IL-6 and IL-10 Levels, Rather Than Viral Load and Neutralizing Antibody Titers, Determine the Fate of Patients With Severe Fever With Thrombocytopenia Syndrome Virus Infection in South Korea

Front Immunol. 2021 Aug 17:12:711847. doi: 10.3389/fimmu.2021.711847. eCollection 2021.

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is a new tick-borne viral disease, and most SFTS virus (SFTSV) infections occur via bites from the tick Haemaphysalis longicornis; however, SFTSV transmission can also occur through close contact with an infected patient. SFTS is characterized by acute high fever, thrombocytopenia, leukopenia, elevated serum hepatic enzyme levels, gastrointestinal symptoms, and multiorgan failure and has a 16.2 to 30% mortality rate. In this study, we found that age, dyspnea rates, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase, multiorgan dysfunction score (MODS), viral load, IL-6 levels, and IL-10 levels were higher in patients with fatal disease than in patients with nonfatal disease during the initial clinical course of SFTS. In addition, we found that IL-6 and IL-10 levels, rather than viral load and neutralizing antibody titers, in patients with an SFTSV infection strongly correlated with outcomes (for severe disease with an ultimate outcome of recovery or death).

Keywords: IL-10; IL-6; South Korea; severe fever with thrombocytopenia syndrome; tick-borne viral diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alanine Transaminase / blood
  • Antibodies, Neutralizing / blood
  • Antibodies, Neutralizing / immunology
  • Antibodies, Viral / blood
  • Antibodies, Viral / immunology
  • Aspartate Aminotransferases / blood
  • Cytokines / blood
  • Dyspnea / etiology
  • Female
  • Humans
  • Interleukin-10 / blood*
  • Interleukin-10 / physiology
  • Interleukin-6 / blood*
  • Interleukin-6 / physiology
  • L-Lactate Dehydrogenase / blood
  • Male
  • Middle Aged
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / mortality
  • Phlebovirus / immunology
  • Republic of Korea / epidemiology
  • Severe Fever with Thrombocytopenia Syndrome / blood
  • Severe Fever with Thrombocytopenia Syndrome / immunology*
  • Severe Fever with Thrombocytopenia Syndrome / mortality
  • Severe Fever with Thrombocytopenia Syndrome / virology
  • Treatment Outcome
  • Viral Load
  • Viremia / blood
  • Viremia / immunology*
  • Viremia / mortality

Substances

  • Antibodies, Neutralizing
  • Antibodies, Viral
  • Cytokines
  • IL10 protein, human
  • IL6 protein, human
  • Interleukin-6
  • Interleukin-10
  • L-Lactate Dehydrogenase
  • Aspartate Aminotransferases
  • Alanine Transaminase