| Association of profoundly impaired immune competence in H1N1v-infected patients with a severe or fatal clinical course. | |
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MedLine Citation:
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PMID: 20670171 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Pandemic A/H1N1v influenza is characterized by a mild clinical course. However, a small subset of patients develops a rapidly progressive course caused by primary viral pneumonia or secondary bacterial infections that, in many cases, lead to death due to respiratory failure. The aim of the present study was to analyze the involvement of the immune response in the clinical presentation of H1N1v influenza. METHODS: The differentiation and functional capability of T cells from H1N1v-infected patients presenting with either mild disease (n=22) or severe or fatal disease (n=6) were compared. Moreover, plasma cytokines and chemokines were quantified. RESULTS: T cells from H1N1v-infected patients presenting with a severe clinical course resulted in impaired effector cell differentiation and failed to respond to mitogenic stimulation. T cell anergy was strictly associated with a severe acute phase of infection, but T cells could be restored in patients able to recover. Of interest, massive expression of CD95 marker was found on anergic T cells, suggesting an apoptosis-related mechanism. Finally, lower plasma levels of interferon-alpha and monocyte chemoattractant protein-1 were found in patients with a worse clinical course of influenza, suggesting impaired production of these cytokines. CONCLUSIONS: Our results show a strict association between host immune competence and the severity of the clinical course of H1N1v infection. By monitoring host functional response, patients with an enhanced risk of developing influenza-associated severe complications could be identified in a timely manner. |
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Authors:
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Chiara Agrati; Cristiana Gioia; Eleonora Lalle; Eleonora Cimini; Concetta Castilletti; Orlando Armignacco; Francesco Nicola Lauria; Federica Ferraro; Mario Antonini; Giuseppe Ippolito; Maria Rosaria Capobianchi; Federico Martini |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Journal of infectious diseases Volume: 202 ISSN: 1537-6613 ISO Abbreviation: J. Infect. Dis. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-05 Completed Date: 2010-09-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0413675 Medline TA: J Infect Dis Country: United States |
Other Details:
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Languages: eng Pagination: 681-9 Citation Subset: AIM; IM |
Affiliation:
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National Institute for Infectious Diseases Lazzaro Spallanzani, Istituto di Ricovero e Cura a Carattere Scientifico, Via Portuense 292, Rome, Italy. agrati@inmi.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Antigens, CD95 / metabolism Cell Differentiation Child Child, Preschool Female Humans Influenza A Virus, H1N1 Subtype / immunology, pathogenicity* Influenza, Human / immunology*, mortality, physiopathology*, virology Interferon-alpha / blood Male Middle Aged Severity of Illness Index T-Lymphocytes / immunology*, pathology* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Antigens, CD95; 0/Interferon-alpha |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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