Hemorrhagic fever with renal syndrome: relationship between pathogenesis and cellular immunity

After phenotype analysis of peripheral blood mononuclear cells (PBMC), soluble interleukin-2 receptor (sIL-2R) levels in plasma or sera from patients with hemorrhagic fever with renal syndrome (HFRS) were measured. The results showed the ratio of activated antigen (CD25, TLiSA1, CD71, and Ia)-positive lymphocytes of PBMC in the acute phase of HFRS was higher than that in convalescent phase. Moreover, there was much higher expression of heteromorphologic lymphocytes than of small lymphocytes. Decreases in T lymphocytes and CD4:CD8 ratios were seen with increases in B lymphocyte ratios and interferon-gamma (IFN-gamma) expression on PBMC surfaces in the acute phase of HFRS. IFN-gamma-positive lymphocytes included CD4, CD8, and CD56 subsets. sIL-2R levels were much higher in sera and plasma in the acute phase, especially the oliguric phase. These findings suggest that patients with HFRS are in a state of high-level cellular immune response, which may be involved in the development of inflammation and pathologic lesions.