Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Japan.
Cytokine. 2012 Dec;60(3):694-700. doi: 10.1016/j.cyto.2012.07.038. Epub 2012 Aug 25.
Proinflammatory cytokines are related to the pathogenesis of enterohemorrhagic Escherichia coli (EHEC) infection and hemolytic-uremic syndrome (HUS). We assessed the kinetics of the release of cytokines such as neopterin, interleukin (IL)-6, IL-8 and tumour necrosis factor (TNF)-α and the soluble forms of type I and II TNF receptors during EHEC O111-induced HUS (EHEC O111/HUS). Fourteen patients with EHEC O111/HUS were enrolled in this study. Serum concentrations of all cytokines other than TNF-α were significantly elevated in patients with severe HUS compared with those in patients with mild HUS. Although serum concentrations of TNF-α were not significantly higher in patients with severe HUS, most patients with acute encephalopathy showed elevated TNF-α levels. Serum concentrations of these cytokines rapidly and markedly increased, and massive hypercytokinaemia developed 1 day before the diagnosis of HUS in patients with severe HUS. Changes in the number of white blood cells and concentration of serum lactate dehydrogenase were significantly larger between the onset of hemorrhagic colitis and the time of the diagnosis of HUS in patients with severe HUS compared with those in patients with mild HUS. Proinflammatory cytokines play an important role in the pathogenesis of EHEC infection and development of severe complications, including HUS and encephalopathy. Monitoring the cytokine profile may be useful for assessing disease activity of EHEC O111 infections.
促炎细胞因子与肠出血性大肠杆菌（EHEC）感染和溶血尿毒综合征（HUS）的发病机制有关。我们评估了细胞因子（如新型蝶呤、白细胞介素（IL）-6、IL-8 和肿瘤坏死因子（TNF）-α）以及 I 型和 II 型 TNF 受体可溶性形式在 EHEC O111 诱导的 HUS（EHEC O111/HUS）中的释放动力学。本研究纳入了 14 例 EHEC O111/HUS 患者。与轻度 HUS 患者相比，严重 HUS 患者除 TNF-α外的所有细胞因子的血清浓度均显著升高。尽管严重 HUS 患者的 TNF-α血清浓度没有显著升高，但大多数急性脑病患者的 TNF-α水平升高。这些细胞因子的血清浓度迅速而显著增加，在严重 HUS 患者发生 HUS 诊断前 1 天，出现大量细胞因子血症。与轻度 HUS 患者相比，严重 HUS 患者从出血性结肠炎发病到 HUS 诊断时白细胞计数和血清乳酸脱氢酶浓度的变化明显更大。促炎细胞因子在 EHEC 感染和严重并发症（包括 HUS 和脑病）的发病机制中起重要作用。监测细胞因子谱可能有助于评估 EHEC O111 感染的疾病活动。
