Dysregulation of cytokines in acute Q fever: role of interleukin-10 and tumor necrosis factor in chronic evolution of Q fever.
Q fever manifests as primary infection or acute Q fever and may become chronic in patients with underlying valvulopathy. Because Coxiella burnetii infection depends on host response, we measured tumor necrosis factor (TNF), interleukin (IL)-6, IL-12, and IL-10 in patients with different clinical presentations of acute Q fever. Compared with control subjects, patients with uncomplicated acute Q fever exhibited increased release of the 4 cytokines. Their amounts were higher in patients with hepatitis than in patients with fever or pneumonia. In patients with valvulopathy, who exhibited the highest risk of chronic evolution, the amounts of TNF and IL-10 were higher than in patients without valvulopathy. TNF production was specifically enhanced in patients who developed Q fever endocarditis. These results show that acute Q fever is associated with cytokine overproduction. Persistent TNF amounts were associated with the occurrence of endocarditis in patients with valvulopathy, and that may be a marker of chronic evolution of Q fever.
Honstettre
Amélie
A
Unité des Rickettsies, Centre National de la Recherche Scientifique Unité Mixte de Recherche 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France.
Imbert
Guenièvre
G
Ghigo
Eric
E
Gouriet
Frédérique
F
Capo
Christian
C
Raoult
Didier
D
Mege
Jean-Louis
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D016997:Coxiella burnetii; D018450:Disease Progression; D004697:Endocarditis, Bacterial / Q000209:etiology; D005260:Female; D006351:Heart Valves / Q000276:immunology / Q000473:pathology; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis / Q000096:biosynthesis / Q000502:physiology*; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000150:complications / Q000276:immunology* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000096:biosynthesis / Q000502:physiology*
D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10