Key result
Severe Enterovirus 71 infection triggers cytokine storms linked to life-threatening complications.
Why the study?
The regulation of host immune responses is suspected to aggravate severe complications of Enterovirus 71 infection, prompting a summary of the pathophysiology of cytokines and chemokines associated with severe disease.
Are specific cytokines and chemokines associated with severe complications in infants and young children with EV71-infected HFMD?
Are specific cytokines and chemokines associated with severe complications in infants and young children with EV71-infected HFMD?
Various cytokines and chemokines are implicated in the pathophysiology of severe EV71-infected HFMD and may serve as predictors for severe complications.
Answers are grounded in this paper and cite their sources.
May support cytokine monitoring for early risk stratification in pediatric EV71; leaves open whether immunomodulation improves outcomes.
Enterovirus 71 (EV71) is one of the most common intestinal virus that causes hand, foot, and mouth disease (HFMD) in infants and young children (mostly ≤5 years of age). Generally, children with EV71-infected HFMD have mild symptoms that resolve spontaneously within 7-14 days without complications. However, some EV71-infected HFMD cases lead to severe complications such as aseptic meningitis, encephalitis, acute flaccid paralysis, pulmonary edema, cardiorespiratory complication, circulatory disorders, poliomyelitis-like paralysis, myocarditis, meningoencephalitis, neonatal sepsis, and even death. The mechanism of EV71 pathogenesis has been studied extensively, and the regulation of host immune responses is suspected to aggravate EV71-induced severe complications. Recently, several cytokines or chemokines such as TNF- α , IFN- γ , IL-1 β , IL-18, IL-33, IL-37, IL-4, IL-13, IL-6, IL-12, IL-23, IL-27, IL-35, IL-10, IL-22, IL-17F, IL-8, IP-10, MCP-1, G-CSF, and HMGB1 have been reported to be associated with severe EV71 infection by numerous research teams, including our own. This review is aimed at summarizing the pathophysiology of the cytokines and chemokines with severe EV71 infection.
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Zhang et al. (2020) conducted a review in Enterovirus 71-infected Hand, Foot, and Mouth Disease. Cytokines and chemokines vs. Mild cases or healthy controls was evaluated. Severe Enterovirus 71 infection is associated with a profound cytokine storm, with multiple cytokines and chemokines predicting the onset of life-threatening complications.
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