Evaluation of the influence of the etiological spectrum herpesviruses into systemic and local immune response in encephalitis in children

E. Skripchenko, G. F. Zheleznikova, N. Skripchenko, E. Gorelik, N. F. Pullman, A. Vilnits, A. Astapova, V. Lobzin
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Abstract

Herpesviruses are the most common etiological agents of encephalitis in children. The most pathogenic properties for humans are: Herpes Simplex virus type 1, type 2, Varicella Zoster virus, Human Herpes virus type 6 and Epstein-Barr virus, combined infection with which, along with the individual characteristics of the patient's immune status, can lead to a severe course and unpredictable outcome encephalitis.Materials and methods. Clinical and neurological monitoring, etiological verification of infectious agents in the blood and cerebrospinal fluid by PCR and ELISA methods were carried out in 85 children with encephalitis at the age of 10—18 years. In patients suffering from herpesvirus encephalitis, the levels of pro-inflammatory cytokines, interleukins, chemokines were determined in the blood during the acute period of the disease and after 10—14 days.Results. A decrease in the production of IFN-α and IFN-γ was revealed, which is an unfavorable factor prolonging the course of an active herpes virus infection. Conclusions. Cytokines should be considered as one of the prognostic factors for the course and outcomes of encephalitis in children, which will allow timely correction of patient management tactics in each specific case and improve the outcome of the disease.
评估疱疹病毒病原谱对儿童脑炎全身和局部免疫反应的影响
疱疹病毒是儿童脑炎最常见的病因。对人类最具致病性的特性是:1型单纯疱疹病毒、2型水痘带状疱疹病毒、6型人类疱疹病毒和爱泼斯坦-巴尔病毒,这些病毒的联合感染,以及患者免疫状态的个体特征,可导致严重的过程和不可预测的结果脑炎。材料和方法。对85例10 ~ 18岁脑炎患儿进行了临床和神经学监测,并采用PCR和ELISA方法对血液和脑脊液中感染因子进行了病因学验证。测定了疱疹病毒性脑炎患者急性期及发病后10 ~ 14天血中促炎因子、白细胞介素、趋化因子的水平。发现IFN-α和IFN-γ的产生减少,这是延长活动性疱疹病毒感染病程的不利因素。结论。细胞因子应被视为儿童脑炎病程和预后的预后因素之一,这将允许在每个特定病例中及时纠正患者管理策略,并改善疾病的预后。
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