• ROHIN DUBBAL Department of General Medicine, K.S. Hegde Medical Academy, Mangalore, Karnataka, India.
  • SRIRAM BS Department of Pharmacology, K.S. Hegde Medical Academy, Mangalore, Karnataka, India.


Objective: The objective of the study was to evaluate the levels of serum interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) during the course of 3rd and 5th days of dengue infection.

Methods: The prospective cohort study was taken up involving 50 adults diagnosed with dengue fever and admitted to Mysore Medical College and Research Institute from December 2015 to November 2016. Detailed history has been taken and clinical examination was carried out. Venous blood sample was collected and serum separated out for estimation of IL-6 and TNF-α levels using ELISA.

Results: It has been observed that the levels of IL-6 and TNF-α raised during 3rd day of infection and there is decrease in levels of IL-6 and no changes have been observed in TNF-α levels during 5th day.

Conclusion: The study concludes that the IL-6 and TNF-α plays a key role in understanding pathogenesis of severity of dengue infection, TNF-α being more sensitive in reaction to pathogen

Keywords: Interleukin-6, Tumor necrosis factor-alpha, Dengue infection


1. Rodenhuis-Zybert IA, Wilschut J, Smit JM. Dengue virus life cycle: Viral and host factors modulating infectivity. Cell Mol Life Sci 2010;67:2773-86.
2. Stanaway JD, Shepard DS, Undurraga EA, Halasa YA, Coffeng LE, Brady OJ, et al. The global burden of dengue: An analysis from the global burden of disease study 2013. Lancet Infect Dis 2016;16:712-23.
3. Haider Z, Ahmad FZ, Mahmood A, Waseem T, Shafiq I, Raza T, et al. Dengue fever in Pakistan: A paradigm shift; changing epidemiology and clinical patterns. Perspect Public Health 2015;135:294-8.
4. Tahir U, Khan UH, Zubair MS, Bahar EM. Wolbachia pipientis: A potential candidate for combating and eradicating dengue epidemics in Pakistan. Asian Pac J Trop Med 2015;8:989-98.
5. World Health Organization. Dengue Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization; 2009.
6. Castillo-Macías A, Salinas-Carmona MC, Torres-López E. Immunology of viral infections with ahigh impact in Mexico: Dengue, chikungunya, and zika. Med Univ 2017;19:198-207.
7. Scheller J, Chalaris A, Schmidt-Arras D, Rose-John S. The pro-and anti-inflammatory properties of the cytokine interleukin-6. Biochim Biophys Acta 2011;1813:878-88.
8. Sriram BS, Ravichandra V. An experimental study evaluating the influence of quercetin on monosodium glutamate induced depression in Swiss albino male mice. Asian J Pharm Clin Res 2019;12:292-4.
9. Ober D, Nguyen TL, Shen L, Ha DQ, Huong VT, Benyoucef S, et al. Tumor necrosis factor alpha levels in plasma and whole-blood culture in dengue-infected patients: Relationship between virus detection and pre-existing specific antibodies. J Med Virol 1998;54:210-8.
10. Hober D, Poli L, Roblin B, Gestas P, Chungue E, Granic G, et al. Serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-1beta (IL-1beta) in dengue-infected patients. Am J Trop Med Hyg 1993;48:324-31.
11. Juffrie M, Meer GM, Hack CE, Haasnoot K, Sutaryo, Veerman AJ. Inflammatory mediators in dengue virus infection in children interleukin-6 and its relation to C-reactive protein and secret phospholipase A2. Am J Trop Med Hyg 2001;65:70-5.
12. Kautner I, Robinson MJ, Kuhnle U. Dengue virus infection: Epidemiology, pathogenesis, clinical presentation, diagnosis and prevention. J Pediatr 1997;131:516-24.
13. Kittigul L, Temprom W, Sujirarat D, Kittigul C. Determination of tumour necrosis factor-alpha levels in dengue virus infected by sensitive biotin-streptavidin enzyme-linked immunosorbent assay. J Virol Methods 2000;90:51-7.
14. Kuno G, Bailey RE. Cytokine responses to dengue infection among Puerto Rican patients. Mem Inst Oswaldo Cruz 1994;89:179-82.
15. Kurane I, Ennis FA. Immunopathogenesis of dengue virus infections. In: Gubler DJ, Kuno G, editors. Dengue and Dengue Hemorrhagic Fever. London: CAB International; 1997. p. 273-90.
16. Kurane I, Innis BL, Nimmannitya S, Nisalak A, Meager A, Janus J, et al. Activation of T lymphocytes in dengue virus infections. High levels of soluble interleukin 2 receptor, soluble CD4, soluble CD8, interleukin 2 and interferon-gamma in sera in children with dengue. J Clin Invest 1991;88:1473-80.
17. Kurane I, Meager A, Ennis FA. Induction of interferon alpha and gamma from human lymphocytes bye dengue virus-infected cells.J Gen Virol 1986;67:1653-61.
18. Lanciotti RS, Calisher CH, Gubler DJ, Chang GF, Vorndam V. Rapid detection and typing of dengue from clinical samples by using reverse transcriptase-polymerase chain reaction. J Clin Microbiol 1992;30:545- 51.
19. Laur F, Murgue B, Deparis X, Roche C, Cassar O, Chunge E. Plasma levels of tumour necrosis factor alpha and transforming growth factor beta-1 in children with dengue 2 virus infection in French Polynesia. Trans R Soc Trop Med Hyg 1998;92:654-6.
20. Malavige GN, Fernando S, Fernando DJ. Seneviratne SL. Dengue viral infections. Postgrad Med J 2004;80:588-601.
63 Views | 74 Downloads
How to Cite
DUBBAL, R., and S. BS. “EVALUATION OF SERUM INTERLEUKIN-6 AND TUMOR NECROSIS FACTOR-ALPHA LEVELS IN PATIENTS WITH DENGUE FEVER – A TERTIARY CARE HOSPITAL BASED STUDY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 13, no. 4, Mar. 2020, pp. 185-7, doi:10.22159/ajpcr.2020.v13i4.36877.
Original Article(s)