Human herpesvirus-6 encephalitis after allogeneic stem cell transplantation: analysis of pathologic condition to predict the development.

为了阐明人类疱疹病毒6型脑炎的免疫学发病机制，我们对172例HCT受者进行了详细的细胞因子研究，其中包括20例HHV-6脑炎患者。检测HHV-6脑炎发生时的脑脊液和血浆中17种细胞因子的含量。HHV-6脑炎患者血浆IL-8、-10、-13、MCP-1、MIP-1b水平明显高于非HHV-6脑炎患者。高水平IL-6预示HHV-6脑炎患者预后不良。在HHV-6脑炎患者中，病情加重(死于脑炎或后遗症)的患者脑脊液中IL-5、-6和-8的水平高于其他患者。我们认为几种细胞因子参与了HHV-6脑炎的发病过程。血浆和脑脊液中细胞因子水平的升高预示着HHV-6脑炎的发展和预后不良。

To elucidate the immunological pathogenesis of human herpesvirus (HHV)-6 encephalitis, we performed detailed cytokine study against 172 HCT recipients, including 20 patients with HHV-6 encephalitis. Seventeen kinds of cytokines in plasma samples collected weekly until 28 days after HCT, and cerebrospinal fluid (CSF) at the time of developing HHV-6 encephalitis were measured. The plasma IL-8, -10, -13, MCP-1, and MIP-1b were significantly higher in patients who developed HHV-6 encephalitis than those without HHV-6 encephalitis. High-level IL-6 predicted poor prognosis for patients with HHV-6 encephalitis. Among patients with HHV-6 encephalitis, IL-5, -6, and -8 in CSF were higher in patients who progress to severe status (died of encephalitis or sequelae) than in other patients. We suggest that several cytokines mediate the pathogenesis of HHV-6 encephalitis. Increased levels of cytokines in plasma and CSF predict development and poor prognosis of HHV-6 encephalitis.