Changes of immune function in patients with enterovirus 71 infection.
- Author:
Dan FU
1
;
Cheng-rong LI
;
Yan-xia HE
;
Ying ZU
;
De-zhi CAO
;
Guo-bing WANG
;
Ji-kui DENG
;
He-ping WANG
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; CD4-Positive T-Lymphocytes; immunology; Case-Control Studies; Child; Child, Preschool; Enterovirus A, Human; Enterovirus Infections; immunology; metabolism; pathology; Female; HLA-DR Antigens; immunology; Humans; Inflammation; Interleukin-10; metabolism; Lymphocyte Count; Male; Tumor Necrosis Factor-alpha; metabolism
- From: Chinese Journal of Pediatrics 2009;47(11):829-834
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the association of changes in immune function with enterovirus 71 (EV71) cases with different severity of the disease.
METHODForty-six EV71-infected patients and 12 age-matched healthy children were enrolled in this study. The patients were divided into four groups according to critical degree of enterovirus 71 infection: hand-foot-and-mouth disease (HFMD); central nervous system disease (CNSD); autonomic nervous system dysregulation (ANSD) and pulmonary edema (PE). We analyzed CD14+ monocyte HLA-DR expression, lymphocyte immunophenotypes, the proportion of CD4+CD25+ Foxp3high regulatory T cells (Treg cells) and Th17 cells, cytokines (IL-1beta, TNF-alpha, IL-10, TGF-beta, IL-6, IL-17A), evaluated the mRNA levels of Foxp3 and ROR-gammat, and serum immunoglobulin and complements.
RESULT(1) Serum concentrations of IL-1beta and TNF-alpha elevated in mild cases, while declined in severe cases, and were lower in PE group (P<0.05). Serum concentrations of IL-10 and IL-10/TNF-alpha ratio gradually raised with the aggravation of the disease, and higher in PE group (P<0.05). (2) Circulating CD14+ monocyte HLA-DR expression, CD3+T cells, CD4+T cells, CD8+T cells, and NK cells gradually decreased, and lower in PE group (P<0.05). There was no significant difference in B cells, immunoglobulin and complement among the four groups. (3) The proportion of CD4+CD25+ Foxp3high Treg cells, mRNA level of Foxp, and serum concentrations of TGF-beta gradually decreased with the aggravation of the disease, while the proportion of Th17 cells, serum concentrations of IL-17A, mRNA level of ROR-gammat, and IL-6 gradually increased with the aggravation.
CONCLUSIONImmune function changed with different illness phases. The mild cases presented systemic inflammatory response syndrome status, while critically ill cases presented compensatory anti-inflammatory response syndrome or mixed antagonist response status. Immunoregulatory treatment of patients with EV71 infection should emphasize different methods at different stage and individualization.
