title: Peripheral T lymphocyte subset imbalances in children with enterovirus 71-induced hand, foot and mouth disease.
abstract: Inflammatory mediators (i.e. cytokines) play a pivotal role in the regulation of pathophysiological processes during EV71-induced hand, foot and mouth disease (HFMD). Different T cell subsets have distinct cytokine secretion profiles, and alteration in the T cell subsets frequency (imbalance) during infection leads to changed cytokine patterns. However, the effects of EV71 infection on T cell subsets were not clear. The objective of this study was to determine whether EV71-induced HFMD can be explained by the emergence of particular T-cell subsets (Th1, Th2, Tc1, Tc2, Th17, Tc17 and Treg cells) and the cytokine they produced (IFN-γ, IL-4, IL-17A and TGF-β1), as well as distinct responses to EV71 infection. We found that when compared to the control group, the percentage of Th1 and Tc1 cells was significantly higher in mild and severe HFMD group. Similar results were found in the Th1/Th2 ratio and IFN-γ levels. On the other hand, the percentage of Th17 cells and IL-17A levels were the highest in severe HFMD cases, and lowest in controls. Similar trend was also found for the Th17/Treg cell ratio. An optimal cutoff value of 2.15% for Th17 cell and 6.72 pg/ml for IL-17A provided a discriminatory value for differentiating the severity of HFMD cases by receiver operating characteristic curve analyses. These findings reveal that the Th1/Th2 and Th17/Treg imbalance exist in HFMD patients, suggesting their involvement in the pathogenesis of EV71 infection, which may have potential value as biomarkers.
authors: Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
authors: Shuxian
authors: S
authors: Li
authors: Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China; Department of Infectious Disease, Hangzhou Children's Hospital, Hangzhou, Zhejiang 310014, China.
authors: Chunyan
authors: C
authors: Cai
authors: Department of Pediatrics, Cixi People's Hospital, Cixi, Ningbo, Zhejiang 315300, China.
authors: Jinyan
authors: J
authors: Feng
authors: Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
authors: Xuejing
authors: X
authors: Li
authors: Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China.
authors: Yingshuo
authors: Y
authors: Wang
authors: Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, The First Affiliated Hospital, Zhejiang University, Hangzhou, Zhejiang 310013, China; Department of Biomedicine, College of Biotechnology, Zhejiang Agriculture and Forestry University, Hangzhou, Zhejiang 311300, China. Electronic address: gastate@zju.edu.cn.
authors: Jun
authors: J
authors: Yang
authors: Department of Pulmonology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China. Electronic address: drchenzm@163.com.
authors: Zhimin
authors: Z
authors: Chen
mesh_terms: D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D029821:Enterovirus A, Human / Q000276:immunology* / Q000302:isolation & purification*; D005260:Female; D006232:Hand, Foot and Mouth Disease / Q000276:immunology* / Q000821:virology*; D006801:Humans; D007223:Infant; D008297:Male; D016176:T-Lymphocyte Subsets / Q000276:immunology*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D018417:Th1 Cells / Q000276:immunology; D058504:Th17 Cells / Q000276:immunology
chemical_list: D016207:Cytokines
keywords: Cytokines; Enterovirus 71; Hand, foot and mouth disease; Imbalance; T cell subsets