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

为阐明人类疱疹病毒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型脑炎患者。每周收集血浆样本，直至HCT后28天，并在HHV-6脑炎时测定脑脊液（CSF）中的17种细胞因子。HHV-6脑炎患者血浆IL-8、IL-10、IL-13、MCP-1和MIP-1b水平明显高于非HHV-6脑炎患者。HHV-6脑炎患者血清IL-6水平升高预示预后不良。在HHV-6脑炎患者中，病情进展至严重状态（死于脑炎或后遗症）的患者CSF中IL-5、IL-6和IL-8水平高于其他患者。我们认为，几种细胞因子介导的HHV-6脑炎的发病机制。血浆和CSF中细胞因子水平升高可预测HHV-6脑炎的发生和预后不良。

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.