Cytokine secretion in acute shigellosis is correlated to disease activity and directed more to stool than to plasma.

Stool and plasma cytokine levels in 60 adults with acute shigellosis were studied by EIA at various intervals (0-45 days) after onset of diarrhea. Cytokine levels correlated with severity of disease. Significantly higher levels of proinflammatory cytokines peaked at onset of disease in stool of patients with severe disease (P < .05). In contrast, interferon-gamma (IFN-gamma) levels, depressed at disease onset, progressively increased during the convalescent stage. Concomitantly obtained plasma cytokine levels were 100 times lower than levels in stool. Controls in Shigella-endemic areas (n = 42) had persistently significantly higher levels of IFN-gamma and interleukin-1 receptor antagonist in both stool and plasma. The lack of host defense activity against shigellosis may be linked to delayed recovery of IFN-gamma. This cytokine may play an important role in elimination of the infection and development of immunity against shigellosis.