Dysregulation of serum gamma interferon levels in vascular chronic Q Fever patients provides insights into disease pathogenesis.
A large community outbreak of Q fever occurred in the Netherlands in the period 2007 to 2010. Some of the infected patients developed chronic Q fever, which typically includes pathogen dissemination to predisposed cardiovascular sites, with potentially fatal consequences. To identify the immune mechanisms responsible for ineffective clearance of Coxiella burnetii in patients who developed chronic Q fever, we compared serum concentrations of 47 inflammation-associated markers among patients with acute Q fever, vascular chronic Q fever, and past resolved Q fever. Serum levels of gamma interferon were strongly increased in acute but not in vascular chronic Q fever patients, compared to past resolved Q fever patients. Interleukin-18 levels showed a comparable increase in acute as well as vascular chronic Q fever patients. Additionally, vascular chronic Q fever patients had lower serum levels of gamma interferon-inducible protein 10 (IP-10) and transforming growth factor β (TGF-β) than did acute Q fever patients. Serum responses for these and other markers indicate that type I immune responses to C. burnetii are affected in chronic Q fever patients. This may be attributed to an affected immune system in cardiovascular patients, which enables local C. burnetii replication at affected cardiovascular sites.
Center for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands jeroen.pennings@rivm.nl.
Jeroen L A
http://orcid.org/0000-0002-9188-6358
JL
Pennings
Department of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Marjolein N T
MN
Kremers
Center for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Hennie M
HM
Hodemaekers
Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Julia C J P
JC
Hagenaars
Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Olivier H J
OH
Koning
Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Nicole H M
NH
Renders
Department of Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Mirjam H A
MH
Hermans
Center for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Arja
A
de Klerk
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Daan W
DW
Notermans
Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
Peter C
PC
Wever
Center for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
Riny
R
Janssen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054357:Chemokine CXCL10 / Q000097:blood; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011778:Q Fever / Q000453:epidemiology / Q000276:immunology* / Q000473:pathology*; D012189:Retrospective Studies; D044967:Serum / Q000737:chemistry*; D016212:Transforming Growth Factor beta / Q000097:blood; D055815:Young Adult
C114753:CXCL10 protein, human; D054357:Chemokine CXCL10; D016212:Transforming Growth Factor beta; D007371:Interferon-gamma