Impact of IL-10-1082A/G gene polymorphism on the severity of EV71 infection in Chinese children

Excerpt

Hand, foot and mouth disease (HFMD) is a common childhood infectious disease. It is caused by a group of enteroviruses classified within the Picornaviridae family, most commonly enterovirus 71 (EV71) and coxsackie virus A16 (CA16) [1]. The majority of HFMD cases are mild and self-limiting, but severe complications such as encephalitis, brain stem encephalitis (BE), acute flaccid paralysis (AFP), pulmonary edema (PE), and even death have been reported, especially in EV71-associated HFMD cases [2, 3]. Since its first description in 1974 [4], EV71 has caused several epidemic outbreaks throughout the world. In the last decades, epidemics of EV71-related HFMD have experienced an uptrend, especially in the Asia-Pacific region [5], leading to millions of cases and hundreds of deaths per year. In mainland China, for instance, a total of 1,997,371 HFMD cases (including 128 fatal cases) were reported during 2015 [6]. While the exact pathogenesis of EV71 infection remains unclear, the host immune inflammatory responses, including acute cytokine and chemokine storms in the blood and cerebrospinal fluid (CSF), are thought to be related to the severity of clinical manifestations. Previous reports have shown that a burst of pro-inflammatory cytokines, such as interleukin (IL)-6, tumor necrosis factor (TNF)-ɑ, and IL-1β, were related to BE, which is further complicated by PE in EV71 infections [7, 8]. …