title: Elevation of human leukocyte antigen-G expression is associated with the severe encephalitis associated with neurogenic pulmonary edema caused by Enterovirus 71.
abstract: Enterovirus 71 (EV71) infection can develop devastating clinical outcomes such as brain stem encephalitis (BE) and pulmonary edema (PE). Alteration of human leukocyte antigen-G (HLA-G) expression or cytokine production was considered playing important roles in virus-related pathogenesis. However, clinical relevance of HLA-G in EV71 infection remains unknown. In the current study, patients were stratified by disease severity as BE (n = 107) and PE (n = 18). HLA-G expression on peripheral blood monocytes from patients with BE (n = 15), patients with PE (n = 15) and control subjects (n = 31) was analyzed with flow cytometry. Plasma soluble HLA-G (sHLA-G) (in 67 BE, 18 PE and 120 control subjects), IL-6 and IL-10 (in 50 patients with BE, 18 patients with PE and 45 control subjects) were determined with enzyme-linked immunosorbent assay. Data showed that the percentage of HLA-G-positive monocytes (mean 7.76 vs 3.68 %, p < 0.001), levels for sHLA-G (median 129.2 vs 70.6 U/ml, p < 0.001), IL-10 (median 160.5 vs 29.5 pg/ml, p < 0.001) and IL-6 (median 20.50 vs 5.21 pg/ml, p = 0.002) was significantly higher in patients with PE than in patients with BE. Taken together, our findings indicated that elevation of HLA-G expression on monocytes, plasma sHLA-G, IL-10 and IL-6 levels was associated with PE in patients infected with EV71.
authors.affiliation: Department of the Laboratory Medicine, the Second Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China.
authors.forename: Xiao-Qun
authors.initials: XQ
authors.lastname: Zheng
authors.forename: Xiao-Qing
authors.initials: XQ
authors.lastname: Chen
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.forename: Miao
authors.initials: M
authors.lastname: Fu
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Chen
authors.forename: Dan-Ping
authors.initials: DP
authors.lastname: Xu
authors.forename: Aifen
authors.initials: A
authors.lastname: Lin
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Yan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018792:Encephalitis, Viral / Q000276:immunology* / Q000473:pathology*; D029821:Enterovirus A, Human / Q000276:immunology*; D004769:Enterovirus Infections / Q000150:complications / Q000276:immunology* / Q000473:pathology / Q000821:virology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D059951:HLA-G Antigens / Q000096:biosynthesis* / Q000097:blood; D006801:Humans; D007223:Infant; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007963:Leukocytes, Mononuclear / Q000737:chemistry / Q000276:immunology; D008297:Male; D011654:Pulmonary Edema / Q000150:complications / Q000276:immunology* / Q000473:pathology; D012720:Severity of Illness Index
chemical_list: D059951:HLA-G Antigens; C508609:IL10 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D016753:Interleukin-10