Kawada Jun-ichi, Kimura Hiroshi, Ito Yoshinori, Hara Shinya, Iriyama Masahiro, Yoshikawa Tetsushi, Morishima Tsuneo
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
J Infect Dis. 2003 Sep 1;188(5):690-8. doi: 10.1086/377101. Epub 2003 Aug 20.
Influenza-associated encephalopathy, a severe neurologic complication of influenza, is being reported more frequently in Japan. We investigated the transcription of cytokine genes in peripheral blood leukocytes and compared patients with influenza and with encephalopathy or febrile convulsions and patients with influenza but without neurologic complications. A quantitative polymerase chain reaction (PCR) revealed that transcription of the interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha genes was up-regulated to a greater extent in patients with encephalopathy than in those without neurologic complications. Plasma IL-6 levels also were higher in patients with encephalopathy, although the difference was marginal. Viral RNA in throat swabs was quantified using a real-time quantitative PCR. The virus load was similar among patients with encephalopathy or febrile convulsions or without neurologic complications. Furthermore, virus load was not correlated with either the transcription of cytokine genes or plasma cytokine concentrations. These results suggest that influenza-associated encephalopathy might be a consequence of systemic immune responses.
流感相关性脑病是流感的一种严重神经并发症，在日本的报告越来越频繁。我们研究了外周血白细胞中细胞因子基因的转录情况，并比较了患有流感且伴有脑病或热性惊厥的患者与患有流感但无神经并发症的患者。定量聚合酶链反应（PCR）显示，与无神经并发症的患者相比，脑病患者中白细胞介素（IL）-6、IL-10和肿瘤坏死因子-α基因的转录上调程度更大。脑病患者的血浆IL-6水平也较高，尽管差异不显著。使用实时定量PCR对咽拭子中的病毒RNA进行定量。脑病或热性惊厥患者或无神经并发症患者的病毒载量相似。此外，病毒载量与细胞因子基因的转录或血浆细胞因子浓度均无相关性。这些结果表明，流感相关性脑病可能是全身免疫反应的结果。
