Zeitschrift für Infektionskrankheiten und Therapie

Abstrakt

Immune System Behavior during Herpesvirus Infection in Childhood

Stamenkovic H, Saranac Lj, Djuric Z, Stankovic T, Kamenov B, Tasic G, Brankovic Lj and Milicevic R

Background: Persistently infected cells by herpesvirus (HSV, CMV, EBV) and their dysfunction are associated with different disorders. The immune and endocrine systems are involved in pathogenesis of herpesvirus infection. Changes of IFN-γ, IL-4, DHEAS and cortisol level are a part of the regulatory mechanisms of the immune and endocrine system responses in persistent herpesvirus infection.

Objectives: The aim of this study was to identify immunoregulatory mechanisms (clinical manifestations, cytokines level-IFN-γ, et IL-4, hormones level-DHEAS, cortisol, parameters of oxidative metabolism, enzymes of cell injury) and their consequences concerning clinical disease expression (low level of hemoglobin (Hb), leucocitopenia, high level of monocytes, hyper gamaglobulins, low level of NBT-test).

Study design: 40 children (1-16 years old) with herpesvirus infection were analyzed. In patients routine laboratory investigations were performed: white blood cells count, lactate dehydrogenize-LDH, creatinin-kinaza- CPK, oxidative metabolism of the blood phagocytes, the ability of phagocytes nitro-blue tetrazolium-NBT reduction and immunoglobulin serum level. Serum levels of IFN-γ, IL-4, DHEAS and cortisol were measured by ELISA test. Normal healthy controls had negative ELISA tests for CMV, HSV and EBV

Results: The high level of LDH, CPK, low ability of NBT reduction and hypergammaglobulins were detected. The increases of IFN-γ, IL-4 level, as well as, the decrease of DHEAS and cortisol level were present. The patients with the high level of IFN-γ, had the high level of LDH, CPK, GOT, GPT, the low level of Hb, leucocitopenia and monocytes.

Conclusions: Two groups of patients were presented. First with the high level of IFN-γ (70%) and second with the high level of IL-4.The patients in the first group, with the high level of IFN-γ, had anemia, respiratory infections, BHR, labial HSV, stomatitis aphtosa. Vasculitis, anginae recidivans, was clinical manifestation characteristics for in patients in the second group with the high level of IL-4. The high level of LDH, CPK, the low ability of NBT reduction and hypergammaglobulins were detected. The patients with the high levels of IFN-γ, had the high level of LDH, CPK, GOT, GPT, the low level of Hb, leukopenia and monocytosis. The decreased level of DHEAS (50%) and the normal level of cortisol (76%) were present. The low levels of DHEAS followed the IgG high values while leucopenia (78%), was followed by high values of DHEAS. The patients with normal cortisol values had the significant monocytosis (80%) while patients with the low cortisol level had the high IgG (85%) level.