Corticosteroids for dengue - why don't they work?
PLoS Negl Trop Dis, 2013;7(12):e2592.
Nguyen TH[1], Nguyen TH[1], Vu TT[1], Farrar J[2], Hoang TL[3], Dong TH[4], Ngoc Tran V[4], Phung KL[1], Wolbers M[2], Whitehead SS[5], Hibberd ML[3], Wills B[2], Simmons CP[6]
Affiliations
PMID: 24349598DOI: 10.1371/journal.pntd.0002592
Impact factor: 4.781
Abstract
background: Dysregulated immune responses may contribute to the clinical complications that occur in some patients with dengue.
findings: In Vietnamese pediatric dengue cases randomized to early prednisolone therapy, 81 gene-transcripts (0.2% of the 47,231 evaluated) were differentially abundant in whole-blood between high-dose (2 mg/kg) prednisolone and placebo-treated patients two days after commencing therapy. Prominent among the 81 transcripts were those associated with T and NK cell cytolytic functions. Additionally, prednisolone therapy was not associated with changes in plasma cytokine levels.
conclusion: The inability of prednisolone treatment to markedly attenuate the host immune response is instructive for planning future therapeutic strategies for dengue.
MeSH terms
Adolescent; Child; Child, Preschool; Cytokines; Dengue; Female; Gene Expression Profiling; Humans; Immunologic Factors; Immunomodulation; Killer Cells, Natural; Male; Placebos; Prednisolone; T-Lymphocytes, Cytotoxic; Treatment Failure; Vietnam; Young Adult
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