TNF-Α, IL-1Β and IL-6 Levels in Pandemic Influenza A (H1N1) 2009 Patients and Effect on Mortality
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RESEARCH ARTICLE
P: 2-2
January 2013

TNF-Α, IL-1Β and IL-6 Levels in Pandemic Influenza A (H1N1) 2009 Patients and Effect on Mortality

Mediterr J Infect Microb Antimicrob 2013;2(2):2-2
1. SB Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, Ankara, Türkiye
2. SB Ankara Eğitim ve Araştırma Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Kliniği, Ankara, Türkiye
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Summary

Introduction: Throughout history, influenza virus pandemics have led to the death of millions of people. The virus sometimes causes pathological changes that can lead to severe illness and death. Inflammatory cytokines and chemokines have been shown to be involved in the pathogenesis of tissue damage in the lungs of animals and humans infected with influenza viruses.
Materials and Methods: The serum concentrations of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and interleukin- 6 (IL-6) were determined with enzyme immunoassay (EIA) in 57 patients who were hospitalized with confirmed influenza and a control group.
Results: Fifty-seven patients with confirmed influenza A (H1N1) 2009 and 62 healthy subjects as the control group were included in this study. Of these patients with influenza, 51 (89.4%) were discharged, and 6 (10.5%) died of influenza-related illness. TNF-α levels were found to be 43.0 pg/mL in fatal patients, 20.9 pg/mL in non-fatal patients, and 4.1 pg/mL in the control group. IL-6 levels were found to be 1074.12 pg/mL in fatal patients, 191.0 pg/mL in non-fatal patients, and 36.1 pg/mL in the control group. The differences between groups were statistically significant (p= 0.003 and p< 0.001, respectively). IL-1β levels were found to be 2.1 pg/mL in fatal patients, 7.1 pg/mL in non-fatal patients, and 7.5 pg/mL in the control group, and the difference was not statistically significant (p= 0.657).
Conclusion: We found that TNF-α and IL-6 levels were significantly higher in patients who died. We suggest that higher levels of pro-inflammatory cytokines may be used as an important marker of mortality.

Keywords:
Influenza A virus H1N1 subtype, tumor necrosis factor-alpha, interleukin-1beta, interleukin-6

References

1
Zhang C, Xu Y, Jia L, Yang Y, Wang Y, Sun Y, Huang L, Qiao F, Tomlinson S, Liu X, Zhou Y, Song H. A new therapeutic strategy for lung tissue injury induced by influenza with CR2 targeting complement inhibitor. Virol J 2010; 7:30.
2
Cheung CY, Poon LL, Lau AS, Luk W, Lau YL, Shortridge KF, Gordon S, Guan Y, Peiris JS. Induction of proinflammatory cytokines in human macrophages by influenza A (H5N1) viruses: a mechanism for the unusual severity of human disease? Lancet 2002; 360: 1831-7.
3
Kobasa D, Jones SM, Shinya K, Kash JC, Copps J, Ebihara H, Hatta Y, Kim JH, Halfmann P, Hatta M, Feldmann F, Alimonti JB, Fernando L, Li Y, Katze MG, Feldmann H, Kawaoka Y. Aberrant innate immune response in lethal infection of macaques with the 1918 influenza virus. Nature 2007; 445: 319-23.
4
Kang YM, Song BM, Lee JS, Kim HS, Seo SH. Pandemic H1N1influenza virus causes a stronger inflammatory response than seasonal H1N1 influenza virus in ferrets. Arch Virol 2011; 156: 759-67.
5
Kim HM, Lee YW, Lee KJ, Kim HS, Cho SW, van Rooijen N, Guan Y, Seo SH. Alveolar macrophages are indispensable for controlling influenza viruses in lungs of pigs. J Virol 2008; 82: 4265-74.
6
Us D. Kuş gribinde sitokin fırtınası. Mikrobiyol Bul 2008; 42: 365-80.
7
Van Reeth K, Van Gucht S, Pensaert M. Correlations between lung proinflammatory cytokine levels, virus replication, and disease after swine influenza virus challenge of vaccination-immune pigs. Viral Immunol 2002; 15: 583-94.
8
Hofmann P, Sprenger H, Kaufmann A, Bender A, Hasse C, Nain M, Gemsa D. Susceptibility of mononuclear phagocytes to influenza A virus infection and possible role in the antiviral response. J Leukoc Biol 1997; 61: 408-14.
9
Conn CA, McClellan JL, Maassab HF, Smitka CW, Majde JA, Kluger MJ. Cytokines and the acute phase response to influenza virus in mice. Am J Physiol 1995; 268: 78-84.
10
Hayden FG, Fritz R, Lobo MC, Alvord W, Strober W, Straus SE. Local and systemic cytokine responses during experimental human influenza A virus infection. Relation to symptom formation and host defense. J Clin Invest 1998; 101: 643-9.
11
Kaiser L, Fritz RS, Straus SE, Gubareva L, Hayden FG. Symptom pathogenesis during acute influenza: interleukin- 6 and other cytokine responses. J Med Virol 2001; 64: 262-8.
12
Giamarellos-Bourboulis EJ, Raftogiannis M, Antonopoulou A, Baziaka F, Koutoukas P, Savva A, Kanni T, Georgitsi M, Pistiki A, Tsaganos T, Pelekanos N, Athanassia S, Galani L, Giannitsioti E, Kavatha D, Kontopidou F, Mouktaroudi M, Poulakou G, Sakka V, Panagopoulos P, Papadopoulos A, Kanellakopoulou K, Giamarellou H. Effect of the novel influenza A (H1N1) virus in the human immune system. PLoS One 2009; 4: e8393.
13
Hagau N, Slavcovici A, Gonganau DN, Oltean S, Dirzu DS, Brezoszki ES, Maxim M, Ciuce C, Mlesnite M, Gavrus RL, Laslo C, Hagau R, Petrescu M, Studnicska DM. Clinical aspects and cytokine response in severe H1N1 influenza A virus infection. Crit Care 2010; 14: R203.
14
To KK, Hung IF, Li IW, Lee KL, Koo CK, Yan WW, Liu R, Ho KY, Chu KH, Watt CL, Luk WK, Lai KY, Chow FL, Mok T, Buckley T, Chan JF, Wong SS, Zheng B, Chen H, Lau CC, Tse H, Cheng VC, Chan KH, Yuen KY. Delayed clearance of viral load and marked cytokine activation in severe cases of pandemic H1N1 2009 influenza virus infection. Clin Infect Dis 2010; 50: 850-9.