Shao Ping, Wu Xiaoxin, Li Hongbo, Wu Zhigang, Yang Zongxin, Yao Hangping
Department of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China.
Mol Med Rep. 2017 May;15(5):2859-2866. doi: 10.3892/mmr.2017.6324. Epub 2017 Mar 15.
The present study examined the relationship between cytokine and chemokine expression and the clinical presentation of hand, foot and mouth disease (HFMD), which is currently unclear. The present study involved 28 patients with mild HFMD, 44 patients with severe HFMD and 26 healthy children. Venous blood was tested for cytokine [interleukin (IL)‑4, IL‑12, IL‑18, tumor necrosis factor‑α (TNF‑α), interferon‑γ (IFN‑γ)] and chemokine expression [IL‑8, regulated on activation, normal T cell expressed and secreted (RANTES), monocyte chemoattractant protein‑1 (MCP‑1) and IFN-γ-inducible protein‑10 (IP‑10)]. Stool samples from the patients were tested for enterovirus 71 (EV71) RNA using reverse transcription-polymerase chain reaction. The results indicated that all cytokine/chemokine levels were increased in patients with severe HFMD compared with in patients with mild HFMD or control subjects. In addition, RANTES, MCP‑1, IL‑4, IL‑12 and IL‑18 levels were higher in mild HFMD patients than in the controls. In patients with severe HFMD, all expression levels (with the exception of IL‑8 and IL‑4) were increased in patients with encephalitis plus pulmonary edema compared with those with encephalitis alone. Furthermore, all levels (with the exception of IL‑8) were increased in EV71‑positive patients compared with EV71‑negative patients. In mild HFMD, all levels (with the exception of IL‑8 and IL‑4) were increased in EV71‑positive patients compared with EV71‑negative patients. However, in severe HFMD, only RANTES, IP‑10 and IFN‑γ levels were increased in EV71‑positive patients compared with EV71‑negative patients. In the EV71‑negative group, all levels were increased in severe HFMD compared with mild HFMD. In the EV71‑positive group, all levels (with the exception of IL‑8) were increased in severe HFMD compared with mild HFMD. These results indicated that cytokines and chemokines participate in HFMD pathogenesis, and may be useful to monitor disease progression and predict prognosis.
目前手足口病（HFMD）的细胞因子和趋化因子表达与临床表现之间的关系尚不清楚，本研究对其进行了探究。本研究纳入了28例轻症手足口病患者、44例重症手足口病患者和26名健康儿童。检测静脉血中的细胞因子[白细胞介素（IL）-4、IL-12、IL-18、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）]和趋化因子表达[IL-8、活化调节正常T细胞表达和分泌因子（RANTES）、单核细胞趋化蛋白-1（MCP-1）和IFN-γ诱导蛋白-10（IP-10）]。采用逆转录-聚合酶链反应检测患者粪便样本中的肠道病毒71型（EV71）RNA。结果表明，与轻症手足口病患者或对照组相比，重症手足口病患者的所有细胞因子/趋化因子水平均升高。此外，轻症手足口病患者的RANTES、MCP-1、IL-4、IL-12和IL-18水平高于对照组。在重症手足口病患者中，合并脑炎加肺水肿的患者所有表达水平（IL-8和IL-4除外）高于单纯脑炎患者。此外，与EV71阴性患者相比，EV71阳性患者的所有水平（IL-8除外）均升高。在轻症手足口病中，与EV71阴性患者相比，EV71阳性患者的所有水平（IL-8和IL-4除外）均升高。然而，在重症手足口病中，与EV71阴性患者相比，EV71阳性患者仅RANTES、IP-10和IFN-γ水平升高。在EV71阴性组中，重症手足口病患者的所有水平高于轻症手足口病患者。在EV71阳性组中，与轻症手足口病相比，重症手足口病患者的所有水平（IL-8除外）均升高。这些结果表明，细胞因子和趋化因子参与手足口病的发病机制，可能有助于监测疾病进展和预测预后。
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