title: Cytokine responses and correlations thereof with clinical profiles in children with enterovirus 71 infections.
abstract: BACKGROUND
  Severe complications associated with EV71 infections caused many infants death. However, the pathogenesis of EV71 infection in the severe cases remained poorly understood.
  
  
  METHODS
  In this study we collected plasma and cerebrospinal fluid (CSF) specimens drawn in the acute and/or recovery phases from EV71-infected individuals, and plasma specimens from healthy children served as normal controls. We compared the levels of cytokines and chemokines determined by a Luminex-based cytokine bead array.
  
  
  RESULTS
  The plasma levels of IL-1β and IL-6 were significantly higher in severe and critical cases than in mild patients and normal controls. Higher plasma levels of IL-6, IL-10, and IL-8 were evident in critical than severe cases. The CSF levels of IL-6, IL-8, and IP-10 were higher, and that of RANTES lower (compared to plasma), in severe and critical patients. Significantly lower CSF levels of cytokines and chemokines were recorded in the recovery than the acute phase in severe and critical cases treated with intravenous immunoglobulin (IVIG) and glucocorticoids. Only the CSF levels of IL-6, IP-10, and IL-8 were significantly correlated with white blood cell counts, and absolute neutrophil and monocyte counts, in severe cases. Furthermore, the CSF levels of IL-6 were correlated with temperature in both cases.
  
  
  CONCLUSIONS
  These data indicate that a major cytokine response and inflammation, in both plasma and the CNS, are features of disease caused by EV71 infection. Systemic inflammation caused by EV71 infection exacerbated the deterioration of the disease, and resulted in the disease progression to the critical illness stage.
authors.affiliation: Medical School of Nanjing University, Nanjing Children's Hospital, Nanjing, 210093, People's Republic of China. 40159611@qq.com.|National Institute for Viral Disease Control and Prevention, China CDC, Chang-Bai Rd 155, Beijing, 100052, People's Republic of China. 40159611@qq.com.
authors.forename: Ning
authors.initials: N
authors.lastname: Ye
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Chang-Bai Rd 155, Beijing, 100052, People's Republic of China. gongxun8269@163.com.|Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, People's Republic of China. gongxun8269@163.com.
authors.forename: Xun
authors.initials: X
authors.lastname: Gong
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Chang-Bai Rd 155, Beijing, 100052, People's Republic of China. cactusea@163.com.
authors.forename: Li-li
authors.initials: LL
authors.lastname: Pang
authors.affiliation: Medical School of Nanjing University, Nanjing Children's Hospital, Nanjing, 210093, People's Republic of China. gaowj828@126.com.|National Institute for Viral Disease Control and Prevention, China CDC, Chang-Bai Rd 155, Beijing, 100052, People's Republic of China. gaowj828@126.com.
authors.forename: Wen-juan
authors.initials: WJ
authors.lastname: Gao
authors.affiliation: Medical School of Nanjing University, Nanjing Children's Hospital, Nanjing, 210093, People's Republic of China. 15910830892@163.com.
authors.forename: Ya-ting
authors.initials: YT
authors.lastname: Zhang
authors.affiliation: Medical School of Nanjing University, Nanjing Children's Hospital, Nanjing, 210093, People's Republic of China. 393979374@qq.com.|National Institute for Viral Disease Control and Prevention, China CDC, Chang-Bai Rd 155, Beijing, 100052, People's Republic of China. 393979374@qq.com.
authors.forename: Xiao-le
authors.initials: XL
authors.lastname: Li
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Chang-Bai Rd 155, Beijing, 100052, People's Republic of China. unali@163.com.
authors.forename: Na
authors.initials: N
authors.lastname: Liu
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Chang-Bai Rd 155, Beijing, 100052, People's Republic of China. dandili@126.com.
authors.forename: Dan-di
authors.initials: DD
authors.lastname: Li
authors.affiliation: Medical School of Nanjing University, Nanjing Children's Hospital, Nanjing, 210093, People's Republic of China. jinyuldyy@163.com.
authors.forename: Yu
authors.initials: Y
authors.lastname: Jin
authors.affiliation: National Institute for Viral Disease Control and Prevention, China CDC, Chang-Bai Rd 155, Beijing, 100052, People's Republic of China. zhaojund@126.com.
authors.forename: Zhao-jun
authors.initials: ZJ
authors.lastname: Duan
mesh_terms: D001831:Body Temperature; D016022:Case-Control Studies; D018946:Chemokine CCL5 / Q000097:blood / Q000134:cerebrospinal fluid; D054357:Chemokine CXCL10 / Q000097:blood / Q000134:cerebrospinal fluid; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood* / Q000134:cerebrospinal fluid; D029821:Enterovirus A, Human / Q000302:isolation & purification*; D004769:Enterovirus Infections / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D007249:Inflammation; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood / Q000134:cerebrospinal fluid; D016209:Interleukin-8 / Q000097:blood / Q000134:cerebrospinal fluid; D007958:Leukocyte Count; D008297:Male; D012720:Severity of Illness Index
chemical_list: C483024:CCL5 protein, human; D018946:Chemokine CCL5; D054357:Chemokine CXCL10; D016207:Cytokines; D005938:Glucocorticoids; C508609:IL10 protein, human; D016756:Immunoglobulins, Intravenous; D015850:Interleukin-6; D016209:Interleukin-8; D016753:Interleukin-10