title: Antigenemia and cytokine expression in rotavirus gastroenteritis in children.
abstract: BACKGROUND
  Antigenemia is commonly found in children with rotavirus infection, although its clinical significance is undetermined. The aim of this study was to evaluate the association of antigenemia with clinical manifestations and cytokine profiles in children infected by rotavirus.
  
  
  METHODS
  In total, 68 children hospitalized with rotavirus gastroenteritis were enrolled. Serum samples were collected for detection of antigenemia and viremia. Clinical, laboratory and demographic data were analyzed. Proinflammatory, Th1 and Th2 cytokines were evaluated by bead-based flow cytometry.
  
  
  RESULTS
  Antigenemia and viremia were found in 45.6% (n = 31) and 5.9% (n = 4) of the 68 rotavirus-infected children, respectively. The mean age of the antigenemia group was significantly greater than that of the non-antigenemia group (43.5 vs. 27.3 months; p = 0.034). The antigenemia group had a significantly shorter length of hospitalization (4.8 vs. 5.8 days; p = 0.0354) in comparison with the non-antigenemia group, and antigenemia was inversely associated with the length of hospitalization (β = 0.31, p = 0.021). A significantly higher tumor necrosis factor (TNF)-β level was found in the patients with antigenemia than those without (236.7 vs. 29.2 pg/mL, p = 0.026). The severity of disease and the rate of extra-intestinal manifestations did not differ between the groups. Viremia was associated with a higher fever (p = 0.012).
  
  
  CONCLUSIONS
  Antigenemia was positively correlated with shorter hospital stay in children with rotavirus infection. Enhanced innate and T-cell-mediated immunity evidenced by up-regulation of TNF-β was found in patients with antigenemia.
authors.affiliation: Divisions of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Tsung-Han
authors.initials: TH
authors.lastname: Yu
authors.forename: Chi-Neu
authors.initials: CN
authors.lastname: Tsai
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Lai
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Chen
authors.forename: Hsun-Chin
authors.initials: HC
authors.lastname: Chao
authors.forename: Che-Wei
authors.initials: CW
authors.lastname: Lin
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Shih-Yen
authors.initials: SY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood*; D005260:Female; D005334:Fever / Q000821:virology; D005759:Gastroenteritis / Q000821:virology*; D020869:Gene Expression Profiling; D006760:Hospitalization; D006801:Humans; D007111:Immunity, Cellular; D007223:Infant; D007422:Intestines / Q000503:physiopathology / Q000821:virology; D007902:Length of Stay; D016014:Linear Models; D008233:Lymphotoxin-alpha / Q000097:blood; D008297:Male; D012367:RNA, Viral / Q000302:isolation & purification; D012401:Rotavirus / Q000472:pathogenicity; D012400:Rotavirus Infections / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D013048:Specimen Handling; D058408:Th1-Th2 Balance; D015854:Up-Regulation; D014766:Viremia / Q000276:immunology / Q000821:virology
chemical_list: D000914:Antibodies, Viral; D000956:Antigens, Viral; D016207:Cytokines; D008233:Lymphotoxin-alpha; D012367:RNA, Viral