title: Immune derangement occurs in patients with H7N9 avian influenza.
abstract: BACKGROUND
  Currently, little is known about the immunological characteristics of patients with avian influenza A (H7N9) virus infection.
  
  
  METHODS
  The numbers and percentages of peripheral blood immune cells were measured in 27 patients with laboratory-confirmed H7N9 virus infection and 30 healthy controls (HCs). The functional phenotypes of T cells and monocytes, as well as serum cytokine levels, were analyzed by flow cytometry.
  
  
  RESULTS
  There were 19 patients (70.4%) with acute respiratory distress syndrome, 13 (48.1%) with secondary respiratory infection, 20 (74%) with systemic inflammatory response syndrome (SIRS; defined as having at least two concurrent SIRS components), 18 (66.7%) with lymphocytopenia and 11 (40.7%) with reduced numbers of monocytes. In comparison with levels in the HCs, the levels of serum interleukin 6 (IL-6), IL-8 and IL-10 and the percentages of CD38+ or Tim-3+ T cells were significantly increased. However, the percentages of human leukocyte antigen-DR + and Tim-3+ monocytes were significantly decreased in patients compared with HCs.
  
  
  CONCLUSIONS
  Patients with avian H7N9 virus infection display profound SIRS concomitantly with an anti-inflammatory response, which may be associated with the rapid progression of and high mortality associated with this novel viral disease.
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Yu
authors.initials: Y
authors.lastname: Shi
authors.forename: Hainv
authors.initials: H
authors.lastname: Gao
authors.forename: Weifeng
authors.initials: W
authors.lastname: Liang
authors.forename: Jifang
authors.initials: J
authors.lastname: Sheng
authors.forename: Lanjuan
authors.initials: L
authors.lastname: Li
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood / Q000276:immunology; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood / Q000276:immunology*; D064766:Influenza A Virus, H7N9 Subtype / Q000276:immunology*; D007251:Influenza, Human / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000175:diagnosis* / Q000276:immunology*
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators