LJ; Centro de Referência de Doenças Imuno-Infecciosas, Campos dos Goytacazes 28025-496, Brazil.; Departamento de Clínica Médica, Faculdade de Medicina de Campos, Campos dos Goytacazes 28035-581, Brazil., Damasco PV; Rede Casa Hospital Rio Laranjeiras, Rio de Janeiro 22240-000, Brazil.; Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-170, Brazil.; Escola de Medicina e Cirurgia, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-330, Brazil., da Cunha RV; Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande 79070-900, Brazil., Dos Santos FB; Viral Immunology Laboratory, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro 21040-360, Brazil., de Oliveira Pinto LM; Viral Immunology Laboratory, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro 21040-360, Brazil., de Azeredo EL; Viral Immunology Laboratory, Instituto Oswaldo Cruz-Fiocruz, Rio de Janeiro 21040-360, Brazil. |
| Abstrakt: |
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-γ, TNF-α, IL-1β, 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-α ( p < 0.001), IL-6 ( p = 0.005), IL-10 ( p < 0.001), IL-18 ( p = 0.001), CXCL8/IL-8 ( p < 0.001), CCL2/MCP-1 ( p < 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-α, IL-1β 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 1.03-1.71; p = 0.027), the area under the receiver operating characteristics curve (AUC) was 0.775 (95% CI 0.681-0.869) 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. |
