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Unique Immune Blood Markers Between Severe Dengue and Sepsis in Children
Doris M Salgado1, Gina M Rivera1, William A Pinto1
1From the Departamento de Pediatría, Universidad Surcolombiana, E.S.E. Hospital Universitario de Neiva, Neiva, Huila, Colombia.
Insights
Pediatric dengue and sepsis show distinct patterns of inflammatory markers like IL-6 and VEGF. Analyzing these cytokine profiles can help differentiate severe pediatric dengue and sepsis, potentially guiding new diagnostic and therapeutic strategies.
Area of Science:
- Pediatric infectious diseases
- Immunology
- Critical care medicine
Background:
- Pediatric dengue and sepsis share overlapping clinical and pathophysiological features.
- Both diseases involve inflammatory cytokines, decoy receptors, and vascular permeability factors.
- Understanding the dynamics of these factors could lead to improved diagnosis and treatment.
Purpose of the Study:
- To compare the concentration levels of 11 soluble factors in children with dengue versus sepsis.
- To investigate the relationship between these factors and disease severity in pediatric patients.
- To explore differences in cytokine responses during various disease phases.
Main Methods:
- Plasma samples were collected from children with dengue or sepsis, ranging from mild to severe.
- Concentrations of 11 soluble factors (proinflammatory, regulatory, vascular permeability) were measured.
- Measurements were taken during early, late, and convalescence phases of illness.
Main Results:
- Sepsis cases showed higher IL-6, VEGF, and sVEGFR2, and lower IL-10 and sTNFR2 compared to severe dengue.
- Soluble ST2 and VEGF/sVEGFR2 levels correlated with dengue severity.
- Secondary dengue infections exhibited a stronger cytokine response than primary infections.
Conclusions:
- Pediatric dengue and sepsis exhibit distinct cytokine response profiles (magnitude, pattern, kinetics).
- These differences are crucial for understanding pathophysiology and clinical outcomes.
- Cytokine analysis offers potential for differentiating these critical pediatric illnesses.
Background:
Pediatric dengue and sepsis share clinical and pathophysiologic aspects. Multiple inflammatory and regulatory cytokines, decoy receptors and vascular permeability factors have been implicated in the pathogenesis of both diseases. The differential pattern and dynamic of these soluble factors, and the relationship with clinical severity between pediatric dengue and sepsis could offer new diagnosis and therapeutic strategies.
Methods:
We evaluated the concentration levels of 11 soluble factors with proinflammatory, regulatory and vascular permeability involvement, in plasma from children with dengue or sepsis, both clinically ranging from mild to severe, in the early, late and convalescence phases of the disease.
Results:
During early acute infection, children with sepsis exhibited specific higher concentration levels of IL-6, vascular endothelial growth factor (VEGF), and its soluble decoy receptor II (sVEGFR2) and lower concentration levels of IL-10 and the soluble tumor necrosis factor receptor 2 (sTNFR2), in comparison with children with severe dengue. In addition, the circulating amounts of soluble ST2, and VEGF/sVEGFR2 were widely associated with clinical and laboratory indicators of dengue severity, whereas secondary dengue virus infections were characterized by an enhanced cytokine response, relative to primary infections. In severe forms of dengue, or sepsis, the kinetics and the cytokines response during the late and convalescence phases of the disease also differentiate.
Conclusions:
Dengue virus infection and septic processes in children are characterized by cytokine responses of a specific magnitude, pattern and kinetics, which are implicated in the pathophysiology and clinical outcome of these diseases.
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