Activation of the cytokine network and unfavorable outcome in patients with yellow fever
Ter Meulen, J.; Sakho, M.; Koulemou, K.; Magassouba, N.'F.; Bah, A.; Preiser, W.; Daffis, S.; Klewitz, C.; Bae, H.-G.; Niedrig, M.; Zeller, H.é; Heinzel-Gutenbrunner, M.; Koivogui, L.; Kaufmann, A.
Journal of Infectious Diseases 190(10): 1821-1827
2004
ISSN/ISBN: 0022-1899 PMID: 15499539 DOI: 10.1086/425016Document Number: 237164
To study the contribution of inflammatory mediators to the pathogenesis of yellow fever (YF), the serum levels of several cytokines and chemokines were measured in 7 patients with fatal YF (f-YF), 11 patients with nonfatal hemorrhagic YF (nf/h-YF), and 18 patients with nonfatal nonhemorrhagic YF (nf/nh-YF). The levels of interleukin (IL)-6, monocyte chemoattractant protein-1, interferon-inducible protein (IP)-10, tumor necrosis factor- alpha , and IL-1 receptor antagonist (IL-1RA) were all statistically significantly higher in the patients with f-YF than in those with nf/nh-YF. In patients with nf/h-YF, only levels of IP-10 and IL-1RA were significantly elevated. The high levels of pro- and anti-inflammatory cytokines and chemokines in serum from patients with f-YF are reminiscent of those seen in patients with bacterial sepsis. This finding has implications for the understanding of the pathophysiology of YF and the development of therapeutic strategies.