Contribution of Immune Responses to

Introduction: Dengue severity is influenced by viral load and the host's immune response. Methods: This observational cross-sectional study was conducted on 62 secondary dengue patients aged 1-12 years. The ISAAC questionnaire was used to assess the history of AD. T-cell functions were evaluated by measuring the levels of IFNγ, IL10, IL13, and CCL2 cytokines in the PHA-stimulated whole blood cultures exposed to Results: The incidence of dengue hemorrhagic fever (DHF) was higher among dengue patients with AD than in those without AD (p=0.010). In the PHA-stimulated whole blood cultures exposed to SGE, higher CCL2 levels were observed in DHF patients than in dengue fever (DF) patients (p=0.044), and higher IL13 levels were found in dengue patients with AD compared to those without AD (p=0.026). In PHA-stimulated whole blood cultures without SGE, lower IFNγ levels were found in DHF patients than in DF patients (p=0.035). Conclusion: AD may be associated with a higher incidence of DHF and increased T-cell IL-13 production in response to SGE. DHF may be associated with increased T-cell CCL2 production in response to SGE, which may reflect greater cell infiltration at the bite site, and reduced T-cell IFN-γ production in response to dengue infection.