title: Cytokine levels in Crimean-Congo hemorrhagic fever.
abstract: BACKGROUND
  Crimean-Congo hemorrhagic fever (CCHF) virus causes severe disease in humans with a mortality reaching 30%. A CCHF outbreak took place in Albania in 2003. As in other viral hemorrhagic fevers cytokines may be involved and play a role in the pathogenesis and outcome of the disease.
  
  
  OBJECTIVE
  To investigate the levels of TNF-alpha, sTNF-R, IL-6 and IL-10 in serum samples obtained from laboratory confirmed CCHF cases and relate them to the severity of the disease.
  
  
  METHODS
  A study population of 51 was divided into three groups: group A, consisting of PCR-positive cases; group B, consisting of PCR-negative and serology-positive cases; group C, consisting of doubly negative cases. Concentrations of serum TNF-alpha, sTNF-R, IL-6 and IL-10 were measured during the illness.
  
  
  RESULTS
  High levels of all cytokines tested were present in one fatal case. Statistically significant differences between the groups were obtained for TNF-alpha and IL-6: TNF-alpha was detected in 3 cases in group A, and in none of the other groups, while IL-6 was elevated in 10/16 patients in group A, 4/9 in group B, and 4/26 in group C. sTNF-R was not significantly different for the three groups. High concentration of IL-10 was detected only in the fatal case.
  
  
  CONCLUSIONS
  TNF-alpha and IL-6 are the cytokines most often detected during a CCHF viral infection. TNF-alpha was associated with the severe form of CCHF, while IL-6 was elevated in both severe and mild cases.
authors.affiliation: A' Department of Microbiology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece. annap@med.auth.gr
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
authors.forename: Silva
authors.initials: S
authors.lastname: Bino
authors.forename: Enkelejda
authors.initials: E
authors.lastname: Velo
authors.forename: Arjan
authors.initials: A
authors.lastname: Harxhi
authors.forename: Majlinda
authors.initials: M
authors.lastname: Kota
authors.forename: Antonis
authors.initials: A
authors.lastname: Antoniadis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000276:immunology; D002648:Child; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006479:Hemorrhagic Fever, Crimean / Q000276:immunology* / Q000401:mortality / Q000473:pathology*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000737:chemistry / Q000302:isolation & purification; D011933:Reagent Kits, Diagnostic; D017423:Sequence Analysis, RNA; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D000914:Antibodies, Viral; D015850:Interleukin-6; D012367:RNA, Viral; D011933:Reagent Kits, Diagnostic; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10