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Dengue virus infection can cause mild dengue fever (DF) or severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Cytokines are believed to be involved in the pathogenesis of dengue infection. However, the role of the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF) in dengue infection is unclear. In this study, serum levels of MIF in adult dengue patients with different disease severity and clinical outcome were determined and compared with the levels of other cytokines, tumor necrosis factor-
(TNF-
), interleukin-6 (IL-6), IL-10, and interferon gamma (IFN-
), in the same patients. Serum levels of MIF, IL-6, and IL-10, but not IFN-
or TNF-
, were higher in all DHF patients who died than in DHF survivors and DF patients. We conclude that in addition to IL-6 and IL-10, elevated levels of serum MIF are a potential predictor of disease severity and clinical outcome in dengue patients.
Received April 17, 2005. Accepted for publication August 30, 2005.
Acknowledgments: We thank Bill Franke for helpful comments on the manuscript.
Financial support: This study was supported by grant NHRI-CN-CL9303P from the National Health Research Institute, Taiwan.
* Address correspondence to Trai-Ming Yeh, Department of Medical Laboratory Sciences and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan 70101, Republic of China. E-mail: today{at}mail.ncku.edu.tw
Authors addresses: Lien-Cheng Chen, Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China, Telephone: 886-6-235-3535, extension 5794, Fax: 886-6-236-3956, E-mail: s5889115{at}mail.ncku.edu.tw. Huan-Yao Lei, Shun-Hua Chen, Hsiao-Sheng Liu, and Yee-Shin Lin, Departments of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China, Telephone: 886-6-235-3535, extension 5611, Fax: 886-6-208-2705, E-mails: hylei{at}mail.ncku.edu.tw, shunhua{at}mail.ncku.edu.tw, a713{at}mail.ncku.edu.tw, and yslin1{at}mail.ncku.edu.tw. Ching-Chuan Liu, Department of Pediatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China, Telephone: 886-6-235-3535, extension 5615, E-mail: liucc{at}mail.ncku.edu.tw. Shu-Chu Shiesh and Trai-Ming Yeh, Department of Medical Laboratory Sciences and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China, Telephone: 886-6-235-3535 extension 5778, Fax: 886-6-236-3956, E-mails: hsieh{at}mail.ncku.edu.tw, and today{at}mail.ncku.edu.tw. Shan-Tair Wang, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China, Telephone: 886-6-235-3535, extension 5561, E-mail: wife{at}mail.ncku.edu.tw. Huey-Wen Shyu, Department of Medical Technology, Fooyin University, Kaohsiung, Taiwan, Republic of China, Telephone: 886-7-781-1151, extension 625, Fax: 886-7-782-7162, E-mail: today{at}mail.ncku.edu.tw.
Reprint requests: Trai-Ming Yeh, Department of Medical Laboratory Sciences and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan 70101, Republic of China, E-mail: today{at}mail.ncku.edu.tw.
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