林秋烽林美悅2026-05-072026-05-072022-06-16https://handle.ncl.edu.tw/11296/65m896https://203.71.86.71/handle/123456789/10895口試委員：蕭信宏 Shin-Hong Shiao;何宗憲 Tzong-Shiann Ho;李垣樟 Yuarn-Jang Lee;張榮善 Jung-Shan Chang;林秋烽 Chiou-Feng Lin 網際網路,開放日期為2025-08-01As dengue infection is one of the most arboviral infections worldwide without available vaccines and medicine, severe dengue is highly dependent on timely and proper medical treatment. However, there is no reliable severity prediction marker for dengue infection progression as dengue warning signs from WHO 2009 still have high sensitivity but low specificity. The other proposed markers are also not readily accessible in clinical settings, especially in rural areas. We developed a 24-cytokine panel from the literature study to overcome this problem and then used it in the dengue patient plasma using the Multiplex Cytokine Assay. Further, Assay results were analyzed, and promising severity biomarkers were proposed. The 24-cytokine panel (IFN-γ, IL-10, IL-6, IL-8, TNF-α, CXCL-10, IL-4, CCL-2, CCL-4, CCL-5, IFN-α, GM-CSF, VEGF, IL-15, IL-13, IL-1Rα, IL-18, IL-12, CXCL-9, CCL-3, IL-17, IL-7, IL-1β, and IL-2) were the chemokine/cytokines that increased in the severe dengue infection. Our pilot study showed that only ten cytokines increased significantly in dengue to healthy (n = 30), with one decrease. However, in the severe to mild, only two cytokines increased statistically (IL-8 and IL-18). We expanded the sample number (n = 92) and found that some cytokines are upregulated (IL-18, IL-10, IL-6, and TNF⍺) and downregulated (IFN-γ, IFN-⍺, IL-7, IL-17, MCP-1, and RANTES) in the more severe dengue infection compared to its milder group. Further, we analyze the AUC of each variable and found that GPT, platelet, IL-6, IL-18, and RANTES are the best possible biomarkers for prediction in different severity groups. The result showed that our panel could be used to assess the severe condition, and GPT, platelet, IL-6, IL-18, and RANTES are promising biomarkers to predict dengue severity in various groups.系所名稱：細胞治療與再生醫學國際博士學位學程thesis