Kd. Yang et al., Altered cellular but not humoral reactions in children with complicated enterovirus 71 infections in Taiwan, J INFEC DIS, 183(6), 2001, pp. 850-856
Enterovirus 71 (EV 71) infections have high neurovirulence and fatality. Im
mune responses were assessed in 78 patients with EV 71 infection. EV 71 men
ingoencephalitis occurred more frequently in younger children and in boys.
C-reactive protein levels were not elevated, although total leukocyte count
s were increased in these patients. The CD40-ligand expression on T cells s
ignificantly decreased in children with meningoencephalitis (P = .041). Pol
ymorphism of the cytotoxic T lymphocyte antigen-4 (CTLA-4) at position 49 o
f exon 1 showed a higher frequency of G/G genotype in patients with EV 71 m
eningoencephalitis than in those without meningoencephalitis (18/31 vs. 14/
47; P = .045) and in control subjects (18/31 vs. 25/931; P = .007). Specifi
c EV 71 neutralizing antibody titers were detectable but did not differ in
children with and without meningoencephalitis in the acute and convalescent
stages. Results from this study suggest that younger children with a certa
in CTLA-4 polymorphism and altered cellular but not humoral response may be
linked to EV 71 meningoencephalitis.