ROLE OF CD4+T CELL SUBSETS IN THE DETERMINATION OF THE CLINICAL OUTCOME OF JAPANESE ENCEPHALITIS INFECTIONAbstract
Japanese encephalitis is the most common arthropod-borne human encephalitis in the world. JEV clinical outcomes vary from complete recovery to recovery with neuropsychiatric sequelae to death. Contribution of T cells to the control and immunopathology of JEV infection has been reported in various studies. CD4+ T cells were found to be major T cells that has role in protection as well as affecting the clinical outcome in murine Japanese encephalitis model. Role of the CD4+ T cells subset in determining outcome of JEV infection is incompletely understood. Therefore, we sought to determine how quantitative difference in CD4+ T cell subsets influences JEV infection outcome. A total of 544 Acute Encephalitis Syndrome (AES) cases were admitted in ICU and AES ward of Kushinagar District Hospital during a period from Aug 2013 to Dec 2015. A diagnosis of JEV infection was based on clinical symptoms and anti-JEV IgM antibody in the acute phase cerebrospinal fluid (CSF) and serum samples measured by IgM antibody capture (MAC)-ELISA. Blood samples were drawn, and flow cytometry analysis was performed. The outcome was recorded as death, recovered, recovered with sequelae. Percentage of T cell subset CD3+ T cells, CD4+ IFNγ+ (Th1), CD4+ IL-4+ (Th2), CD4+ IL-17+ (Th17) and CD4+CD25high+Foxp3+ T reg cells were analyzed and compared between patients with different outcome. CD4+ Th1 percentage was found to be significantly in recovered patients when compared to other disease groups. A positive correlation was observed between GCS and Tregs cells (r=0.34 P=0.002). We conclude that CD4Th1 might be associated with recovery after JE infection. Treg cells expansion during JEV infection may lead to improvement in neurological manifestation.
A. Zia, M. K. Rai, V. Agarwal and T. N. Dhole *
Department of Microbiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
19 May 2017
21 August 2018
21 January 2019
01 February, 2019