Some children develop only minor symptoms from a measles infection while others require hospitalization. Understanding these extremes of measles infection could lead not only to lower severity of infection, but potentially lower the global death rate. A number of studies have shown a significantly weaker immune system predisposes an individual to a more severe infection. This 2025 study published in the Journal of Communicable Diseases, investigated cytokine levels in 21 infants and children ages 1 month to 14 years with severe and moderate measles infection. (Cytokines are immune system hormones that control immune response). Children with severe measles infection had significantly higher levels of the inflammatory hormones Tumor Necrosis Factor (TNF-α) and Interleukin-6 (IL-6). Of interest, and worth further investigation, a large number of environmental factors have also been identified that artificially increase these cytokines, thereby potentially contributing to severity.
ABSTRACT
Introduction: Measles is a significant global health concern that causes substantial morbidity and mortality, particularly in infants and children.
Aim: This study aimed to evaluate the levels and balance of pro-inflammatory (TNF-α and IL-6) and anti-inflammatory (IL-4) cytokines in the serum of infants and children with measles, based on disease severity.
Methods: A prospective observational study was conducted involving 21 infants and children aged 1 month to 14 years with moderate or severe measles, along with a control group of 25 healthy children. Serum cytokine concentrations were measured using ELISA, and acute-phase biomarkers (C-reactive protein and procalcitonin) were evaluated.
Results: The experimental group showed significantly higher TNF-α and IL-6 levels than the control group (P<0.05). IL-4 levels were also elevated in the experimental group, particularly in severe cases (P<0.001). Correlation analysis revealed positive associations between cytokine levels and disease severity (IL-4: r=0.52, IL-6: r=0.64, TNF-α: r=0.48). Negative correlations were observed between cytokine and lymphocyte counts, whereas inverse relationships were found with C-reactive protein and procalcitonin levels.
Conclusion: These findings suggest that the complex interplay between pro-inflammatory and anti-inflammatory cytokines contributes to the immunopathology of measles, with higher levels of TNF-α, IL-6, and IL-4 being associated with increased disease severity. Keywords: Measles, Cytokines, Inflammation, Immunopathogenesis, Interleukins, Proinflammatory