Consistent with cytokine-driven vascular pathology, a prospective Indonesian study showed higher TNF-α, IL-6, and IL-17 in DHF versus DF, while IL-10 was higher in DF; secondary dengue also had higher TNF-α, IL-6, IL-17 and lower IL-10 than primary infection, aligning with a more pro-inflammatory milieu and plasma-leak risk. This evidence concerns the gene TNF and dengue disease.