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CHARACTERISTIC CYTOKINE AND CHEMOKINE PROFILES IN ENCEPHALITIS OF INFECTIOUS, IMMUNE-MEDIATED, AND UNKNOWN AETIOLOGY
Quimiocina
Citocina
Etiologia infecciosa
Autor
Afiliación
The Walton Centre NHS Foundation Trust. Liverpool, United Kingdom / University of Liverpool. The Institute of Infection and Global Health. Liverpool, United Kingdom / University of Liverpool. NIHR Health Protection Research Unit in Emerging and Zoonotic Infections. Liverpool, United Kingdom.
University of Liverpool. The Institute of Infection and Global Health. Liverpool, United Kingdom / University of Liverpool. NIHR Health Protection Research Unit in Emerging and Zoonotic Infections. Liverpool, United Kingdom / Alder Hey Children’s NHS Foundation Trust,. Liverpool, United Kingdom.
Public Health England. London, United Kingdom.
Public Health England. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Vírus Respiratório e Sarampo. Rio de Janeiro, RJ, Brasil.
Chelsea and Westminster NHS Foundation Trust. London, United Kingdom.
Public Health England. Vaccine Evaluation Unit. Manchester, United Kingdom.
The Walton Centre NHS Foundation Trust. Liverpool, United Kingdom / University of Liverpool. The Institute of Infection and Global Health. Liverpool, United Kingdom / University of Liverpool. NIHR Health Protection Research Unit in Emerging and Zoonotic Infections. Liverpool, United Kingdom.
University of Liverpool. The Institute of Infection and Global Health. Liverpool, United Kingdom / University of Liverpool. NIHR Health Protection Research Unit in Emerging and Zoonotic Infections. Liverpool, United Kingdom / Alder Hey Children’s NHS Foundation Trust,. Liverpool, United Kingdom.
Public Health England. London, United Kingdom.
Public Health England. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Vírus Respiratório e Sarampo. Rio de Janeiro, RJ, Brasil.
Chelsea and Westminster NHS Foundation Trust. London, United Kingdom.
Public Health England. Vaccine Evaluation Unit. Manchester, United Kingdom.
The Walton Centre NHS Foundation Trust. Liverpool, United Kingdom / University of Liverpool. The Institute of Infection and Global Health. Liverpool, United Kingdom / University of Liverpool. NIHR Health Protection Research Unit in Emerging and Zoonotic Infections. Liverpool, United Kingdom.
Resumen en ingles
Background
Encephalitis is parenchymal brain inflammation due to infectious or immune-mediated processes.
However, in 15–60% the cause remains unknown. This study aimed to determine if
the cytokine/chemokine-mediated host response can distinguish infectious from immunemediated
cases, and whether this may give a clue to aetiology in those of unknown cause.
Methods
We measured 38 mediators in serum and cerebrospinal fluid (CSF) of patients from the
Health Protection Agency Encephalitis Study. Of serum from 78 patients, 38 had infectious,
20 immune-mediated, and 20 unknown aetiology. Of CSF from 37 patients, 20 had infectious,
nine immune-mediated and eight unknown aetiology.
Results
Heat-map analysis of CSF mediator interactions was different for infectious and immunemediated
cases, and that of the unknown aetiology group was similar to the infectious pattern.
Higher myeloperoxidase (MPO) concentrations were found in infectious than immunemediated
cases, in serum and CSF (p = 0.01 and p = 0.006). Serum MPO was also higher
in unknown than immune-mediated cases (p = 0.03). Multivariate analysis selected serum
MPO; classifying 31 (91%) as infectious (p = 0.008) and 17 (85%) as unknown (p = 0.009)
as opposed to immune-mediated. CSF data also selected MPO classifying 11 (85%) as
infectious as opposed to immune-mediated (p = 0.036). CSF neutrophils were detected in
eight (62%) infective and one (14%) immune-mediated cases (p = 0.004); CSF MPO correlated
with neutrophils (p<0.0001).Conclusions
Mediator profiles of infectious aetiology differed from immune-mediated encephalitis; and
those of unknown cause were similar to infectious cases, raising the hypothesis of a possible
undiagnosed infectious cause. Particularly, neutrophils and MPO merit further investigation.
Palabras clave en portugues
Encefalite mediada por imunidadeQuimiocina
Citocina
Etiologia infecciosa
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