Correlation between the concentrations of tumor necrosis factor-α and the severity of disease in patients infected with Orientia tsutsugamushi

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• 作者：Hiromichi Iwasaki ; Jiro Mizoguchi ; Nobuhiro Takada ; Katsunori Tai ; Satoshi Ikegaya ; Takanori Ueda
• 关键词：Hypercytokinemia ; Orientia tsutsugamushi ; Tetracycline ; Tumor necrosis factor-α ; Interleukin-10
• 刊名：International Journal of Infectious Diseases
• 出版年：2010
• 出版时间：April 2010
• 年：2010
• 卷：14
• 期：4
• 页码：e328-e333
• 全文大小：361 K

文摘

Background

Patients with tsutsugamushi disease sometimes die if they do not receive appropriate chemotherapy. This study measured the concentration of several cytokines both before and after the administration of tetracyclines, and evaluated the changes in cytokine levels in patient serum to investigate the relationship between serum levels of cytokines and disease severity.

Methods

A total of nine patients were infected with Orientia tsutsugamushi. The diagnosis of tsutsugamushi disease was made using an indirect immunoperoxidase antibody test. The serum concentrations of cytokines were measured using enzyme-linked immunosorbent assays.

Results

The levels of interleukin (IL)-10 (mean 71.7 pg/ml) and IL-12p40 (mean 588 pg/ml) were elevated in all patients in the acute phase, above the normal upper limits. Tumor necrosis factor-α (TNF-α) levels (mean 9.20 pg/ml) were elevated in 89 % and interferon-γ (IFN-γ) levels (mean 41.0 pg/ml) in 44 % of patients. The down-regulation of these overproduced cytokines was observed after chemotherapy. There was a significant correlation between the concentrations of TNF-α in the acute phase and the severity of disease (r = 0.918).

Conclusion

The concentration of TNF-α may predict the severity of tsutsugamushi disease in the acute infectious phase.