title: Modulation of cytokine production by intravenous immunoglobulin in patients with enterovirus 71-associated brainstem encephalitis.
abstract: BACKGROUND
  Several epidemics of enterovirus 71 (EV71) infections occurred in Taiwan since 1998.
  
  
  OBJECTIVE
  We performed the study to determine the changes in cytokine profiles associated with administration of intravenous immunoglobulin (IVIG) in patients with EV71-associated brainstem encephalitis complicated by autonomic nervous system (ANS) dysfunction and pulmonary edema.
  
  
  METHODS
  Plasma cytokine concentrations (IL-1beta, IL-6, IL-8, IFN-gamma, TNF-alpha, IL-2, IL-4, IL-5, IL-10, and IL-13) were monitored on admission and within 12-24h after administration of IVIG in a cohort of children (n=22) with virologically confirmed EV71 infection, from March 2000 through April 2004.
  
  
  RESULTS
  Plasma levels of IFN-gamma, IL-6, IL-8, IL-10, and IL-13 levels significantly decreased in patients with pulmonary edema after administration of IVIG, P<0.05. Plasma levels of IL-6 and IL-8 were significantly decreased in patients with ANS dysregulation after administration of IVIG, P<0.05. Administration of IVIG was not associated with significant changes in plasma concentration of IL-1beta, IL-2, IL-4, IL-5 IL-10, IL-13 and TNF-alpha in patients with ANS dysregulation.
  
  
  CONCLUSIONS
  These findings suggest that IVIG might be considered to have a therapeutic role in EV71-associated brainstem encephalitis. A clinical trial is needed to support this hypothesis.
authors.affiliation: Department of Emergency Medicine, National Cheng Kung University & Hospital, 138 Sheng Li Road, 70428 Tainan, Taiwan.
authors.forename: Shih-Min
authors.initials: SM
authors.lastname: Wang
authors.forename: Huan-Yao
authors.initials: HY
authors.lastname: Lei
authors.forename: Mei-Chih
authors.initials: MC
authors.lastname: Huang
authors.forename: Ling-Yao
authors.initials: LY
authors.lastname: Su
authors.forename: Hui-Chen
authors.initials: HC
authors.lastname: Lin
authors.forename: Chun-Keung
authors.initials: CK
authors.lastname: Yu
authors.forename: Jung-Lung
authors.initials: JL
authors.lastname: Wang
authors.forename: Ching-Chuan
authors.initials: CC
authors.lastname: Liu
mesh_terms: D001933:Brain Stem; D002675:Child, Preschool; D016207:Cytokines / Q000096:biosynthesis* / Q000097:blood; D018792:Encephalitis, Viral / Q000150:complications / Q000276:immunology* / Q000628:therapy; D029821:Enterovirus A, Human; D004769:Enterovirus Infections / Q000150:complications / Q000276:immunology* / Q000628:therapy; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D011654:Pulmonary Edema / Q000150:complications
chemical_list: D016207:Cytokines; D016756:Immunoglobulins, Intravenous