title: Activation of the cytokine network and unfavorable outcome in patients with yellow fever.
abstract: To study the contribution of inflammatory mediators to the pathogenesis of yellow fever (YF), the serum levels of several cytokines and chemokines were measured in 7 patients with fatal YF (f-YF), 11 patients with nonfatal hemorrhagic YF (nf/h-YF), and 18 patients with nonfatal nonhemorrhagic YF (nf/nh-YF). The levels of interleukin (IL)-6, monocyte chemoattractant protein-1, interferon-inducible protein (IP)-10, tumor necrosis factor- alpha , and IL-1 receptor antagonist (IL-1RA) were all statistically significantly higher in the patients with f-YF than in those with nf/nh-YF. In patients with nf/h-YF, only levels of IP-10 and IL-1RA were significantly elevated. The high levels of pro- and anti-inflammatory cytokines and chemokines in serum from patients with f-YF are reminiscent of those seen in patients with bacterial sepsis. This finding has implications for the understanding of the pathophysiology of YF and the development of therapeutic strategies.
authors.affiliation: Department of Virology, Philipps University Marburg, Marburg, Germany. j.termeulen@crucell.com
authors.forename: Jan
authors.initials: J
authors.lastname: ter Meulen
authors.forename: Mohamed
authors.initials: M
authors.lastname: Sakho
authors.forename: Kekoura
authors.initials: K
authors.lastname: Koulemou
authors.forename: N'Faly
authors.initials: N
authors.lastname: Magassouba
authors.forename: Aissatou
authors.initials: A
authors.lastname: Bah
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Preiser
authors.forename: Stephane
authors.initials: S
authors.lastname: Daffis
authors.forename: Christian
authors.initials: C
authors.lastname: Klewitz
authors.forename: Hi-Gung
authors.initials: HG
authors.lastname: Bae
authors.forename: Matthias
authors.initials: M
authors.lastname: Niedrig
authors.forename: Hervé
authors.initials: H
authors.lastname: Zeller
authors.forename: Monika
authors.initials: M
authors.lastname: Heinzel-Gutenbrunner
authors.forename: Lamine
authors.initials: L
authors.lastname: Koivogui
authors.forename: Andreas
authors.initials: A
authors.lastname: Kaufmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018932:Chemokine CCL2 / Q000097:blood; D054357:Chemokine CXCL10; D019743:Chemokines, CXC / Q000097:blood; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood* / Q000276:immunology; D005260:Female; D016701:Guinea; D006470:Hemorrhage; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood* / Q000276:immunology; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012795:Sialoglycoproteins / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D015004:Yellow Fever / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D054357:Chemokine CXCL10; D019743:Chemokines, CXC; D016207:Cytokines; C507763:IL1RN protein, human; D018836:Inflammation Mediators; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6; D012795:Sialoglycoproteins; D014409:Tumor Necrosis Factor-alpha