Changes and effects of multiple immuno-proinflammatory cytokines and anti-inflammatory cytokines in the pathogenesis of patients with hemorrhagic fever and renal syndrome

Objective To investigate the changes and effects of proinflammatory cytokines and anti-inflammatory cytokines in acute phase (including febrile phase, hypotension shock phase, oliguria phase) and convalescent patients with hemorrhagic fever and renal syndrome (HFRS). Methods Levels of serum tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), transforming growth factor -β1 (TGF-β1), interleukin-6 (IL-6)and interleukin-10 (IL-10) in 30 patients with HFRS from the Fourth Affiliated Hospital of Harbin Medical University and Center Hopital of Heilongjiang Agricultural Reclamation Hongxinglong Administration from April 2016 to June 2017 were detected. And the levels of cystatin C, creatinine (Cr), lactate dehydrogenase (LDH), activated partial thromboplastin time (APTT) of these patients were also dectected. Thirteen healthy volunteers were selected as the control group to detect the above indexes. The results were analyzed by SAS 9.3 International Standard Statistical Programming Software. Results The levels of IFN-γ (χ2= 4.273,P= 0.0336), TNF-α (χ2= 16.3562,P <0.0001), IL-6 (χ2= 9.752,P= 0.0018) and IL-10 (χ2= 6.3352,P= 0.0118) of patient with HFRS in acute stage were all significantly higher than those of the control group, all with significant differences (allP< 0.05). TGF-β1 level of patients with HFRS in acute stage was significantly lower than that of the control group, with significant difference (χ2 = 7.822,P= 0.0056). The level of TGF-β1 of patient with HFRS in recovery stage was close to or slightly lower than the control group, with no significant difference (χ2 = 3.000,P= 0.0833). The levels of Cystatin C, Cr, LDH and APTT of patients at different HFRS stages all showed increase in the acute stage and decrease in the recovery stage, which were consistent with the trend of TNF-α, IFN-γ, IL-6 and IL-10 levels. Conclusions At acute stage of HFRS, proinflammatory cytokines such as TNF-α, IFN-γ, IL-6 increased, and anti-inflammatory cytokines such as TGF-β1 secreted by CD4+CD25+FoxP3 Treg cells (regulatory T cells) decreased. The imbalance of cytokines was an important mechanism that causes the body immunologic pathological injury. Key words: Proinflammatory cytokine; Anti-inflammatory cytokine; Hemorrhagic fever with renal syndrome