Abstract

ObjectiveTo determine the relationship of cytokine/chemokine expression with the clinical presentation of hand, foot and mouth disease (HFMD).ResultsAll cytokine/chemokine levels were higher in severe HFMD patients than in mild HFMD patients or controls (P < 0.01). RANTES, MCP-1, IL-4, IL-12 and IL-18 levels were higher in mild HFMD patients than in the controls (P < 0.05). In severe HFMD, all levels (except IL-8 and IL-4) were higher in patients with encephalitis plus pulmonary edema than in those with encephalitis alone (P < 0.05). All levels (except IL-8) were higher in EV71-positive patients than in EV71-negative patients (P < 0.05). In mild HFMD, all levels (except IL-8 and IL-4) were higher in EV71-positive patients than in EV71-negative patients (P < 0.05). In severe HFMD, only RANTES, IP-10 and IFN-γ levels were higher in EV71-positive patients than in EV71-negative patients (P < 0.05). In the EV71-negative group, all levels were higher in severe HFMD than in mild HFMD (P < 0.01). In the EV71-positive group, all levels (except IL-8) were higher in severe HFMD than in mild HFMD (P < 0.01).Materials and MethodsThis study involved 28 mild HFMD patients, 44 severe HFMD patients and 26 healthy children. Venous blood was tested for cytokines (IL-4, IL-12, IL-18, TNF-α, IFN-γ) and chemokines (IL-8, RANTES, MCP-1, IP-10). Stool samples from the patients were tested for EV71 nucleic acid using reverse transcription polymerase chain reaction.ConclusionsCytokines/chemokines participate in HFMD pathogenesis, and could have potential value in monitoring disease progression and predicting prognosis.

Highlights

  • Hand, foot and mouth disease (HFMD) is a common acute infectious disease caused by a variety of human intestinal viruses

  • RANTES, monocyte chemotactic protein-1 (MCP-1), IL-4, IL-12 and IL-18 levels were higher in mild HFMD patients than in the controls (P < 0.05)

  • In severe HFMD, only RANTES, IFN-γ– inducible protein-10 (IP-10) and IFN-γ levels were higher in enterovirus 71 (EV71)-positive patients than in EV71-negative patients (P < 0.05)

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Summary

Introduction

Foot and mouth disease (HFMD) is a common acute infectious disease caused by a variety of human intestinal viruses. HFMD usually affects preschool children (age < 5 years) and has caused widespread epidemics in this population in recent years [1]. It is commonly caused by enterovirus 71 (EV71) and coxsackievirus A16 [2]. Patients with mild HFMD present only mild fever and a self-limiting herpetic rash on the hands, feet and mouth. In patients with severe HFMD, the disease progresses rapidly, and may involve meningitis, brainstem encephalitis, pulmonary angioneurotic www.impactjournals.com/oncotarget edema, pulmonary hemorrhage, myocarditis and even cardiopulmonary failure and death [3, 4]

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