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In enterovirus 71 encephalitis with cardio-respiratory compromise elevated IL-1β, IL-1 receptor antagonist and G-CSF are markers of poor prognosis.
MedLine Citation:
PMID:  22829643     Owner:  NLM     Status:  Publisher    
Background. Enterovirus 71 (EV71) causes large outbreaks of hand foot and mouth disease (HFMD), with severe neurological complications and cardio-respiratory compromise, but the pathogenesis is poorly understood.Methods. We measured 30 chemokines and cytokines in serum and cerebrospinal fluid (CSF) samples from Malaysian children hospitalized with EV71 infection (n=88), comprising uncomplicated HFMD (n=47), meningitis (n=8), acute flaccid paralysis (n=1), encephalitis (n=21) and encephalitis with cardio-respiratory compromise (n=11). Four of the latter patients died.Results. Both pro- and anti-inflammatory mediators were elevated with different patterns of mediator abundance in the CSF and vascular compartments. Serum concentrations for IL-1β, IL-1Ra, and G-CSF were raised significantly in patients who developed cardio-respiratory compromise (p=0.013, p=0.004, p<0.001). Serum IL-1Ra and G-CSF were also significantly elevated in patients that died, with a serum G-CSF/IL-5 ratio > 100 at admission being the most accurate prognostic marker for death (p<0.001, Accuracy 85.5%, Sensitivity 100%, and Specificity 84.7%).Conclusion. Given IL-1β has a negative inotropic action on the heart, and that both its natural antagonist, IL-1Ra, and G-CSF are being assessed as treatments for acute cardiac impairment, the findings suggest we have identified functional markers of EV71 related cardiac dysfunction and potential treatment options.
Michael J Griffiths; Mong H Ooi; See C Wong; Anand Mohan; Yuwana Podin; David Perera; Chae H Chieng; Phaik H Tio; Mary J Cardosa; Tom Solomon
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-24
Journal Detail:
Title:  The Journal of infectious diseases     Volume:  -     ISSN:  1537-6613     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0413675     Medline TA:  J Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Brain Infections Group, Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, L69 7BE, United Kingdom.
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