Patologìâ (May 2021)
Cytokine profile of patients with the measles infection of varying severity
Abstract
Aim: to determine the nature of the cytokine response in patients with measles infection of varying severity, both with and without complications. Materials and methods. 65 patients who were treated in the Kharkiv regional infectious hospital from 2017 to 2019 were included in the study. All patients were divided into 4 groups depending on the severity of the disease and the presence of complications. All patients included in the study on the day of admission to the hospital and on the 10th day of hospital stay were examined for serum concentrations of pro- and anti-inflammatory cytokines as well as interferons alpha and gamma, which was carried out by solid-phase enzyme immunoassay using kits manufactured by “Vector-best” company (RF) according to the manufacturer’s instructions. Statistical processing of the obtained data was carried out using the IBM SPSS Statistics 22.0 software package. Results. The study of the levels of pro- and anti-inflammatory cytokines in dynamics showed a decrease in their levels on the 10th day of hospital stay in patients who did not have complications, and their increase in patients whose illness was accompanied by the development of pneumonia. Levels of INFα and INFγ in dynamics increased in all groups of patients. Significant changes in relation to the control group in the ratio of pro- and anti-inflammatory cytokines in the dynamics were observed only in patients with a dissociative type of cytokine response. In patients of this group on the 1st and 10th days of hospital stay the ratio index of IL-6/IL-10 was shifted towards a significant predominance of proinflammatory cytokines. Conclusions. The study demonstrates the presence of three possible types of cytokine response in patients with measles infection of varying severity: normoreactive, dissociative and hyporeactive. Each type was typical to a specific group of patients and influenced the clinical course of the disease and the development of complications, which is associated with the dynamics of increasing levels of pro- and anti-inflammatory cytokines and increasing levels of INFα and INFγ. The dynamics of increase in levels of these factors in severe disease is lower than in moderate disease. Taking into account the obtained data it can be assumed that in process of anti-infectious immunity formation in response to measles infection the prevalence of the Th-1 immune response over the Th-2 response becomes important.
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