engleski

Immune response in patients with hemorrhagic fever with renal syndrome and leptospirosis

Hemorrhagic fever with renal syndrome (HFRS) and leptospirosis continue to cause significant number of human illnesses worldwide, in both urban and rural regions. Both HFRS and leptospirosis are endemic diseases in Croatia. Clinical pictures of HFRS and leptospirosis can closely mimic each other and patients mostly have fever, headache, myalgia liver and kidney disorders. Immune mechanisms behind the development of symptoms and lesions induced by hantaviruses and leptospiras are largely unknown. Clinical studies have implicated the importance of increased levels of interleukin (IL)-1, IL-6, IL-10 and tumor necrosis factor a (TNF-alpha) in the outcome of HFRS. Moreover, increased levels of TNF-alpha and soluble IL-2 receptors were found in patients with leptospirosis. The aim of our study was to analyze the role of some cytokines and chemokines in patients with HFRS and leptospirosis. Serum samples were taken from 16 patients with leptospirosis and 16 patients with HFRS during acute illness, hospitalized from January 2001 to April 2002. Healthy controls (n=16) were laboratory workers and blood donors. The levels of IL-10, CCL-2 (MCP-1, monocyte chemoattractant protein) and CXCL-8 (IL-8) in patients sera were measured by commercial ELISA. Significantly higher levels of CCL2 and CXCL8 were found in patients with HFRS or leptospirosis than in negative controls, but there were no significant differences in the levels of both chemokines between patients with HFRS or leptospirosis. IL-10 was elevated in about 30% of patients in the early acute phase of both diseases. Further studies are necessary to understand better the role of these cytokines and their possible diagnostic or prognostic value in patients with HFRS or leptospirosis.

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