Autoantibody Profiles and Prognostic Significance in Severe Fever With Thrombocytopenia Syndrome (SFTS) Patients

Abstract

To examine the relationship between autoantibodies, inflammatory cytokines, and coagulation abnormalities in patients with severe fever with thrombocytopenia syndrome (SFTS) and assess their potential as prognostic markers. A total of 105 SFTS patients and 85 healthy controls (HCs) were included. Serum levels of antinuclear antibodies (ANAs), anti-neutrophil cytoplasmic antibodies (ANCAs), anti-endothelial cell antibodies (AECAs), antiphospholipid antibodies (aPLs), as well as inflammatory cytokines and chemokines were measured to evaluate their correlation with prognosis. AECA positivity was found in over 50% of SFTS patients, with higher titers correlating with poor prognosis. AECA levels were associated with hypertension, consciousness disorder, and advanced age. Elevated aPLs were observed and associated with coagulation dysfunction, including prolonged activated partial thromboplastin time (APTT) and thrombin time (TT). Serum levels of inflammatory cytokines and chemokines (IL-1β, IL-6, IL-8, CCL2, and CXCL10) were significantly higher in SFTS patients compared to HCs. Elevated AECA and aPLs, along with a dysregulated cytokine/chemokine profile, were identified as significant prognostic indicators in SFTS, offering potential biomarkers for disease severity. Further research is needed to explore the mechanistic roles of these immune responses and to develop targeted therapies.