title: Prognostic value of cerebrospinal fluid cytokine changes in herpes simplex virus encephalitis.
abstract: A recent trial suggested that corticosteroid was beneficial in herpes simplex virus encephalitis (HSVE), but that precise role remains unclear. We assessed the differences of cerebrospinal fluid (CSF) cytokine changes between different outcomes and between patients with and without corticosteroid administration at the acute stage of HSVE. Interleukin (IL)-1beta, IL-2, IL-6, IL-10, interferon (IFN)-gamma, and tumor necrosis factor-alpha were measured in 56 serial CSFs taken from 20 adult HSVE patients. Their outcomes were poor in 7 and good in 13 patients, and corticosteroid was administered in 10. The differences in the initial and maximum cytokine values were assessed among the different outcomes. The decline rate of cytokine values between the initial and second CSF samples was also assessed between patients with and without corticosteroid. The initial IFN-gamma and maximum IL-6 with a poor outcome were higher than those with a good outcome (p=0.019 for IFN-gamma and p=0.013 for IL-6). The decline rate of IL-6 in patients with corticosteroid was higher than that without corticosteroid (p=0.034). The initial IFN-gamma and maximum IL-6 CSF values represented prognostic biomarkers in HSVE. One pharmacological mechanism related to corticosteroid in HSVE is apparently inhibition of pro-inflammatory cytokines such as IL-6.
authors.affiliation: Division of Neurology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamichou, Itabashi-ku, Tokyo 173-8610, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kamei
authors.forename: Naoto
authors.initials: N
authors.lastname: Taira
authors.forename: Masaki
authors.initials: M
authors.lastname: Ishihara
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sekizawa
authors.forename: Akihiko
authors.initials: A
authors.lastname: Morita
authors.forename: Kenji
authors.initials: K
authors.lastname: Miki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shiota
authors.forename: Akira
authors.initials: A
authors.lastname: Kanno
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Mizutani
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Itoyama
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Morishima
authors.forename: Kaname
authors.initials: K
authors.lastname: Hirayanagi
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000134:cerebrospinal fluid; D016207:Cytokines / Q000134:cerebrospinal fluid*; D020803:Encephalitis, Herpes Simplex / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000134:cerebrospinal fluid; D015850:Interleukin-6 / Q000134:cerebrospinal fluid; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018139:Simplexvirus; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D015415:Biomarkers; D016207:Cytokines; D015850:Interleukin-6; D007371:Interferon-gamma; D000212:Acyclovir