CF Wang, CY Cai, SX Li, JF Zheng, B Ye, ZM Chen

Abstract

Objectives: In order to identify EV71 meningitis-specific cytokine alteration in plasma and cerebrospinal fluid (CSF) that differs from other enterovirus (OEV)-infected ones, we compared data obtained from HFMD patients with EV71 meningitis or OEV meningitis. Methods: We elucidated the cytokine network based on the cytokine (IL-4, IFN-γ, IL-17A, TGF-β1) profiles both in plasma and CSF from hand foot and mouth disease (HFMD), cases with aseptic meningitis (AM) due to EV71 (n=37) or OEV (n=26) infection using enzyme-linked immunosorbent assay. Plasma from healthy control (n=20) or CSF from febrile convulsion subjects (n=20) was run as control. Aetiological diagnosis was based on the detection of enteroviral RNA in the throat swab by real-time PCR. Results: Plasma IFN-γ levels were much higher in HFMD patients than controls, but no difference was shown between EV71 and OEV-infected ones. Meanwhile, plasma IL-17A levels in OEV-infected cases were significantly lower than EV71-infected subjects without differing from healthy controls. Furthermore, CSF IL-17A levels were much higher in EV71-infected groups than OEV-infected ones or subjects with febrile convulsion. In addition, no significant correlation was found between plasma cytokine levels and CSF corresponding cytokine levels. Similarly, there was no remarkable relationship between CSF cytokine levels and CSF leukocytes counts. Conclusion: EV71 cause different immune responses from OEV. IL-17A in the central nervous system, as well as in blood, appeared to be involved in the pathogenesis of EV71 AM.