Serum Immune Markers Differentiation in Patients With Puumala or Dobrava Virus Infections

Sa？etak Hemorrhagic fever with renal syndrome (HFRS) is widely distributed in Europe and caused mostly by two different orthohantaviruses: Puumala virus (PUUV) and Dobrava virus (DOBV). Several studies have implicated that HFRS is an immunologically mediated disease and that the proinflammatory cytokines may have a role in the immunopathogenesis of HFRS. In this study, we have detected: IL-2; IL-6; their soluble receptors (sIL-2R, sIL-6R); TNF-alpha; sCD23; and total IgE in two consecutive sera of HFRS patients, and have looked for their possible relation with the main blood and biochemical findings in order to determine their possible role in disease progression. The differences in the level of measured parameters between PUUV- and DOBV-infected patients were also observed. The sIL-2R, sIL-6R and sCD23 levels were elevated in all HFRS patients, but we did not find any statistical difference between 1st and 2nd sera. The total IgE was elevated in about 1/3 of HFRS patients in both sera. We detected higher IL-6, sIL-2R and sCD23 levels in the sera of patients with DOBV infection than in patients with PUUV infection, with no statistically significant difference. The total IgE level was elevated in five of the six tested patients with DOBV infection, and they had a statistically higher level of total IgE than patients with PUUV infection. Almost all the listed biochemical and blood parameters in HFRS patients stand either in positive or in negative correlation with sIL-2Rapha. The levels of urea and creatinine, which are the hallmarks of HFRS severity, stand in positive correlation with sIL-2Rapha, IL-6, sIL-6R and sCD23. The level of the total IgE stands either in positive or in negative correlation with proteins and parameters of the liver function. We have also found a high positive correlation between the total IgE level and basophile count