tailieunhanh - Báo cáo y học: "Clinical aspects and cytokine response in severe H1N1 influenza A virus infection"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Clinical aspects and cytokine response in severe H1N1 influenza A virus infection. | Hagau et al. Critical Care 2010 14 R203 http content 14 6 R203 c CRITICAL CARE RESEARCH Open Access Clinical aspects and cytokine response in severe H1N1 influenza A virus infection 1 2 1 21 1 Natalia Hagau Adriana Slavcovici Daniel N Gonganau Simona Oltean Dan S Dirzu Erika S Brezoszki 1 1 1 113 Mihaela Maxim Constantin Ciuce Monica Mlesnite Rodica L Gavrus Carmen Laslo Radu Hagau Magda Petrescu1 Daniela M Studnicska1 Abstract Introduction The immune responses in patients with novel A H1N1 virus infection nvA H1N1 are incompletely characterized. We investigated the profile of Th1 and Th17 mediators and interferon-inducible protein-10 IP-10 in groups with severe and mild nvA H1N1 disease and correlated them with clinical aspects. Methods Thirty-two patients hospitalized with confirmed nvA H1N1 infection were enrolled in the study 21 patients with nvA H1N1 -acute respiratory distress syndrome ARDS and 11 patients with mild disease. One group of 20 patients with bacterial sepsis-ARDS and another group of 15 healthy volunteers were added to compare their cytokine levels with pandemic influenza groups. In the nvA H1N1 -ARDS group the serum cytokine samples were obtained on admission and 3 days later. The clinical aspects were recorded prospectively. Results In the nvA H1N1 -ARDS group obesity and lymphocytopenia were more common and IP-10 interleukin IL -12 IL-15 tumor necrosis factor TNF a IL-6 IL-8 and IL-9 were significantly increased versus control. When comparing mild with severe nvA H1N1 groups IL-6 IL-8 IL-15 and TNFa were significantly higher in the severe group. In nonsurvivors versus survivors IL-6 and IL-15 were increased on admission and remained higher 3 days later. A positive correlation of IL-6 IL-8 and IL-15 levels with C-reactive protein and with 5-day interval between symptom onset and admission and a negative correlation with the PaO2 FiO2 ratio were found in nvA H1N1 groups. In obese patients with influenza disease a significant .