Cytokine profiles of patients with enterohemorrhagic Escherichia coli-induced hemolytic-uremic syndrome

Abstract

Proinflammatory cytokines are related to the pathogenesis of EHEC infection and hemolytic-uremic syndrome (HUS). We assessed the kinetics of the release of cytokines such as neopterin, interleukin (IL)-6, IL-8 and tumour necrosis factor (TNF)-α and the soluble forms of type I and II TNF receptors during EHEC-induced HUS. Twenty one patients with EHEC-induced HUS were enrolled in this study. Serum concentrations of all cytokines were significantly elevated in patients with severe HUS compared with those in patients with mild HUS. Serum concentrations of these cytokines rapidly and markedly increased, and massive hypercytokinaemia developed in a short time after the onset of HUS in patients with severe HUS. Changes in the number of white blood cells and concentration of serum lactate dehydrogenase were significantly larger between the onset of hemorrhagic colitis and the time of the diagnosis of HUS in patients with severe HUS compared with those in patients with mild HUS. Proinflammatory cytokines play an important role in the pathogenesis of EHEC infection and development of severe complications, including HUS and encephalopathy. Monitoring the cytokine profile may be useful for assessing disease activity of EHEC infections.