Abstract
Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are still urgent medical issues in developing countries and in some communities of high-income countries. The aim of our study was to evaluate plasma cytokine concentrations in children with RHD and their correlation with antibody concentrations to viruses of the Herpesviridae family. Sixty-two patients with RHD aged 8 to 17 years were included in the study. The concentrations of TNF-α, IL-4, IL-8, IL-10 and IFN-γ were evaluated; IgG and IgM antibodies to cytomegalovirus (CMV), herpes simplex virus (HSV) groups I-II and Epstein-Barr virus (EBV) in serum were determined by ELISA method. A significant increase of cytokine concentrations (TNF-α, IL-8, IL-4 and IL-10) was recorded in RHD patients. Antibodies to intracellular Herpesviridae family viruses were detected in all children with RHD. Children with RHD were significantly more likely to have IgG HSV I-II antibodies, and IgG and IgM EBV antibodies compared to controls (p<0.05). The concentration of IgM antibody to CMV showed positive correlation with TNF-α; the concentration of IgG antibody to EBV showed negative correlation with TNF-α; and the concentration of IgG and IgM antibodies to EBV showed positive correlation with IL-10 levels. Considering positive correlation of IL-10 concentration with IgG and IgM antibody concentrations to EBV, and the significance of IL-10 in the progression of RHD, the possible predisposing role of EBV in the progression of RHD can be postulated, which needs further study. Key words: child; cytokines ; Herpesviridae; rheumatic heart disease
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