Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
Cytokine. 2011 May;54(2):167-72. doi: 10.1016/j.cyto.2011.01.006. Epub 2011 Mar 2.
Since April 2009, the number of patients with 2009 pandemic H1N1 influenza virus infection has been increasing in Japan just as in the rest of the world. Patients with 2009 pandemic H1N1 influenza-associated encephalopathy (pIE) have also been reported. The common clinical symptoms of this condition are seizures and progressive coma with high-grade fever. We previously reported the possible association between seasonal influenza-associated encephalopathy (sIE) and proinflammatory cytokines. However, the pathogenesis of pIE remains to be elucidated.
In pIE patients with a poor outcome, the serum levels of interleukin (IL)-6, IL-10, and soluble tumor necrosis factor (TNF) receptor (sTNFR1) were significantly higher than those in pIE patients without neurological sequelae. Similarly, the cerebrospinal fluid (CSF) IL-6 levels in pIE patients with a poor outcome were significantly higher than those in pIE patients without neurological sequelae.
Our results suggest that IL-6, TNF-α, and IL-10 play important roles in pIE, and that the serum levels of IL-6, IL-10, and sTNFR1 and the CSF levels of IL-6 are related to neurological complications.
自 2009 年 4 月以来，日本的 2009 年大流行性 H1N1 流感病毒感染患者数量与世界其他地区一样一直在增加。也有与 2009 年大流行性 H1N1 流感相关脑炎（pIE）相关的报道。这种疾病的常见临床症状是癫痫发作和高热伴进行性昏迷。我们之前曾报道过季节性流感相关脑炎（sIE）与促炎细胞因子之间可能存在关联。但是，pIE 的发病机制仍有待阐明。
预后不良的 pIE 患者的血清白细胞介素（IL）-6、IL-10 和可溶性肿瘤坏死因子（TNF）受体（sTNFR1）水平明显高于无神经后遗症的 pIE 患者。同样，预后不良的 pIE 患者的脑脊液（CSF）IL-6 水平明显高于无神经后遗症的 pIE 患者。
我们的结果表明，IL-6、TNF-α 和 IL-10 在 pIE 中起重要作用，并且血清 IL-6、IL-10 和 sTNFR1 水平以及 CSF 中 IL-6 的水平与神经系统并发症有关。
