Lu Qing-Bin, Cui Ning, Hu Jian-Gong, Chen Wei-Wei, Xu Wen, Li Hao, Zhang Xiao-Ai, Ly Hinh, Liu Wei, Cao Wu-Chun
School of Public Health, Peking University, Beijing 100191, PR China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China.
The 154 Hospital, People's Liberation Army, Xinyang 464000, PR China.
Vaccine. 2015 Mar 3;33(10):1250-5. doi: 10.1016/j.vaccine.2015.01.051. Epub 2015 Jan 30.
The immunological responses of patients with severe fever with thrombocytopenia syndrome (SFTS) remain largely unknown. We aim to study the magnitude and sustainability of host immune responses and their correlation with clinical, virological and hematological parameters.
A longitudinal cohort study was performed in a SFTS reference hospital. The sequential immunological evaluation was determined for SFTSV infected patients, including anti-SFTSV IgM, IgG antibodies and the lymphocyte subsets.
Altogether 298 laboratory-confirmed SFTS cases were analyzed, from whom 55 patients were followed after convalescence. SFTSV specific IgM antibody could be detected at medium of 9 days, surged to peak levels by 4 weeks, and remained persistent until 6 months after disease onset. SFTSV specific IgG antibody could be detected at medium of 6 weeks; surged to peak levels by 6 months, and remained positive in most of the patients even at 3 years after infection. SFTS patients experienced obvious T cell, B cell and NK cells loss during the first week of infection, which was rapidly restored to normal levels. A significantly lower level of humoral immunity was identified concurrently from severe disease, especially in acute phase of the infection. These abnormalities can be used as a potential indicator in the prediction of an adverse clinical outcome.
Information gained from this study have clinical significance in enhancing our understanding of SFTS immunological characteristics and the disease pathogenesis.
严重发热伴血小板减少综合征（SFTS）患者的免疫反应在很大程度上仍不清楚。我们旨在研究宿主免疫反应的强度和可持续性及其与临床、病毒学和血液学参数的相关性。
在一家SFTS参考医院进行了一项纵向队列研究。对SFTSV感染患者进行了序贯免疫评估，包括抗SFTSV IgM、IgG抗体和淋巴细胞亚群。
共分析了298例实验室确诊的SFTS病例，其中55例患者在康复后进行了随访。SFTSV特异性IgM抗体在发病后第9天左右可检测到，4周时升至峰值水平，并一直持续到发病后6个月。SFTSV特异性IgG抗体在发病后第6周左右可检测到，6个月时升至峰值水平，即使在感染后3年，大多数患者仍呈阳性。SFTS患者在感染的第一周出现明显的T细胞、B细胞和NK细胞减少，随后迅速恢复到正常水平。同时，重症患者尤其是感染急性期的体液免疫水平显著降低。这些异常可作为预测不良临床结局的潜在指标。
本研究获得的信息对于增强我们对SFTS免疫特征和疾病发病机制的理解具有临床意义。
