title: Status of cellular rather than humoral immunity is correlated with clinical outcome of enterovirus 71.
abstract: We valuated specific cellular and humoral immune response of cases of enterovirus 71 (EV71) infection and correlated immune response with clinical outcome. After obtaining informed consent, we enrolled 30 EV71 cases including 7 cases with brainstem encephalitis plus pulmonary edema, 12 cases of CNS (CNS) involvement and 11 uncomplicated cases. We measured antibodies specific to EV71, lymphocyte proliferation response and EV71-stimulated cellular response of Th1/Th2 cytokines and chemokines. The 7 EV71 cases involving brainstem encephalitis plus pulmonary edema had a significantly lower phytohemagglutinin stimulation index than other cases (p = 0.04). After EV71 stimulation of peripheral mononuclear cells, there was a significant increase in cellular Th1 cytokine (gamma-interferon) and proinflammatroy cytokines. However, cases with pulmonary edema had significantly lower cellular gamma-interferon (p = 0.04), lower cellular IL-1beta (p = 0.04), lower cellular IL-6 (p = 0.04), lower cellular tumor necrosis factor-alpha response (p = 0.04), and lower cellular macrophage inflammatory protein-1alpha (p = 0.04) response compared with other cases. Their titers of EV71 neutralizing antibodies demonstrated no difference among cases. These results suggest lower EV71-specific cellular response may be associated with immunopathogenesis of EV71-related pulmonary edema.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
authors.forename: Luan-Yin
authors.initials: LY
authors.lastname: Chang
authors.forename: Chao A
authors.initials: CA
authors.lastname: Hsiung
authors.forename: Chun-Yi
authors.initials: CY
authors.lastname: Lu
authors.forename: Tzou-Yien
authors.initials: TY
authors.lastname: Lin
authors.forename: Fu-Yuan
authors.initials: FY
authors.lastname: Huang
authors.forename: Yu-Han
authors.initials: YH
authors.lastname: Lai
authors.forename: Yu-Ping
authors.initials: YP
authors.lastname: Chiang
authors.forename: Bor-Luen
authors.initials: BL
authors.lastname: Chiang
authors.forename: Chin-Yun
authors.initials: CY
authors.lastname: Lee
authors.forename: Li-Min
authors.initials: LM
authors.lastname: Huang
mesh_terms: D000914:Antibodies, Viral / Q000097:blood*; D000917:Antibody Formation; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D004770:Enterovirus / Q000302:isolation & purification; D004769:Enterovirus Infections / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D007223:Infant; D008213:Lymphocyte Activation; D008297:Male; D011379:Prognosis; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
chemical_list: D000914:Antibodies, Viral; D016207:Cytokines