Cytokines in adenoviral disease in children: Association of interleukin-6, interleukin-8, and tumor necrosis factor alpha levels with clinical outcome☆,☆☆,★,★★
Section snippets
Patients
We studied 38 inpatients at the Ricardo Gutiérrez Children's Hospital with a diagnosis of acute lower respiratory tract infection caused by adenovirus. All children had negative test results for human immunodeficiency virus and were apparently healthy until the time of adenovirus infection; they had no neoplasms and were not receiving immunosuppressive treatment. Patients with positive bacterial culture results (from blood, cerebrospinal fluid, urine, or feces) were excluded from the study.
Clinical findings in adenovirus infection of diverse course
Group I included 10 children in whom adenovirus illness was bronchiolitis (n = 8) or pharyngitis (n = 2; both were severely undernourished and were the only two subjects included in the study despite the lack of lower respiratory tract infection).
Group II included 12 patients with an admission diagnosis of bronchiolitis, pneumonia, or interstitial pneumonitis, some of whom had sensory alterations. Respiratory failure developed at some time during their hospitalization, requiring mechanical
DISCUSSION
We found that the presence of IL-6, IL-8, and TNF-α is significantly associated with severe or fatal adenovirus infection. Moreover, elevated levels of these cytokines correlate with many of the clinical characteristics that make adenovirus disease difficult to distinguish from an invasive bacterial infection.
The adenovirus-related mortality rate is usually low, although in malnourished children with severe respiratory infection the risk of death is two to three times higher than that of
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2019, Journal of Microbiology, Immunology and InfectionCitation Excerpt :Elevation of proinflammatory cytokine effect was found in IL-6, IL-1β and GM-CSF that will induce T, B cell, eosinophil and neutrophil activation and chemoattractant in vivo. Increased concentrations of IL-6 were associated with hypoperfusion, febrile peaks, tonic-clonic seizures, and septic shock of adenovirus infection in children.17 Elevation of Th2 cytokines such as IL-4 and MIP-1α could induce Th2 related activation response and T-cell recruitment.
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From the Laboratorio de Virología, Hospital de Niños "Ricardo Gutiérrez," and Clinical Immunology, IO/IIHEMA, Academia Nacional de Medicina, Buenos Aires, Argentina
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Supported in part by a grant from Fundaciaon "Alberto J. Roemmers."
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Reprint requests: A.S. Mistchenko, MD, PhD, Laboratorio de Virología, Hospital de Niños "Ricardo Gutiérrez," Gallo 1330, 1425 Buenos Aires, Argentina.
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