title: Proinflammatory cytokine reactions in enterovirus 71 infections of the central nervous system.
abstract: Enterovirus 71 (EV71) infection can lead to devastating clinical outcomes. An appreciation of the scientific relationship between cytokine response and patient mortality may help limit the risks posed by this deadly illness. We present the results of a study that compared the cerebrospinal fluid (CSF) and serum levels of interleukin-6 (IL-6) and interleukin-1beta (IL-1beta) in 24 patients with EV71 infection. Cases in this study involved diverse manifestations or complications, including encephalitis, poliomyelitis-like syndrome, meningitis, and pulmonary edema. CSF levels of IL-6 in study patients were found to be consistently higher during the first 2 days of central nervous system (CNS) involvement than afterward. Compared with patients who did not have pulmonary edema, patients who experienced pulmonary edema had dramatically varied blood values, including IL-6, white blood cell counts, and glucose levels. Our findings suggest that the combination of CNS and systemic inflammatory response may trigger EV71-related cardiopulmonary collapse.
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan, Republic of China.
authors.forename: Tzou-Yien
authors.initials: TY
authors.lastname: Lin
authors.forename: Shao-Hsuan
authors.initials: SH
authors.lastname: Hsia
authors.forename: Yhu-Chering
authors.initials: YC
authors.lastname: Huang
authors.forename: Chang-Teng
authors.initials: CT
authors.lastname: Wu
authors.forename: Luan-Yin
authors.initials: LY
authors.lastname: Chang
mesh_terms: D002494:Central Nervous System Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism / Q000821:virology*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism*; D004770:Enterovirus; D004769:Enterovirus Infections / Q000097:blood / Q000134:cerebrospinal fluid / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000097:blood / Q000134:cerebrospinal fluid; D007958:Leukocyte Count; D008297:Male; D017063:Outcome Assessment, Health Care; D013577:Syndrome
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D005947:Glucose