PMID- 32912408
OWN - NLM
STAT- MEDLINE
DCOM- 20201006
LR  - 20201006
IS  - 2095-4352 (Print)
VI  - 32
IP  - 8
DP  - 2020 Aug
TI  - [Differences in immune damage between patients with severe fever with 
      thrombocytopenia syndrome and patients with tsutsugamushi disease].
PG  - 947-952
LID - 10.3760/cma.j.cn121430-20200420-00314 [doi]
AB  - OBJECTIVE: To analyze the difference of immune damage between patients with 
      severe fever with thrombocytopenia syndrome (SFTS) and patients with 
      tsutsugamushi disease. METHODS: A prospective case-control study was conducted. 
      Thirty-one patients with SFTS and 16 patients with tsutsugamushi disease admitted 
      to the First Affiliated Hospital of Anhui Medical University from October 2014 to 
      June 2017 were enrolled, and another 10 healthy people were enrolled as control. 
      The counts of CD4(+) and CD8(+) T lymphocytes, and the proportion of CD3(+) T 
      lymphocytes, natural kill cells (NK cells), B lymphocytes and plasma cells were 
      detected by flow cytometry. Thirty-four inflammatory mediators were determined by 
      a multiplex Luminex((R)) system synchronously. The differences of lymphocytes and 
      cytokines between the two groups were compared. RESULTS: The proportion of CD3(+) 
      T lymphocytes, the counts of CD4(+) and CD8(+) T lymphocytes in SFTS patients 
      were significantly lower than those in patients with tsutsugamushi disease (t 
      values were 4.860, 9.411 and 5.030, respectively, all P < 0.01), and the 
      proportion of NK cells and B lymphocytes were significantly higher than those in 
      patients with tsutsugamushi disease (t values were 2.344 and 5.896, respectively, 
      both P < 0.05). The proportion of plasma cells in peripheral blood of SFTS 
      patients was (7.7+/-1.2)%, the highest proportion of plasma cells in severe SFTS 
      patients was up to 30%, and all patients showed lambda monoclonal cell group in plasma 
      cells. No plasma cells were detected in tsutsugamushi disease patients. The 
      abnormal expressions of interleukin-1 receptor antibody (IL-1RA), interleukin 
      (IL-6, IL-15, IL-10, IL-8), tumor necrosis factor-alpha (TNF-alpha), gamma-interferon 
      (IFN-gamma), granulocyte colony-stimulating factor (G-CSF), eosinophil chemotactic 
      factor (Eotaxin), IFN-gamma-inducible protein-10 (IP-10), monocyte chemoattractant 
      protein-1 (MCP-1), macrophage inflammatory protein (MIP-1alpha, MIP-1beta), 
      platelet-derived growth factor (PDGF-AA, PDGF-AB/BB), activated regulatory normal 
      T cells and secretion factors (RANTES) were found in patients with SFTS and 
      tsutsugamushi disease. The levels of IL-1RA, IL-6, IL-15, IL-10, TNF-alpha, IFN-gamma, 
      G-CSF, Eotaxin, IL-8, IP-10, MCP-1 and MIP-1alpha in SFTS patients were significantly 
      higher than those in patients with tsutsugamushi disease (Z values were 2.312, 
      2.447, 3.660, 5.444, 1.965, 2.402, 2.402, 2.997, 3.525, 2.481, 3.817, and 2.211, 
      respectively, all P < 0.05), while PDGF-AA, PDGF-AB/BB and RANTES were 
      significantly lower than those in patients with tsutsugamushi disease (Z values 
      were 3.728, 2.514, 2.649, respectively, all P < 0.05). Correlation analysis 
      showed that RANTES, PDGF-AA and PDGF-AB/BB levels were significantly positively 
      correlated with the level of platelet in patients with SFTS and tsutsugamushi 
      disease (SFTS: r values were 0.223, 0.365, 0.330; tsutsugamushi disease: r values 
      were 0.263, 0.632, 0.407, respectively, all P < 0.05). In SFTS patients, compared 
      with the survival group (n = 21), the CD3(+) and CD4(+) T lymphocytes in the 
      death group (n = 10) significantly decreased, while the plasma cells 
      significantly increased (t values were 3.980, 3.314 and 26.692, respectively, all 
      P < 0.01); IL-1RA, IL-6, IL-15, IL-10, TNF-alpha, IFN-gamma, G-CSF, Eotaxin, IL-8, IP-10, 
      MCP-1, MIP-1alpha and MIP-1beta significantly increased, while PDGF-AA, PDGF-AB/BB and 
      RANTES significantly decreased (Z values were 3.930, 4.014, 2.832, 3.592, 2.958, 
      3.508, 2.578, 3.254, 4.270, 3.465, 2.663, 3.085, 3.107, 3.639, 3.043 and 3.825, 
      respectively, all P < 0.05). CONCLUSIONS: The immune function was impaired more 
      seriously in SFTS patients than that in tsutsugamushi disease patients. Excessive 
      humoral immunity and apoptosis of T lymphocytes are closely related to the death 
      in SFTS patients. The detection of CD4 cells, plasma cells and proinflammatory 
      and anti-inflammatory cytokines (e.g. IL-6, IL-10) had great clinical 
      significance for the differentiation and illness evaluation in disease with SFTS 
      or tsutsugamushi disease.
FAU - Hu, Lifen
AU  - Hu L
AD  - Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical 
      University, Hefei 230022, Anhui, China.
FAU - Kong, Qinxiang
AU  - Kong Q
AD  - Department of Infectious Diseases, Chaohu Hospital of Anhui Medical University, 
      Hefei 230022, Anhui, China. Corresponding author: Li Jiabin, Email: 
      lijiabin@ahmu.edu.cn.
FAU - Yue, Chengcheng
AU  - Yue C
AD  - Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical 
      University, Hefei 230022, Anhui, China.
FAU - He, Lingling
AU  - He L
AD  - Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical 
      University, Hefei 230022, Anhui, China.
FAU - Xia, Lingling
AU  - Xia L
AD  - Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical 
      University, Hefei 230022, Anhui, China.
FAU - Li, Jiabin
AU  - Li J
AD  - Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical 
      University, Hefei 230022, Anhui, China.
AD  - Department of Infectious Diseases, Chaohu Hospital of Anhui Medical University, 
      Hefei 230022, Anhui, China. Corresponding author: Li Jiabin, Email: 
      lijiabin@ahmu.edu.cn.
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
JT  - Zhonghua wei zhong bing ji jiu yi xue
JID - 101604552
SB  - IM
MH  - Case-Control Studies
MH  - Humans
MH  - *Phlebovirus
MH  - Prospective Studies
MH  - *Scrub Typhus
MH  - *Thrombocytopenia
EDAT- 2020/09/12 06:00
MHDA- 2020/10/07 06:00
CRDT- 2020/09/11 05:32
PHST- 2020/09/11 05:32 [entrez]
PHST- 2020/09/12 06:00 [pubmed]
PHST- 2020/10/07 06:00 [medline]
AID - 10.3760/cma.j.cn121430-20200420-00314 [doi]
PST - ppublish
SO  - Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2020 Aug;32(8):947-952. doi: 
      10.3760/cma.j.cn121430-20200420-00314.