Dynamics of the level of interleukins in the blood of children undergoing hemorrhagic fever with renal syndrome

Abstract

Background: Hemorrhagic fever with renal syndrome (HFRS) is caused by hantavirus, which does not have a direct cytopathic effect on endotheliocytes, but serves only as an initiator of immune inflammation. Cytokines play a leading role in the pathogenesis of many infectious diseases, including HFRS. In the literature available to us, we have not seen a single publication devoted to the dynamics of cytokines in children with HFRS. Methods and materials: The study included 147 children with HFRS hospitalized in an infectious diseases hospital in Ufa. Patients were conditionally divided into 2 groups. The first group consisted of 73 patients who were treated with a diagnosis of HFRS of moderate severity. The second group included 74 patients with a diagnosis of severe HFRS. The age in the two groups was 5–17 years. The average age is 11.1 ± 1.6 y. Results: In children with HFRS, there is an increase in the concentration of pro-inflammatory cytokines IL-1β and TNFa, starting from the febrile period. The peak increase in these cytokines is observed in the oliguric period. During the period of polyuria, the level of pro-inflammatory cytokines decreases. Moreover, during the recovery period, their difference from the control group is not statistically significant. The level of inf and inf-γ in children with HFRS decreases since the febrile period, the greatest decrease is observed in the oliguric period with severe HFRS. In the polyuric period, the level of inf and inf-γ rises, but with a severe form of the disease, their level is statistically significantly higher than in the control group even during the recovery period. The concentration of the anti-inflammatory cytokine IL-10 in the febrile period tends to increase, a statistically significant increase is noted in the oliguric period and continues to increase in the polyhuric period. In the convalescence phase, the level of IL-10 is not statistically different from the control group, while in adult patients, the level of IL-10 in the convalescence period is significantly higher than in the control group. Conclusion: Thus, the content of cytokines in children with HFRS depends on the period and severity of the disease.