Comparative clinical and epidemiological characteristics and cytokine profile of viral diarrhea in adults

• Main Author: N. V. Epifantseva
• Format: Article
• Language: Russian
• Published: Journal Infectology 2020-06-01
• Series: Žurnal Infektologii
• Subjects: rotavirus; norovirus; viral diarrhea; cytokines; interleukins; inflammation
• Online Access: https://journal.niidi.ru/jofin/article/view/1053

The aim of the work is to determine the clinical and pidemiological features and indicators of the cytokine profile in patients with viral diarrhea in the adult population, to establish the influence of inflammatory mediators on the course of the disease.Materials and methods-we analyzed the patient’s hospital records, as well as the blood serum of patients diagnosed with viral diarrhea. The experimental group consisted of 29 patients aged 23,2 ±8,4, with an equal distribution among men and women. The 1 experimental group included 22 patients with norovirus infection, the 2 comparison group consisted of 7 people with rotavirus  gastroenteritis. The control group consisted of 20 somatically healthy people of the appropriate age (23,3±1,4). The concentration of  proinflammatory and anti-inflammatory cytokines in blood serum  was determined by ELISA using reagents from Vector-best LLC(Novosibirsk). Statistical processing of the obtained data was carried out using electronic programs Microsoft Excel 2010, Statistica 6.0, with the determination of the statistical significance of differences at the achieved significance level p≤0.05 using the Mann – Whitney test (U-test). When calculating correlations, we used Spearman’s coefficient, r = -1+1 (r=0-0, 3 – weak connection, r= 0,3–0,7 – medium strength connection, r= 0,7–1 – strong connection; «+» – direct connection, «–» – feedback). The distribution of features was evaluated using the Shapiro – Wilkes W test.Results: in the course of work, the prevalence of norovirus infection among adult patients with viral diarrhea was established. Among the ways of infection, the food and water routes predominated, contact and household was noted, mainly, when caring for children with intestinal infection. In the clinical picture, all patients had a moderate intoxication syndrome. With rotavirus infection, catarrhal and pronounced gastroenteritis syndromes were determined, while for norovirus gastroenteritis, catarrhal syndrome was not characteristic, and patients also had a tendency to constipation. When assessing the cytokine status, an increase in the concentration of IL-2, IL-6, TNF-α, IL-10 was found, regardless of the etiological factor, at normal levels of IL-1β and low IL-4, as well as a strong direct dependence of the severity of feverish intoxication syndrome on the level of IL-2, IL-1β and IL-4. The effect of Pro-inflammatory and anti-inflammatory cytokine production on the duration of individual syndromes and on the duration of the disease as a whole has not been established.  Conclusion – norovirus infection, in contrast to rotavirus infection, occurs without an obvious respiratory catarrhal syndrome, with the predominance of intoxication over gastroenteritis, while in rotavirus infection, the syndrome of intoxication and gastroenteritis are expressed equally. In viral diarrhea, there is an increase in IL-2, IL-6, TNF-a, and IL-10, which play an important role in the development of feverintoxication syndrome and the formation of antiviral protection.