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Interleukin-8 Predicts Fatal Kala-Azar: A Case-Control Study.

Simone Soares Lima1,2, Débora Cavalcante Braz3, Vladimir Costa Silva4

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|September 26, 2025
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Summary

Interleukin-8 (IL-8) serum levels can predict fatal outcomes in kala-azar patients. Elevated IL-8 concentrations upon admission indicate a higher risk of mortality from this disease.

Keywords:
cytokinesinflammationmortalityprognosisvisceral leishmaniasis

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Area of Science:

  • Immunology
  • Tropical Medicine
  • Biomarker Discovery

Background:

  • Kala-azar (visceral leishmaniasis) presents significant mortality risks, particularly in endemic regions.
  • Early identification of biomarkers is crucial for timely intervention and risk stratification.
  • Serum cytokines are potential indicators of disease severity and prognosis.

Purpose of the Study:

  • To identify serum cytokine profiles that predict fatal outcomes in kala-azar patients.
  • To evaluate specific cytokines, including IL-1β, IL-6, IL-8, IL-10, IL-12, and TNF-α, as prognostic biomarkers.
  • To establish a reliable predictive threshold for mortality using identified biomarkers.

Main Methods:

  • Comparison of serum cytokine levels between 48 deceased kala-azar patients and 42 survivors.
  • Quantification of cytokines using flow cytometry.
  • Statistical analysis including Wilcoxon rank-sum test and Receiver Operating Characteristic (ROC) analysis with Youden's index.

Main Results:

  • Significantly higher Interleukin-8 (IL-8) concentrations were observed in deceased patients (median 76.5 pg/mL) compared to survivors (median 26.4 pg/mL; p < 0.0001).
  • ROC analysis determined an optimal IL-8 cutoff of 49.3 pg/mL, with a clinical threshold of 50 pg/mL.
  • An IL-8 level ≥ 50 pg/mL predicted fatal kala-azar with 70.8% sensitivity and 76.2% specificity (AUC 0.75).
  • Other tested cytokines (IL-1β, IL-6, IL-10, IL-12, TNF-α) did not show significant prognostic value.

Conclusions:

  • Serum IL-8 levels ≥ 50 pg/mL serve as a reliable predictor of fatal kala-azar.
  • IL-8 emerges as a valuable prognostic biomarker for identifying high-risk patients.
  • This finding can aid in early risk stratification and targeted management strategies for kala-azar.