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Correlation between the concentrations of tumor necrosis factor-alpha and the severity of disease in patients infected with Orientia tsutsugamushi.

AbstractBACKGROUND:
Patients with tsutsugamushi disease sometimes die if they do not receive appropriate chemotherapy. This study measured the concentration of several cytokines both before and after the administration of tetracyclines, and evaluated the changes in cytokine levels in patient serum to investigate the relationship between serum levels of cytokines and disease severity.
METHODS:
A total of nine patients were infected with Orientia tsutsugamushi. The diagnosis of tsutsugamushi disease was made using an indirect immunoperoxidase antibody test. The serum concentrations of cytokines were measured using enzyme-linked immunosorbent assays.
RESULTS:
The levels of interleukin (IL)-10 (mean 71.7 pg/ml) and IL-12p40 (mean 588 pg/ml) were elevated in all patients in the acute phase, above the normal upper limits. Tumor necrosis factor-alpha (TNF-alpha) levels (mean 9.20 pg/ml) were elevated in 89% and interferon-gamma (IFN-gamma) levels (mean 41.0 pg/ml) in 44% of patients. The down-regulation of these overproduced cytokines was observed after chemotherapy. There was a significant correlation between the concentrations of TNF-alpha in the acute phase and the severity of disease (r=0.918).
CONCLUSION:
The concentration of TNF-alpha may predict the severity of tsutsugamushi disease in the acute infectious phase.
AuthorsHiromichi Iwasaki, Jiro Mizoguchi, Nobuhiro Takada, Katsunori Tai, Satoshi Ikegaya, Takanori Ueda
JournalInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 14 Issue 4 Pg. e328-33 (Apr 2010) ISSN: 1878-3511 [Electronic] Canada
PMID19699129 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
  • Interleukin-12 Subunit p40
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Interleukin-4
  • Interferon-gamma
  • Tetracycline
Topics
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents (administration & dosage)
  • Female
  • Humans
  • Interferon-gamma (blood)
  • Interleukin-10 (blood)
  • Interleukin-12 Subunit p40 (blood)
  • Interleukin-4 (blood)
  • Male
  • Middle Aged
  • Orientia tsutsugamushi (growth & development)
  • Scrub Typhus (drug therapy, immunology, parasitology)
  • Severity of Illness Index
  • Tetracycline (administration & dosage)
  • Tumor Necrosis Factor-alpha (blood)

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