MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17 cytokine profile

Waleed H Mahallawi, Omar F Khabour, Qibo Zhang, Hatim M Makhdoum, Bandar A Suliman, Waleed H Mahallawi, Omar F Khabour, Qibo Zhang, Hatim M Makhdoum, Bandar A Suliman

Abstract

The Middle East respiratory syndrome coronavirus (MERS-CoV) has been recognized as a highly pathogenic virus to humans that infects the respiratory tract and is associated with high morbidity and mortality. Studies in animal models suggest that MERS-CoV infection induces a strong inflammatory response, which may be related to the severity of disease. Data showing the cytokine profiles in humans during the acute phase of MERS-CoV infection are limited. In this study, we have analyzed the profile of cytokine responses in plasma samples from patients with confirmed MERS-CoV infections (n = 7) compared to healthy controls (n = 13). The cytokine profiles, including T helper (Th) 1, Th2 and Th17 responses, were analyzed using cytometric bead array (CBA). A prominent pro-inflammatory Th1 and Th17 response was clearly seen in patients with MERS-CoV infection, with markedly increased concentrations of IFN-γ, TNF-α, IL-15 and IL-17 compared to controls. IL-12 expression levels showed no difference between patients with MERS-CoV infection and the healthy controls despite the significantly increased levels of IFN-α2 and IFN-γ (P < .01). No changes were observed in the levels of IL-2, IL-4, IL-5, IL-13, and TGF-α (P > .05). Our results demonstrate a marked pro-inflammatory cytokine response during the acute phase of MERS-CoV infection in humans.

Keywords: Cytokines; Humans; Interferons; MERS-CoV.

Conflict of interest statement

Authors have nothing to declare.

Copyright © 2018 Elsevier Ltd. All rights reserved.

Figures

Fig. 1
Fig. 1
Changes in the plasma levels of interferons in patients with MERS-CoV infection. Significant increases in the plasma levels of (A) IFN-α2 and (B) IFN-γ. Data are expressed as Mean ± SEM. * indicates significant difference.
Fig. 3
Fig. 3
Levels of selected cytokines in patients with MERS-CoV infection. Plasma levels of (A) IL-5, (B) IL-10, (C) IL-13, (D) IL-17, (E) TNF-α, and (F) TGF-α in patients with MERS-CoV infection. Significant elevations were observed for IL-10, IL-17 and TNF-α while no changes were observed in the levels of IL-5, IL-13 and TGF-α. Data are expressed as Mean ± SEM. * indicates significant difference.
Fig. 2
Fig. 2
Changes in the levels of four α-helix bundle-containing cytokines in patients with MERS-CoV infection. Levels of (A) IL-2, (B) IL-4, (C) IL-12p40, (D) IL-12p70 and (E) IL-15 were measured in plasma samples. Strong elevation only in the levels of IL-15 in all patients (P 

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