Role of Cytokine Response in Disease Progression and Severe Clinical Outcomes in Leptospirosis

Abstract

Event Abstract Back to Event Role of Cytokine Response in Disease Progression and Severe Clinical Outcomes in Leptospirosis Mitermayer G. Reis1* 1 Oswaldo Cruz Fundation, Brazil Background: Leptospirosis is a zoonotic disease caused by pathogenic spirochetes of the genus Leptospira. The role of the immune response in determining clinical outcomes is not yet well understood. We hypothesized that acute-phase serum cytokine response may play a role in disease progression, risk for death, and development of specific clinical outcomes, including severe pulmonary hemorrhage syndrome (SPHS). Methods: We prospectively enrolled 172 patients with laboratory-confirmed mild (n=23) and severe leptospirosis (n=149) during active outpatient and hospital-based surveillance, respectively. Circulating concentrations of pro- and anti-inflammatory cytokines were measured using Cytometric-Bead-Array. Logistic regression was used to evaluate the association between cytokine concentrations and clinical outcomes. Results: Concentrations of IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17A, and TNF-α were significantly higher (P<0.05) in hospitalized patients with severe disease compared to outpatients with mild disease. Among hospitalized patients, levels of IL-6 (P<0.0001), IL-8 (P=0.0049), IL-10 (P<0.0001), and IFN-γ (P=0.0195) were significantly higher in fatal cases compared to severe nonfatal cases. High levels of IL-6 and IL-10 were independently associated (P<0.05) with fatal outcome after adjustment for age and days of symptoms. Finally, among fatal cases, IL-6 levels were higher among those who had SPHS compared to those who did not (P=0.0519). Conclusion: Our findings suggest that severe cases of leptospirosis are differentiated from mild disease by the presence of a cytokine storm process, and that IL-6 and IL-10 may play an immunopathogenic role in the development of life-threatening clinical outcomes in human leptospirosis. Keywords: Cytokines, IL-6, IL-10, Le, Leptospirosis, Response imune Conference: 15th International Congress of Immunology (ICI), Milan, Italy, 22 Aug - 27 Aug, 2013. Presentation Type: Abstract Topic: Innate immunity Citation: Reis MG (2013). Role of Cytokine Response in Disease Progression and Severe Clinical Outcomes in Leptospirosis. Front. Immunol. Conference Abstract: 15th International Congress of Immunology (ICI). doi: 10.3389/conf.fimmu.2013.02.00393 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 18 Mar 2013; Published Online: 22 Aug 2013. * Correspondence: Dr. Mitermayer G Reis, Oswaldo Cruz Fundation, Salvador, Brazil, miter@bahia.fiocruz.br Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Mitermayer G Reis Google Mitermayer G Reis Google Scholar Mitermayer G Reis PubMed Mitermayer G Reis Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.