Immunology and Host ResponseCytokine Profiles in Human Parechovirus Type 3-induced Sepsis-like SyndromeShimizu, Masaki MD, PhD*; Shimizu, Hiroyuki MD, PhD†; Jinkawa, Asumi MD‡; Yamamiya, Mari MD‡; Shinozaki, Eri MD‡; Yokoyama, Tadafumi MD, PhD‡; Ohta, Kazuhide MD, PhD‡; Sakumura, Naoto MD*; Takakuwa, Maiko MD*; Fujita, Shuhei MD, PhD§; Fusagawa, Shintaro MD¶; Nakagishi, Yasuo MD‖; Nariai, Eri BS**; Yachie, Akihiro MD, PhD*Author Information From the *Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan †Department of Clinical Laboratory Medicine, Fujisawa Municipal Hospital, Fujisawa, Japan ‡Department of Pediatrics, Kanazawa Medical Center, Kanazawa, Japan §Department of Pediatrics, Toyama Prefectural Central Hospital, Toyama, Japan ¶Department of Pediatrics, Tomakomai Municipal Hospital, Tomakomai, Japan ‖Department of Pediatric Rheumatology, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Japan **Ishikawa Prefectural Institute of Public Health and Environmental Science, Kanazawa, Japan. Accepted for publication October 11, 2019. The authors have no funding or conflicts of interest to disclose. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (www.pidj.com). Address for correspondence: Masaki Shimizu, MD, PhD, Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan. E-mail: email@example.com. The Pediatric Infectious Disease Journal: February 2020 - Volume 39 - Issue 2 - p 137-139 doi: 10.1097/INF.0000000000002534 Buy SDC Metrics Abstract We aimed to assess the kinetics of the release of proinflammatory cytokines and to clarify clinical usefulness as an indicator of the disease activity in human parechovirus type 3 virus (HPeV3)-induced sepsis-like syndrome. We measured serum levels of neopterin, interleukin (IL)-6 and the soluble forms of tumor necrosis factor (TNF) receptor types I (sTNF-RI) and II (sTNF-RII). Serum samples were obtained from 12 patients with HPeV3-induced sepsis-like syndrome and 28 healthy children. Disease course after onset was divided into 3 phases: early (day 1–2), peak (day 3–6) and recovery (day 9–16) phases. Serum IL-6 levels rapidly and markedly elevated in early phase and gradually decreased to those in healthy children in recovery phase. Furthermore, serum neopterin, sTNFR-I and sTNFR-II levels increased rapidly and markedly in onset phase and remained elevated in peak phase. These levels gradually decreased in recovery phase. Serum IL-18 levels increased from onset phase to peak phase and decreased in recovery phase. These results indicate that proinflammatory cytokines, in particular, interferon gamma, TNF-α and IL-18 are closely related to the development of HPeV3-induced sepsis-like syndrome. Serum levels of these cytokines might be a useful indicator of the disease activity. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.