Short communicationLow serum levels of CCL5 are associated with longer duration of viral shedding in norovirus infection
Section snippets
Background
Norovirus is the most common cause of viral gastroenteritis [1], [2] and can be detected in stool for several weeks following symptomatic infection [3]. The duration of shedding varies among individuals [4], but the factors behind this variation are not well understood. Longer duration of shedding is common in infants [5] and immunocompromised patients [6], suggesting that immune mechanisms are involved.
In animal models, innate immunity is responsible for initial control of norovirus infection
Objective
The aim of this study was to examine the relation between cytokine levels and viral clearance in patients with community-onset norovirus genogroup II gastroenteritis.
Study design
Adult patients admitted with suspected gastroenteritis were screened for inclusion in a prospective cohort study at the Department of Infectious Diseases of a 2000-bed teaching hospital in Gothenburg, Sweden, during three consecutive years (2010–2012). An overview of the study cohort and inclusion criteria is presented in Fig. 1. Age and sex; date of first symptom and symptom resolution; date of admission and discharge; gastroenteritis symptoms, summarized as Vesikari scores [12]; and Charlson
Results
In total, we included 93 patients with NoV GII infection. Duration of shedding could be determined in 28 participants without immune deficiency (<7 days in 7 patients, 7–14 days in 5 patients, >21 days in 7 patients and >28 days in 9 patients). The twelve patients with duration of shedding <14 days constituted the rapid clearance group, and the 16 patients with duration of shedding >21 days the slow clearance group. Their characteristics are presented in Table 1. The difference in sex
Discussion
In this longitudinal study of elderly hospitalized patients, slow clearance of norovirus infection was associated with low serum levels of CCL5 during acute gastroenteritis.
In general, levels of lymphocyte stimulating mediators were increased in norovirus patients compared to controls (except for CCL27, a skin-specific mediator [15]). CXCL9 and CXCL10, IL-18, soluble IL-2 receptor α and MIF are all related to a Th1-type response [16], [17], [18], [19], [20], and we found no indications that
Funding
Grants from the Regional Research Funds for Western Sweden (VGFOUREG 231011, 314211, 482001) and the Swedish Society of Medicine (SLS 249951).
Competing interests
None declared.
Ethical approval
Approved by the Regional Ethical Review Board in Gothenburg, Sweden.
Acknowledgements
The authors would like to thank Anna Rosnäs, Helen Christiansen, Ingela Kinell and Maria Andersson for expert technical assistance.
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The innate immune response to lower respiratory tract E. Coli infection and the role of the CCL2-CCR2 axis in neonatal mice
2017, CytokineCitation Excerpt :At all three time points, neonatal lungs had significantly lower expression of Ccl5 than the juvenile lungs. Of note, lower serum levels of CCL5 has been associated with delayed clearance and prolonged viral shedding with norovirus [21] and an increased risk of bronchopulmonary dysplasia in preterm infants [22]. Taken together these findings indicate that the neonatal lung can induce expression of several chemokines, including those with antimicrobial activities, as early as 24 h after initiation of Ec-LRTI.
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