title: The significance of serum and fecal levels of interleukin-6 and interleukin-8 in hospitalized children with acute rotavirus and norovirus gastroenteritis.
abstract: BACKGROUND
  Rotavirus and norovirus are the most common known causes of viral gastroenteritis in children. This study examined the association between serum interleukin 6 (IL-6) and interleukin 8 (IL-8) levels and disease severity in the acute phase of rotavirus and norovirus gastroenteritis in children, and it also explored the role of fecal cytokine levels in children with viral and bacterial gastroenteritis.
  
  
  METHODS
  This prospective study enrolled patients aged 4 months to 14 years admitted with acute gastroenteritis in a tertiary care center. Peripheral blood samples were collected for IL-6 and IL-8 assays within the first 3 days of diarrhea. Stool samples were obtained from the patients in the first 24 hours after admission.
  
  
  RESULTS
  Serum IL-6 and IL-8 were measured in children with viral (n = 66) and bacterial (n = 23) infections, and in healthy controls (n = 10). In the acute phase of gastroenteritis, a moderately positive correlation was found between serum IL-6 levels and disease severity (rs = 0.41, p < 0.01). Serum IL-8 levels correlated with the duration of fever (rs = 0.28, p = 0.03). Fecal IL-6 levels correlated with the maximum number of daily bowel movements (rs = 0.35, p < 0.05). Rotavirus infection induced significantly higher serum IL-8 levels than norovirus infection (p < 0.05). Receiver operating characteristic (ROC) curve analysis showed that absolute neutrophil count (ANC), maximum body temperature (BT), and Vesikari score were significant predictors in discriminating rotavirus from norovirus gastroenteritis.
  
  
  CONCLUSIONS
  IL-6 and IL-8 are involved in the pathogenesis of acute gastroenteritis in both rotavirus and norovirus. An ANC of less than 9000/mm(3), maximum BT of less than 38.2°C, and Vesikari score of less than 14 at the end of the course are potential predictors of norovirus infection in children compared with rotavirus gastroenteritis.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Pediatrics, School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Shan-Ming
authors.initials: SM
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Ching-Pin
authors.initials: CP
authors.lastname: Lin
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Jeng-Dau
authors.initials: JD
authors.lastname: Tsai
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Chao
authors.affiliation: Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan; Department of Pediatrics, School of Medicine, Chung Shan Medical University, Taichung, Taiwan. Electronic address: cshy098@csh.org.tw.
authors.forename: Ji-Nan
authors.initials: JN
authors.lastname: Sheu
mesh_terms: D000208:Acute Disease; D002097:C-Reactive Protein / Q000032:analysis; D017250:Caliciviridae Infections / Q000276:immunology*; D002673:Child, Hospitalized; D002675:Child, Preschool; D005243:Feces / Q000737:chemistry*; D005260:Female; D005759:Gastroenteritis / Q000276:immunology* / Q000821:virology; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood*; D016209:Interleukin-8 / Q000032:analysis / Q000097:blood*; D008297:Male; D029322:Norovirus; D011446:Prospective Studies; D012400:Rotavirus Infections / Q000276:immunology*
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6; D016209:Interleukin-8; D002097:C-Reactive Protein
keywords: interleukin-6; interleukin-8; norovirus; rotavirus