Prognostic value of cerebrospinal fluid cytokine changes in herpes simplex virus encephalitis.
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.
Kamei
Satoshi
S
Division of Neurology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-kamichou, Itabashi-ku, Tokyo 173-8610, Japan.
Taira
Naoto
N
Ishihara
Masaki
M
Sekizawa
Tsuyoshi
T
Morita
Akihiko
A
Miki
Kenji
K
Shiota
Hiroshi
H
Kanno
Akira
A
Suzuki
Yutaka
Y
Mizutani
Tomohiko
T
Itoyama
Yasuto
Y
Morishima
Tsuneo
T
Hirayanagi
Kaname
K
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
D000305:Adrenal Cortex Hormones; D000998:Antiviral Agents; D015415:Biomarkers; D016207:Cytokines; D015850:Interleukin-6; D007371:Interferon-gamma; D000212:Acyclovir