Increased T cell activation and cytokine production in patients during both primary and secondary Dengue virus infections showed greater clinical severity of illness associated with cytokine storm characterized by elevated plasma pro-inflammatory cytokines such as IFN-γ, IL-6, IL-8, IL-10, CXCL9, CXCL10, CXCL11, MIF, TNF-α, and VEGF (130, 131). This evidence concerns the gene TNF and dengue disease.