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Cytokine network in scrub typhus: high levels of interleukin-8 are associated with disease severity and mortality.
[scrub typhus]
Scrub
typhus
,
caused
by
Orientia
tsutsugamushi
,
is
endemic
in
the
Asia
-
Pacific
region
.
Mortality
is
high
if
untreated
,
and
even
with
treatment
as
high
as
10
-
20
%
,
further
knowledge
of
the
immune
response
during
scrub
typhus
is
needed
.
The
current
study
was
aimed
at
comparing
plasma
levels
of
a
variety
of
inflammatory
mediators
in
scrub
typhus
patients
and
controls
in
South
India
in
order
to
map
the
broader
cytokine
profile
and
their
relation
to
disease
severity
and
clinical
outcome
.
We
examined
plasma
levels
of
several
cytokines
in
scrub
typhus
patients
(
n
=
129
)
compared
to
healthy
controls
(
n
=
31
)
and
infectious
disease
controls
(
n
=
31
)
,
both
in
the
acute
phase
and
after
recovery
,
by
multiplex
technology
and
enzyme
immunoassays
.
Scrub
typhus
patients
were
characterized
by
marked
changes
in
the
cytokine
network
during
the
acute
phase
,
differing
not
only
from
healthy
controls
but
also
from
infectious
disease
controls
.
While
most
of
the
inflammatory
markers
were
raised
in
scrub
typhus
,
platelet
-derived
mediators
such
as
RANTES
were
markedly
decreased
,
probably
reflecting
enhanced
platelet
activation
.
Some
of
the
inflammatory
markers
,
including
various
chemokines
(
e
.
g
.
,
interleukin-
8
,
monocyte
chemoattractant
peptide-
1
and
macrophage
inflammatory
protein-
1
β
)
and
downstream
markers
of
inflammation
(
e
.
g
.
,
C-
reactive
protein
and
pentraxin-
3
)
,
were
also
associated
with
disease
severity
and
mortality
during
follow-up
,
with
a
particular
strong
association
with
interleukin-
8
.
Our
findings
suggest
that
scrub
typhus
is
characterized
by
a
certain
cytokine
profile
that
includes
dysregulated
levels
of
a
wide
range
of
mediators
,
and
that
this
enhanced
inflammation
could
contribute
to
disease
severity
and
clinical
outcome
.
Diseases
Validation
Diseases presenting
"marked changes in the cytokine network during the acute phase"
symptom
scrub typhus
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