ter Meulen Jan, Sakho Mohamed, Koulemou Kekoura, Magassouba N'Faly, Bah Aissatou, Preiser Wolfgang, Daffis Stephane, Klewitz Christian, Bae Hi-Gung, Niedrig Matthias, Zeller Hervé, Heinzel-Gutenbrunner Monika, Koivogui Lamine, Kaufmann Andreas
Department of Virology, Philipps University Marburg, Marburg, Germany.
J Infect Dis. 2004 Nov 15;190(10):1821-7. doi: 10.1086/425016. Epub 2004 Oct 12.
To study the contribution of inflammatory mediators to the pathogenesis of yellow fever (YF), the serum levels of several cytokines and chemokines were measured in 7 patients with fatal YF (f-YF), 11 patients with nonfatal hemorrhagic YF (nf/h-YF), and 18 patients with nonfatal nonhemorrhagic YF (nf/nh-YF). The levels of interleukin (IL)-6, monocyte chemoattractant protein-1, interferon-inducible protein (IP)-10, tumor necrosis factor- alpha , and IL-1 receptor antagonist (IL-1RA) were all statistically significantly higher in the patients with f-YF than in those with nf/nh-YF. In patients with nf/h-YF, only levels of IP-10 and IL-1RA were significantly elevated. The high levels of pro- and anti-inflammatory cytokines and chemokines in serum from patients with f-YF are reminiscent of those seen in patients with bacterial sepsis. This finding has implications for the understanding of the pathophysiology of YF and the development of therapeutic strategies.
为研究炎症介质在黄热病（YF）发病机制中的作用，我们检测了7例黄热病致死患者（f - YF）、11例非致死性出血性黄热病患者（nf/h - YF）和18例非致死性非出血性黄热病患者（nf/nh - YF）血清中多种细胞因子和趋化因子的水平。与nf/nh - YF患者相比，f - YF患者血清中白细胞介素（IL）-6、单核细胞趋化蛋白-1、干扰素诱导蛋白（IP）-10、肿瘤坏死因子-α和IL - 1受体拮抗剂（IL - 1RA）的水平均有统计学显著升高。在nf/h - YF患者中，只有IP - 10和IL - 1RA水平显著升高。f - YF患者血清中促炎和抗炎细胞因子及趋化因子的高水平让人联想到细菌性败血症患者的情况。这一发现对理解黄热病的病理生理学及治疗策略的制定具有重要意义。
