INTRODUCTION: Dengue is the most prevalent mosquito-borne viral disease and one of the most serious infectious diseases worldwide. Infection by any of the serotypes of dengue viruses (DEN-1–DEN-4) may result in different severities ranging from a relatively benign fever, called dengue fever (DF), to fatal dengue shock syndrome. The pathogenesis of dengue hemorrhagic fever (DHF) and dengue shock syndrome is thought to be mediated by various host factors. Previous reports have suggested an involvement of immunoresponse mediators as well as apoptosis-related molecules in the severity of dengue infection.

OBJECTIVE: Our aim was to elucidate the cellular gene responses to dengue viral infection at the transcriptional level and to correlate expression levels with disease activity and/or clinical manifestation.

METHODS: Expression levels of interleukin 8 (IL-8), IL-1β, matrix metalloproteinase 9 (MMP-9), and Fas in peripheral blood cells were assayed for 10 children with DF, 10 children with DHF, and 5 healthy controls by using real-time reverse-transcription quantitative polymerase chain reaction.

RESULTS: Expression levels of IL-8, IL-1β, MMP-9, and Fas were higher in children who developed DHF than in those with DF.

CONCLUSIONS: The messenger RNA expression levels of IL-8, IL-1β, MMP-9, and Fas were significantly elevated in children with DHF, which suggests that these mediators are involved in the pathogenesis. The messenger RNA expression level might serve as a predictor of dengue disease activity. Reverse-transcription polymerase chain reaction has a potential to be another rapid and useful tool in assessing disease severity, leading to a proper therapeutic plan.

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