Association of low serum TGF-beta level in hantavirus infected patients with severe disease

作者:Sadeghi Mahmoud; Lahdou Imad; Ettinger Jakob; Navid Mojdeh Heidary; Daniel Volker; Zeier Martin; Hofmann Joerg; Opelz Gerhard; Schnitzler Paul*
来源:BMC IMMUNOLOGY, 2015, 16(1): 19.
DOI:10.1186/s12865-015-0085-0

摘要

Background: Hantaviruses are emerging zoonotic pathogens which cause hemorrhagic fever with renal syndrome, an immune-mediated pathogenesis is discussed. The aim of the present study was to investigate the role of TGF-beta expression in acute hantavirus infection. Results: We retrospectively studied 77 patients hospitalised with acute Puumala infection during a hantavirus epidemic in Germany in 2012. Hantavirus infection was confirmed by positive anti-Puumala hantavirus IgG and IgM. Plasma levels of transforming growth factor (TGF)-beta 1 and TGF-beta 2 were analysed. Based on glomerular filtration rate on admission, patients were divided in mild and severe course of disease. Puumala virus RNA was detected by PCR amplification of the viral L segment gene. Out of 77 Puumala virus infected patients, 52 (68%) were male. A seasonal distribution was detected in our cohort with a peak in summer 2012, the highest incidence was observed in the age group of 30-39 years. Puumala virus RNA was detectable in 4/77 cases. Patients with severe disease had a significant longer hospital stay than patients with mild disease (6.2 vs 3.6 days). Thrombocyte count (186 vs 225 per nl), serum TGF-beta 1 (74 vs 118 ng/l) and TGF-beta 2 (479 vs 586 pg/l) were significantly lower in severe compared to mild disease. However, C-reactive protein (CRP) was significantly higher in patients with severe disease (62 vs 40 mg/l). TGF-beta 1/Cr was the most sensitive and specific marker associated with renal dysfunction. Conclusion: High serum CRP and low serum TGF-beta in the early phase of hantavirus infection is associated with a severe course of disease. Our results support the hypothesis of an immune-mediated pathogenesis in hantavirus infection.