Host Cytokine Storm Is Associated With Disease Severity of Severe Fever With Thrombocytopenia Syndrome

• Published in: The Journal of infectious diseases Vol. 206; no. 7; pp. 1085 - 1094
• Main Authors: Sun, Yulan, Jin, Cong, Zhan, Faxian, Wang, Xianjun, Liang, Mifang, Zhang, Quanfu, Ding, Shujun, Guan, Xuhua, Huo, Xixiang, Li, Chuan, Qu, Jing, Wang, Qin, Zhang, Shuo, Zhang, Yanping, Wang, Shiwen, Xu, Anqiang, Bi, Zhenqiang, Li, Dexin
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.10.2012
• Subjects: Acute diseases; Aged; Antibodies, Viral - blood; Biological and medical sciences; Bunyaviridae Infections - blood; Bunyaviridae Infections - immunology; Bunyaviridae Infections - mortality; Cluster Analysis; Cytokines; Cytokines - blood; Ebola virus; Female; Fever; Fundamental and applied biological sciences. Psychology; Host-Pathogen Interactions; Humans; Immunoglobulin G - blood; Infections; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Phlebovirus - genetics; Phlebovirus - immunology; Thrombocytopenia; Viral diseases; Viral infections; Viral Load; Viruses; Infection; Thrombocytopenia; Platelet; Hemopathy; Fever; Cytokine
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jis452

Background. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral disease in China, caused by SFTS virus (SFTSV). Severe SFTS patients can quickly proceed to multiorgan dysfunction and death; however, underlying pathogenic mechanisms remain unclear. Methods. Serum samples from 15 fatal and 44 nonfatal SFTS cases were subjected to multiplex-microbead immunoassays to detect a broad spectrum of cytokines. The viral load and virus-specific IgG titers were also tested by real-time PCR and ELISA, respectively. Results. Cytokines IL-IRA, IL-6, IL-10, G-CSF, IP-10, and MCP-1 were elevated in SFTS patients and produced at robust levels in fatal cases. In contrast, cytokines PDGF-BB and RANTES decreased in SFTS patients. These cytokines reverted to normal ranges during the convalescent phase of SFTSV infection. Cytokines IL-1β, IL-8, MIP-1α, and MIP-1β showed a unique pattern of elevation in fatal cases but not in nonfatal cases. However, these cytokines increased in the convalescent phase of nonfatal SFTS cases. Our regression analysis revealed that the serum viral load correlated with these cytokines. Moreover, levels of these cytokines correlated with various clinical parameters and virus-specific IgG titers. Conclusion. The study demonstrates that SFTSV infection induces a cytokine storm with abnormally expressed cytokine profiles, which are associated with the disease severity.