Corticosteroids for dengue - why don't they work?

Thi Hanh Tien Nguyen ; Than Ha Quyen Nguyen ; Tuan Trung Vu ; Jeremy Farrar ; Truong Long Hoang ; Thi Hoai Tam Dong ; Van Ngoc Tran ; Khanh Lam Phung ; Marcel Wolbers ; Stephen S Whitehead ; +3 more... Martin L Hibberd ORCID logo ; Bridget Wills ; Cameron P Simmons ; (2013) Corticosteroids for dengue - why don't they work? PLoS neglected tropical diseases, 7 (12). e2592-. ISSN 1935-2727 DOI: 10.1371/journal.pntd.0002592
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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.


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