Korean Journal of Nephrology 1999;18(5):692-699.

신증후성 출혈열 환자에서의 혈장 싸이토카인치의 변화 (Serial Changes in Plasma Cytokine Levels in Hemorrhagic Fever with Renal Syndrome)

Abstract

Hemorrhagic fever with renal syndrome (HFRS) in Korea is caused by 2 serotypes of hantavirus, Hantaan and Seoul. Even though the number of peripheral CD8' T-lymphocytes is markedly elevated in the acute phase of HFRS, the pathogenetic role of this phenomena is not clear. To elucidate the role of cell-mediated immune response in HFRS, we measured concentrations of cytokines, such as IL-1, IL-2, IL-4, IL-6, IL-10 and IFN-r in plasma samples obtained from 15 patients (15 men, 20-24 years old) at various phase of illness. Cytokines were measured by ELISA in plasma samples. The plasma concentration of IL-10 was elevated in 13/15 patients. The median maximum value, during days 4-8, was 23 ng/L (range, 0-70.2). The maximum values were significantly higher(p=0.005) than the baseline. IL-1 and IL-6 was detected in 6 patients. Other cytokine responses (IL-2, IL-4, IFN-r ) were negligible. There was no significant correlation between maximum levels of IL-10 and maximum serum concentration of creatinine (r=0.118, p=0.675), and lowest plate#let count (r=-0.088, p=0.765). Kinetics of IL-10 were quite similar in HFRS patients with maximum creatinine values >3 mg/dL and in those with values <3 mg/dL. In conclusion, plasma IL-10 levels, but not IL-2, IL-4 or INF-r were elevated in acute phase of HFRS, and it suggests that the systemic immunosuppressive activities of IL-10 might have some pathogenetic role in HFRS.