Temporal Cytokine Profiling of Acute Dengue, Zika, Chikungunya, and Mayaro Virus Infections in Northern Peru

Background: Arboviruses, including Dengue virus (DENV), Chikungunya virus (CHIKV), Zika virus (ZIKV), and Mayaro virus (MAYV) are important causes of acute febrile illness (AFI) in high-risk regions in Peru. Differential diagnosis based on clinical manifestations is challenging due to overlapping symptoms. We conducted a pioneering study to compare cytokine profiles among these arboviruses, aiming to elucidate distinct immunological features for diagnostic and therapeutic insights.Methods: We conducted a cross-sectional study in patients with acute febrile illness from Cajamarca, Peru. Blood samples were collected for the diagnosis of arboviruses and the quantification of cytokines. Diagnosis of Dengue, Zika, Chikungunya, and Mayaro virus infections relied on specific IgM antibody detection via enzyme-linked immunosorbent assays (ELISA). Cytokine quantification was carried out by ELISA assays for IL-2, IL-6, IL-10, TNF-α, and IFN-γ. Comparative analysis of cytokine levels was performed between all viruses and controls.Results: A total of 20 patients were recruited for each arbovirus and control group. Our study revealed similarities in clinical symptoms across arboviral infections, with headaches, myalgias, and arthralgias as the predominant symptoms. IL-2 levels were similar across the arboviruses; however, DENV and ZIKV patients had higher levels compared to controls. Elevated IL-6 levels were associated with CHIKV and ZIKV, while IL-10 levels were highest in DENV as compared to other arboviruses. TNF-α and IFN-γ were significantly elevated in DENV and ZIKV, and they were significantly higher in DENV compared to MAYV.Conclusion: Our findings provide valuable insights into the unique cytokine profiles of arboviral infections. We found similar levels of IL-2 across the arboviral groups, IL-6 was predominantly elevated in CHIKV and ZIKV, while IL-10 showed the highest levels in DENV. TNF-α and IFN-γ showed a similar pattern, with DENV and ZIKV patients expressing the highest levels. Understanding the distinct immunological signatures of these arboviruses is crucial for effective diagnostic and therapeutic approaches in high-risk regions.