Comparison of clinical and laboratory characteristics between children and adults with dengue

Over the past several years, the epidemiological profile of dengue has been changing progressively and is currently characterized by an increase in the number of cases in children under 15 years of age. This study was aimed at comparing the clinical and laboratory features between adults and children with dengue; therefore, we performed a cross-sectional analysis of 5686 individuals with laboratory-confirmed dengue who sought treatment at a healthcare facility in Rio de Janeiro, Brazil from 2010 to 2011. A multivariate analysis indicated that myalgia (OR = 2.58; CI 95% = 2.08-3.18), retro-orbital pain (OR = 1.36; CI 95% = 1.15-1.62), nausea (OR = 1.92; CI 95% = 1.60-2.30), and arthralgia (OR = 3.64; CI 95% = 2.72-4.89) were the most frequent clinical symptoms in adults, whereas vomiting (OR = 0.52; CI 95% = 0.43-0.61) and skin rash (OR = 0.46; CI 95% = 0.25-0.85) were the most prevalent symptoms in children. Adults exhibited a higher hemoconcentration (OR = 3.04; CI 95% = 2.53-3.65), thrombocytopenia (OR = 2.17; CI 95% = 1.80-2.60), increased erythrocyte sedimentation rate (OR = 1.81; CI 95% = 1.53-2.14), and increased ALT (OR = 3.13; CI 95% = 2.44-4.02) than did children. In addition, adults exhibited a higher frequency of the severe forms of the disease (OR = 1.74; CI 95% = 1.12-2.72) and hospitalization (OR = 2.21; CI 95% = 1.59-3.06) relative to children. Based on these results, this study demonstrated significant differences in the clinical and laboratory presentations and disease severity between adults and children affected by dengue

Comparison of clinical and laboratory characteristics between children and adults with dengue

Over the past several years, the epidemiological profile of dengue has been changing progressively and is currently characterized by an increase in the number of cases in children under 15 years of age. This study was aimed at comparing the clinical and laboratory features between adults and children with dengue; therefore, we performed a cross-sectional analysis of 5686 individuals with laboratory-confirmed dengue who sought treatment at a healthcare facility in Rio de Janeiro, Brazil from 2010 to 2011. A multivariate analysis indicated that myalgia (OR = 2.58; CI 95% = 2.08-3.18), retro-orbital pain (OR = 1.36; CI 95% = 1.15-1.62), nausea (OR = 1.92; CI 95% = 1.60-2.30), and arthralgia (OR = 3.64; CI 95% = 2.72-4.89) were the most frequent clinical symptoms in adults, whereas vomiting (OR = 0.52; CI 95% = 0.43-0.61) and skin rash (OR = 0.46; CI 95% = 0.25-0.85) were the most prevalent symptoms in children. Adults exhibited a higher hemoconcentration (OR = 3.04; CI 95% = 2.53-3.65), thrombocytopenia (OR = 2.17; CI 95% = 1.80-2.60), increased erythrocyte sedimentation rate (OR = 1.81; CI 95% = 1.53-2.14), and increased ALT (OR = 3.13; CI 95% = 2.44-4.02) than did children. In addition, adults exhibited a higher frequency of the severe forms of the disease (OR = 1.74; CI 95% = 1.12-2.72) and hospitalization (OR = 2.21; CI 95% = 1.59-3.06) relative to children. Based on these results, this study demonstrated significant differences in the clinical and laboratory presentations and disease severity between adults and children affected by dengue

Regulation of inflammatory chemokine receptors on blood T cells associated to the circulating versus liver chemokines in dengue fever

Submitted by Sandra Infurna ([email protected]) on 2016-08-23T17:36:56Z No. of bitstreams: 1 luzia_pinto_etal_IOC_2012_pdf.pdf: 2540207 bytes, checksum: af0db94f39a761c4b3ce0bdb94242401 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2016-08-23T17:54:11Z (GMT) No. of bitstreams: 1 luzia_pinto_etal_IOC_2012_pdf.pdf: 2540207 bytes, checksum: af0db94f39a761c4b3ce0bdb94242401 (MD5)Made available in DSpace on 2016-08-23T17:54:11Z (GMT). No. of bitstreams: 1 luzia_pinto_etal_IOC_2012_pdf.pdf: 2540207 bytes, checksum: af0db94f39a761c4b3ce0bdb94242401 (MD5) Previous issue date: 2012Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biotecnologia e Fisiologia de Infecções Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.Centro Regional de Referência em Dengue. Campos dos Goytacazes, RJ, Brasil.Centro Regional de Referência em Dengue. Campos dos Goytacazes, RJ, Brasil.Universidade Federal do Mato Grosso do Sul. Setor Hemonúcleo. MS, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biotecnologia e Fisiologia de Infecções Virais. Rio de Janeiro, RJ, Brasil.Universidade do Estado do Rio de Janeiro. Hospital Universitário Pedro Ernesto. Rio de Janeiro, RJ, Brasil.Centro Regional de Referência em Dengue. Campos dos Goytacazes, RJ, Brasil.Universidade Federal do Mato Grosso do Sul. Setor Hemonúcleo. MS, Brasil.Universidade do Estado do Rio de Janeiro. Hospital Universitário Pedro Ernesto. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biotecnologia e Fisiologia de Infecções Virais. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Imunologia Viral. Rio de Janeiro, RJ, Brasil.Little is known about the role of chemokines/chemokines receptors on T cells in natural DENV infection. Patients from DENV-2 and -3- outbreaks were studied prospectively during the acute or convalescent phases. Expression of chemokine receptor and activation markers on lymphocyte subpopulations were determined by flow cytometry analysis, plasma chemokine ligands concentrations were measured by ELISA and quantification of CCL5/RANTES(+) cells in liver tissues from fatal dengue cases was performed by immunochemistry. In the acute DENV-infection, T-helper/T-cytotoxic type-1 cell (Th1/Tc1)-related CCR5 is significantly higher expressed on both CD4 and CD8 T cells. The Th1-related CXCR3 is up-regulated among CD4 T cells and Tc2-related CCR4 is up-regulated among CD8 T cells. In the convalescent phase, all chemokine receptor or chemokine ligand expression tends to reestablish control healthy levels. Increased CCL2/MCP-1 and CCL4/MIP-1β but decreased CCL5/RANTES levels were observed in DENV-patients during acute infection. Moreover, we showed an increased CD107a expression on CCR5 or CXCR3-expressing T cells and higher expression of CD29, CD44(HIGH) and CD127(LOW) markers on CCR4-expressing CD8 T cells in DENV-patients when compared to controls. Finally, liver from dengue fatal patients showed increased number of cells expressing CCL5/RANTES in three out of four cases compared to three death from a non-dengue patient. In conclusion, both Th1-related CCR5 and CXCR3 among CD4 T cells have a potential ability to exert cytotoxicity function. Moreover, Tc1-related CCR5 and Tc2-related CCR4 among CD8 T cells have a potential ability to exert effector function and migration based on cell markers evaluated. The CCR5 expression would be promoting an enhanced T cell recruitment into liver, a hypothesis that is corroborated by the CCL5/RANTES increase detected in hepatic tissue from dengue fatal cases. The balance between protective and pathogenic immune response mediated by chemokines during dengue fever will be discussed

The combination of CD29, CD127 or CD44 markers with CCR4-expressing T cells.

<p>Statistical differences were assessed by the Mann Whitney U test to evaluate differences in parameters between controls and DENV-patients.</p>*<p>represents P values <0.05 between Controls versus DENV-patients and ^&between DF vs DF WS/Severe.</p

Relationship between chemokine receptor changes with frequency of peripheral T cells.

<p>Each acute or convalescent DENV-patients are represented. Correlations were explored using Spearman’s rho test. Statistically significant r values and P are given above the figures.</p

Expression of CCR5, CXCR3 and CCR4 on T cells from DENV-patients and healthy controls.

<p>Representative dot plots showing the expression of CCR5 (A), CXCR3 (B) and CCR4 (C) on CD4 or CD8 T cells in one healthy control and one DENV-patient. The values in italics in each region of the quadrants indicate the values of cells’ frequency of the quadrants. The bold-, italic and framed numbers on the right indicate the percentages of chemokine receptors among T cells. (D) Percentage of CCR5-expressing among CD4+ or CD8+ T cells; (E) percentage of CXCR3-expressing among CD4+ or CD8+ T cells; (F) percentage of CCR4-expressing among CD4+ or CD8+ T cells. Horizontal bars indicate the mean values, standard deviation for each population. Appropriate matched isotype control antibodies were used to discriminate between positive and negative populations. The Mann–Whitney U-test was used to analyze differences between control and patient groups. Statistically significant P values for differences between patients and controls are shown above the figures.</p

Demographic and clinical characteristics of DENV confirmed patients.

<p>DF, DF Without WS; WS/Severe, DF With WS+ Severe; ND, Not determined.</p><p>Illness Day^a corresponds to the days of the start of any symptoms until the moment when the patient was interviewed; Bleeding^b includes skin haemorrhages, epistaxis, gingival, gastrointestinal, urinary tract haemorrhage or metrorrhagia; Fluid leakage^c signs of plasma leakage (pleural or pericardial effusion, ascites); Hypotension^d defined by pulse pressure below 20 mm Hg and/or hypotensive for age; Convalescent patients who have early symptoms for more than 15 days. Include some of the patients in the acute phase. Statistical differences were assessed by the Mann Whitney U test to evaluate differences in different parameters between controls and DENV-patients.</p>*<p>represents P values <0.05 between DF versus WS/Severe and & represents P values <0.05 between Acute versus Convalescent patients.</p

Detection of cells expressing the chemokine CCL5/RANTES in liver tissues from dengue fatal cases.

<p>Samples were incubated with CCL5/RANTES-specific antibodies and secondary horseradish peroxidase-conjugated antibodies, revealed with DAB. (A) Liver tissue of one dengue case reacted with CCL5/RANTES-specific antibodies. (B) One dengue case incubated with the secondary antibody only. (C) Quantification of the number of CCL5/RANTES positive cells in the four fatal dengue cases and three fatal non-dengue cases. CCL5/RANTES expressing cells were indicated by →. The Mann–Whitney U-test was used to analyze differences between control and patient groups. Statistically significant P values for differences between patients and controls are shown above the figures.</p

The detection of CD29, CD127 or CD44^high markers on T cells.

<p>Statistical differences were assessed by the Mann Whitney U test to evaluate differences in parameters between controls and DENV-patients.</p>*<p>represents P values <0.05 between Controls versus DENV-patients and ^&between DF vs DF WS/Severe.</p

Circulating CCL2/MCP-1, CCL4/MIP-1β and CCL5/RANTES are differentially expressed DENV-patients.

<p>Each individual is represented, comparing healthy controls, acute or convalescent DENV-patients. The Mann–Whitney U-test was used to analyze differences between control and patient groups. Statistically significant P values for differences between patients and controls are given above the figures.</p