title: Systemic cytokine responses in patients with influenza-associated encephalopathy.
abstract: Influenza-associated encephalopathy, a severe neurologic complication of influenza, is being reported more frequently in Japan. We investigated the transcription of cytokine genes in peripheral blood leukocytes and compared patients with influenza and with encephalopathy or febrile convulsions and patients with influenza but without neurologic complications. A quantitative polymerase chain reaction (PCR) revealed that transcription of the interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha genes was up-regulated to a greater extent in patients with encephalopathy than in those without neurologic complications. Plasma IL-6 levels also were higher in patients with encephalopathy, although the difference was marginal. Viral RNA in throat swabs was quantified using a real-time quantitative PCR. The virus load was similar among patients with encephalopathy or febrile convulsions or without neurologic complications. Furthermore, virus load was not correlated with either the transcription of cytokine genes or plasma cytokine concentrations. These results suggest that influenza-associated encephalopathy might be a consequence of systemic immune responses.
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan. k-kawada@qa2.so-net.ne.jp
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kawada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
authors.forename: Shinya
authors.initials: S
authors.lastname: Hara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Iriyama
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Morishima
mesh_terms: D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood / Q000235:genetics / Q000378:metabolism*; D018792:Encephalitis, Viral / Q000276:immunology* / Q000821:virology; D005260:Female; D006801:Humans; D007223:Infant; D009980:Influenza A virus / Q000276:immunology; D009981:Influenza B virus / Q000276:immunology; D007251:Influenza, Human / Q000150:complications* / Q000276:immunology*; D016753:Interleukin-10 / Q000096:biosynthesis / Q000235:genetics; D015850:Interleukin-6 / Q000096:biosynthesis / Q000235:genetics; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D008297:Male; D012367:RNA, Viral / Q000097:blood; D003294:Seizures, Febrile / Q000276:immunology* / Q000821:virology; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics / Q000378:metabolism; D015854:Up-Regulation; D019562:Viral Load
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D012367:RNA, Viral; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10