Cytokine Storm Related to CD4+ T Cells in Influenza Virus-Associated Acute Necrotizing Encephalopathy.

IF 4.3 4区 医学 Q2 IMMUNOLOGY Immune Network Pub Date : 2024-04-29 eCollection Date: 2024-04-01 DOI:10.4110/in.2024.24.e18
Shushu Wang, Dongyao Wang, Xuesong Wang, Mingwu Chen, Yanshi Wang, Haoquan Zhou, Yonggang Zhou, Yong Lv, Haiming Wei
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Abstract

Acute necrotizing encephalopathy (ANE) is a rare but deadly complication with an unclear pathogenesis. We aimed to elucidate the immune characteristics of H1N1 influenza virus-associated ANE (IANE) and provide a potential therapeutic approach for IANE. Seven pediatric cases from a concentrated outbreak of H1N1 influenza were included in this study. The patients' CD4+ T cells from peripheral blood decreased sharply in number but highly expressed Eomesodermin (Eomes), CD69 and PD-1, companied with extremely high levels of IL-6, IL-8 in the cerebrospinal fluid and plasma. Patient 2, who showed high fever and seizures and was admitted to the hospital very early in the disease course, received intravenous tocilizumab and subsequently showed a reduction in temperature and a stable conscious state 24 h later. In conclusion, a proinflammatory cytokine storm associated with activated CD4+ T cells may cause severe brain pathology in IANE. Tocilizumab may be helpful in treating IANE.

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流感病毒相关急性坏死性脑病中与 CD4+ T 细胞有关的细胞因子风暴
急性坏死性脑病(ANE)是一种罕见但致命的并发症,发病机制尚不清楚。我们旨在阐明甲型 H1N1 流感病毒相关急性坏死性脑病(IANE)的免疫特征,并为 IANE 提供一种潜在的治疗方法。本研究纳入了集中爆发的甲型 H1N1 流感中的 7 例儿科病例。患者外周血中的 CD4+ T 细胞数量急剧下降,但高度表达 Eomesodermin(Eomes)、CD69 和 PD-1,同时脑脊液和血浆中的 IL-6、IL-8 含量极高。患者 2 在病程早期就出现了高烧和抽搐,并被送入医院,在接受了静脉注射托西珠单抗后,体温有所下降,24 小时后意识状态稳定。总之,与活化的 CD4+ T 细胞相关的促炎细胞因子风暴可能会导致 IANE 出现严重的脑部病变。托西珠单抗可能有助于治疗IANE。
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来源期刊
Immune Network
Immune Network Immunology and Microbiology-Immunology
CiteScore
2.90
自引率
3.30%
发文量
36
期刊介绍: Immune Network publishes novel findings in basic and clinical immunology and aims to provide a medium through which researchers in various fields of immunology can share and connect. The journal focuses on advances and insights into the regulation of the immune system and the immunological mechanisms of various diseases. Research that provides integrated insights into translational immunology is given preference for publication. All submissions are evaluated based on originality, quality, clarity, and brevity
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